ฝัง
- เผยแพร่เมื่อ 22 พ.ค. 2024
- In this video, Dr Syl analyses old footage of severe Catatonia. Catatonia is a psychiatric syndrome that can occur as a result of multiple things such as schizophrenia, severe depression, severe anxiety and other organic causes (i.e. encephalitis). Dr Syl also explores the use of a catatonia measuring instrument called the Bush Francis Catatonia Rating Scale.
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** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. If anything in this video was distressing please consider calling LifeLine 131114 **
Timestamps
00:00 - Introduction
01:10 - Discussion about Catatonia
05:30 - Footage review
10:48 - Closing comments - ภาพยนตร์และแอนิเมชัน
Link to footage: th-cam.com/video/V55klYxkjvQ/w-d-xo.html
What should I review next?
MAOIs ..... the only AD that really works..... vintage is sometimes best.
Oh... and maybe delerium ?
@@michaelford3391 I suggest medication induced delirium please Dr Syl 🙏🏽
Could you review the local case of "The Bourke Street Killer", Jason Gargasoulas?
m.th-cam.com/video/VkdomRLEOv8/w-d-xo.html&pp=ygUUYm91cmtlIHN0cmVldCBraWxsZXI%3D
I am diagnosed with schizophrenia and I experience episodes of catatonia. I never knew there was a name for this, so this video was extremely helpful. I have always considered theses episodes as "shutdowns". For me, they last about 20 minutes and during that time I am fully aware of what is happening around me but can't respond or move until my brain comes out of it. These episodes are more likely to happen during prolonged periods of pyschosis. Also, I want to add that in my personal experience, I don't find these episodes troubling. I am relaxed and feeling almost a bit of euphoria during these episodes rather than anxiety and panic. (I have never done street drugs) Thank you Dr Syl for making these videos and helping to spread the word on mental illness in a kind and considerate way, which was not the norm for pyschiatrists in the 1980's when I was diagnosed.
Thank you for your description. That does help me understand a little bit. I assume that I experience some of this as well but only for a few seconds or a couple of minutes until I can almost force myself to move. I am completely conscious, it just seems like my body doesn't want to move until I give it a reason. It usually happens when I'm relaxed and the only anxiety is what I caused myself.
It’s comforting to know you’re not freaking out in some panic but relaxed and feel good.
I agree. Thank you.
that is not my experience of catatonia. catalonia is prolonged without treatment. i was catatonic for weeks until the ect built up. i couldn't eat i had a feeding tube. i don't think it's possible to be catatonic for short periods of time, i think you are experiencing something else.
@@stoneyvowell1239seconds? This is not catatonia.
this is an interesting video to me. I had a catatonic episode when I had just turned 19 (almost ten years ago now) and it was the result of what I would call a 'mental breakdown', in layman's terms. I thought I would describe how it felt and what I went through for anyone scrolling the comments that might be interested.
in short, I've had a hard life in general, and especially up to that point in my life, life had been very cruel to me. I spent most of my life growing up protecting my younger sister from harm, in my mind, and I endured more than any child ever should in an effort to keep her safe for more than ten years. in my young mind, the danger we faced came from our home, and for some reason, it had never occurred to me that the outside world was also just as dangerous. I was so focused on the home, that I didn't often think about the dangers that lay just outside our front door.
one day, my little sister (age 16) called me, and I could instantly tell that something wasn't right. I quickly met with my sister to talk in person, and she told me that something really bad had happened to her, and that she needed help. I did everything I could to help her that day, and since I had spent most of my life in survival mode up to that point, I was able to keep my mind quite well while we were together considering the situation. as always, I felt that I had to endure and be strong for her.
but once I went home that day, I just started thinking. and it felt like I was winding myself up into this wild tangle that I can't explain, and once I was wound, I started to unwind again. I was almost in a trance just living my thoughts, really feeling every single thought as though it was real, and it felt like I couldn't stop. I just kept thinking, 'what did I sacrifice myself for if I couldn't protect her in the end'. it was almost funny, how perfectly cruel it was.
