Catatonia

Catatonia is a serious but treatable condition that affects movement, speech, and behavior. A person may become unresponsive, unusually still, or display repetitive or unusual movements. It’s not a disorder on its own—it’s usually a symptom of an underlying mental health or medical issue.

In the sections below, we answer common questions about catatonia, its causes, symptoms, and treatment options. Early recognition and care can make a big difference in recovery.

What is Catatonia?

Catatonia is a serious condition where a person experiences changes in movement, speech, and behavior. They might become very still, stop talking, or repeat other people’s words or movements. It’s not a disease by itself—it usually shows up as a symptom of something else, like a mental health condition (such as schizophrenia or bipolar disorder), a medical issue, or even drug use.

 Are there different types of catatonia?

Yes, catatonia comes in a few forms:

1. Retarded (or Stuporous) Catatonia – The person might seem frozen, barely move or speak, and appear totally disconnected from their surroundings.
2. Excited Catatonia – This is the opposite: the person might be overly active, restless, or even aggressive, but still in a confused or detached state.
3. Malignant Catatonia – This is rare but life-threatening. It includes dangerous physical symptoms like high fever, fast heart rate, or unstable blood pressure.

What signs should I look out for?

Some of the most common signs include:

• Not speaking at all (mutism)
• Staying in the same position for hours (posturing)
• Mimicking someone else's words (echolalia) or movements (echopraxia)
• Resisting instructions without reason (negativism)
• Showing no emotional response
• Repeating meaningless movements
• Odd or rigid body positions (sometimes called "waxy flexibility")

A doctor typically looks for at least three of these symptoms to consider a diagnosis.

 What causes catatonia?

It can be triggered by:

• Mental health conditions like schizophrenia, depression, or bipolar disorder
• Medical problems such as brain infections or neurological issues
• Drug use or withdrawal
• Severe stress or trauma

Since it can come from so many different causes, it's important to figure out what’s really going on underneath.

How do doctors diagnose catatonia?

There’s no single test for catatonia. Diagnosis usually involves:

• A detailed evaluation of the person’s symptoms and history
• Observing how they respond to a small dose of a calming medication like lorazepam (this is called a "lorazepam challenge")
• Ruling out other medical or mental conditions through lab tests or imaging

How is catatonia treated?

The good news is that catatonia often responds well to treatment. Some options include:

1. Benzodiazepines (like lorazepam) – These calming medications are usually the first choice. Many people improve within hours or days.
2. Electroconvulsive Therapy (ECT) – If medications don’t help, ECT can be very effective, especially in severe cases.
3. Other Medications – Sometimes doctors try medications like memantine or mood stabilizers if standard treatments aren’t working.

Antipsychotic medications are used carefully because in some people, they might actually make symptoms worse.

 Is hospital care necessary?

Often, yes—especially if the person can’t care for themselves, eat, drink, or stay safe. In the hospital, doctors can closely monitor the person, make sure they’re hydrated and fed, and prevent complications like blood clots or infections.

What is catatonic depression?

This is when catatonia shows up as part of a very severe depression. The person might be completely withdrawn, not move, not eat, and show no reaction to the world around them. It’s extremely serious, but treatable.

What’s the outlook?

With the right treatment—especially if it’s started early—many people recover fully from catatonia. However, waiting too long to get help can lead to serious complications, even life-threatening ones.

Final Thoughts

Catatonia can be frightening for both the person experiencing it and their loved ones. But it's also highly treatable, especially when caught early. If you notice signs in yourself or someone else, don't wait—get medical help right away. With the right care, recovery is very possible.