In this day and age, the large majority of people are only exposed to schizophrenia through the media, and that’s usually in some work of sensationalized fiction in the movies or books. Without fail this pertains to paranoid schizophrenia and so the mass public doesn’t realize that there are actually other types of schizophrenia that can manifest themselves in those living with the disorder. One of those other types of schizophrenia is catatonic schizophrenia.
Catatonic Schizophrenia Symptoms
Catatonic schizophrenia is not categorized by the positive symptoms that you witness in other forms of schizophrenia, but by the negative symptoms that arise. Negative symptoms refer to concept that something is removed from the sufferer, versus added, such as hallucinations or delusions. In catatonic schizophrenia the set of symptoms heavily feature a reduction in motor capabilities. This can occur in many different ways.
For some people experiencing this difficulty, they will enter into what is known as a catatonic stupor. Autonomous activity such as the person’s heartbeat will continue as always, but the voluntary and pre-planned actions can cease altogether. This can be impeded to the point of complete stillness in the person with schizophrenia or activity can be excited and become repetitive. This is called catatonic excitement, which includes repeated motions such as the fanning of fingers or kicking of the leg. These motor movements have no meaning behind them and will often be started due to the mimicking of a movement performed by someone else. In addition to a complete stillness, a person may exhibit what is called wavy flexibility as well, where they can be positioned into specific poses and the individual will maintain them for hours on end.
The problem with the stupor or excitement of this subtype of schizophrenia is that it majorly interferes with normal functioning and day-to-day living. A person who is rigid, non-responsive, immobile, or caught in a loop of repetitive motions is going to have a hard time performing simple activities such as house chores and personal hygiene. Attempts to force the person to leave these rigid positions can be met with seemingly super-human strength and resistance.
Other negative symptoms associated with catatonic schizophrenia are those affecting the mind as well. Motivation, interest, emoting, thinking, and vocalizing can all be reduced to a near inactivity. Echolalia and echopraxia, which is the mimicking and repeating of vocalizations and movements, may appear as a form of communication, but they are meaningless and stereotypic events unrelated to external stimuli.
Catatonic Schizophrenia Treatment
The inability to engage in psychotherapeutic treatment makes this illness more difficult to treat. Of the most immediate importance is that the person dealing with these catatonia symptoms must be made to rest or they can become extremely exhausted and dehydrated from the repeated hyperactivity. This can be achieved through the administering of medicine along with other medicines intended to help curb the symptoms.
Once the physical safety of the patient is assured, the next step is to reduce the symptomatic expressions. This is accomplished through the use of benzodiazepines. Once symptoms are reduced, the root cause of the disorder must still be approached. Antipsychotics are not recommended as they can worsen the symptoms, however electroconvulsive therapy has been shown to be an effective treatment modality. Due to the excessive activity related to glutamate, NMDA receptor antagonists may be used to stifle and reduce these conditions to a more normal level.
Unfortunately, most catatonic schizophrenics will need personalized care. This means there will either be a hospitalization or the constant presence of a family member, social worker, or psychiatric nurse.
Catatonic Schizophrenia Risk Factors
As with all forms of schizophrenia, a person is more likely to develop this illness if certain variables are present. These include but are not limited to the following:
- Genetics and Family History of Schizophrenia
- Fetal Exposure to Viral Infections and Malnutrition
- Early Life Stressors such as Trauma and Abuse
- Parental or Personal Use of Illicit Substances
Just because these variables are present does not mean that a person will develop schizophrenia. As always, a professional diagnosis must occur first, but an online schizophrenia quiz can provide insight to the family or individual before seeking professional opinions.
Although we understand the differences in neurological and behavioral expressions of the different types of schizophrenia, it remains unclear why a person develops one type and not another. However, we have managed to classify the symptoms and provide labels, which boost professional communication regarding these subtypes. This has allowed us to provide specialized treatment to each subtype differently. Catatonic schizophrenia is one of the least recognized forms of schizophrenia but one of the most devastating.