What is Catatonic Schizophrenia? Exploring Examples and Treatment Options

Schizophrenia isn’t common, but nor is it unheard of. Nearly 1% of Americans suffer from schizophrenia—which doesn’t sound like a lot, but comes out to tens of millions of people. Even among that group though, catatonia is very rare.

It is not certain what causes schizophrenia to sometimes take the form of catatonia. As with other cases of schizophrenia, some of the potential factors may include:

• Genetics and family history
• Fetal malnutrition
• Childhood viral infection
• Childhood trauma
• Childhood abuse
• Drug abuse

There are experts who believe that a person with a disposition to schizophrenia may experience a catatonic state after drug or alcohol abuse, but that connection has not been proven positively. There are even experts who disagree that this is a distinct subset of schizophrenia, and that the diagnosis is more a matter of social and professional mores.

Regardless, it does have distinct characteristics that aren’t always recognized as schizophrenia. That’s why it is important to understand and recognize those symptoms, so that you can find a proper diagnosis and receive the right treatment.

One of the reasons this disorder so often goes unrecognized or misdiagnosed is that its symptoms can often be unfortunately mistaken as signs of another illness or disorder. Some of its effects may look like nothing more than eccentricities to the untrained eye.

The symptoms of catatonic schizophrenia may include:

• Stupor. This is the most prevalent symptom of catatonia, and the one most commonly associated with the phrase. This is extreme withdrawal, which at the far end involves a complete shutdown of psychomotor activity, including no interaction with external stimuli.
• Mutism. Sometimes a function of stupor, this is when the sufferer lapses into essential silence, ceasing verbal communication.
• Contortions. These involve catalepsy (the adopting of unusual positions), posturing (holding a posture against gravity), and “waxy flexibility”, where their arm or leg can be molded into shape by someone else and held in that position until it is changed.
• Mimicry. Echolalia and echopraxia, where the schizophrenic mimics a person’s words or actions for no seeming reason.
• Movements. Strange movements, including excessive repetition of physical actions, or strange and seemingly pointless motions.
• Agitation. The sufferer gets upset or angry for no visible reason.

Of course, anytime we say “no apparent reason” or “seemingly pointless” it is just that way on the outside. There are no pointless actions or inexplicable reasons for the person with catatonic schizophrenia. These are logical reaction to internal stimuli. But they are no less potentially harmful for that.

The risks of catatonic schizophrenia are many. There are physical and mental health risks that are associated with schizophrenia, complications that arise from behavior and moods. There are also social risks that are borne from the cultural stereotype that the schizophrenic is dangerous.

• Malnutrition. Withdrawal and the internal desire to maintain unusual movements or positions can overwhelm the need to eat, which can lead to dangerous states of hunger, dehydration, and malnutrition.
• Depression. People with schizophrenia have a 5% chance of attempting suicide in their lifetimes. While it isn’t known if this is higher or lower with catatonia, it is a clear and present risk.
• Social repercussions. These can include a higher chance of being institutionalized or imprisoned, shunned at school, sent to detention instead of educated, difficulty finding or keeping employment, and more.
• Isolation. Increased isolation is often a complication of an undiagnosed and untreated mental health condition.
• Substance abuse. Increased substance abuse is often associated with mental disorders, often as a result of many other factors.

In fact, many of these factors feed into each other. Lack of viable employment can lead to poverty and homelessness, which can cause depression and make substance abuse more likely. All of these make the chances of treatment even less likely.

It’s a cruel, society-wrought cycle. But it doesn’t have to be this way.