Depression With Catatonic Features
Catatonic disorders come with symptoms that reflect a disturbance in motor (movement) behavior. The symptoms can be either psychological or of a physical origin (physiological). In depression with catatonic features, the patient may hold himself quite still for long periods of time. Or he may move in a very agitated and random manner.
The symptoms of this type of depression vary from patient to patient. Some will express extreme negativism, while others will choose not to speak (elective mutism). Some will move in a strange fashion, while others will imitate the movements of others (echopraxia). There may also be echolalia, in which the patient echoes another's thoughts and words. In some cases, the symptoms are so severe that the patient requires constant supervision to protect both the patient and others. At other times, catatonia is expressed in a less extreme manner, through slowed motor activity.
Catatonic behavior may also pop up from time to time in people with other types of mood disorders. For instance, those with bipolar syndrome may sometimes exhibit immobility or agitated random movement. When depression is severe, just moving a finger may cause intense emotional pain. In some, the depression is so deep that getting out of a chair may take hours and be quite painful. As the depression lifts, the catatonic symptoms decline.
It is believed that mood disorders may be due in part to irregular production of the brain's neurotransmitters. These chemicals are responsible for conducting impulses from one nerve cell to the next. The main neurotransmitters linked to depression are serotonin and norepinephrine. Research in animal subjects shows that nearly all the antidepressant medications change the way the receptors of these neurotransmitters operate. Another neurotransmitter that is implicated in depressive disorders is dopamine.
Catatonic symptoms are seen most often in patients suffering from bipolar I disorder. In this mood disorder, the patient wavers between periods of mania and depressive episodes. During the manic phase, catatonic excitement is expressed through random movement that seems to be unrelated to the patient's environment. There may also be repetition of movements, words, and phrases.
During the depressive episodes, there may be catatonic immobility. These symptoms include long periods of immobility, during which the body may remain in a rigid position. The patient may hold his body position for hours or days. The positions may be quite odd or even inappropriate. While someone suffers from these catatonic symptoms, you may be able to position his body for him, in which case, he may hold the position at length.