I remember falling down onto the ground in my apartment, and I was sort of kneeling, and it felt like I was under water. like I was surrounded by this hazy water. what I was sensing with my physical senses was hazy white water, but since I was sort of seeing and feeling my thoughts, I simultaneously felt like I was moving through this black space where there was no light or feeling or sound. I think I was crying, at first, but it was hard to tell. I was vaguely aware of the fact that my roommate was there, trying to help me, but she felt and sounded so far away that I thought that there was no point in answering her, and I wasn't sure that I could answer her even if I wanted to do so. it felt like I had no control over my own body or voice. I also couldn't see her - with my physical senses, I could only see this hazy white water that I was surrounded by, while my mind was floating through this black space that I could also simultaneously perceive somehow. I could just barely hear her voice, but I couldn't make out what she was saying, though I thought that she sounded scared. I was worried about her, but there was nothing I could do.
I could also occasionally hear the noisy people down the hall in our apartment complex that were screaming and making these awful sounds, and occasionally, I could hear them laughing. I wondered if they were drunk, or having a party. I continued to float through both the hazy water in the real world, and the black space in my thoughts. since my hearing was my only sense that I could somewhat perceive other than my thoughts, I focused on the sounds down the hall. there was this uncanny feeling to them, and they felt familiar. I wondered if I knew those people. slowly, I realized that those voices down the hall were familiar for a reason - because it was my own voice. it just sounded far away because of the hazy water I was surrounded by. I barely recognized the sound of my own voice. I was the person that was screaming and laughing. I didn't sound human. that's the last thing that I remember.
I woke up in the hospital with a nurse standing next to me. I looked over at her, and she hurried walked over to me and called my name. I answered her, and she said 'welcome back honey. we were worried about you. can you hear me? do you know where you are?' I guess I had been catatonic for some time - awake, but not answering, or responding. I don't remember a thing from that time. I voluntarily stayed in the hospital for a couple of days after that. it was a strange experience, but for me, it wasn't something that I was overly worried about at the time. I was still just trying to survive life, so I sort of shook it off, so to speak. I had more important issues to deal with in my life at that time.
I'd like to see a psychiatrist at some point, to discuss other memory loss that I've had in my life - I've repressed and recovered memories, I've blacked out totally sober just because I got so upset (not unconscious; I mean totally conscious and awake and active, but no memory of what occurred or what I did while blacked out) and there have just been many times where I've done things that I don't recall at all. there have been times where it felt like I blinked, and everything was different. I set a fire once while blacked out like that - thankfully no one was hurt. one minute, I was in my apartment very upset about something that had happened to me that day, then I blinked, and suddenly I found myself outside, looking at this massive fire that I had apparently set, according to my poor roommate (she was an angel), who tried her best to stop me, but I guess I wouldn't acknowledge her, or stop what I was doing. sometimes it's scary, but since I live in America, I've never been able to afford to see a professional. if my ship ever comes in, seeing a psychiatry professional is certainly something I'd like to do. I just thought it might be of interest or of help to someone in these comments if I described my experience with catatonia.
th-cam.com/video/9fJYTMn7Q-Q/w-d-xo.htmlsi=Bo8yb-e1kqlFGQwn
Perhaps this video might help give you some answers
Hearing your experience felt really significant to hear. I wish you comfort and peace for your future. And hopefully circumstances that allow you access to a trauma based or generalised therapist
Compassion is infectious.
One of the ways I could objectively see my mental health improving was watching my catatonic episodes decrease in number over time. I almost NEVER have them anymore. I started having them when I first started showing signs of anxiety, which quickly snowballed into other diagnoses, such as depression, panic disorder, PTSD, insomnia, restless leg syndrome, nightmares, derealization, etc. Until seeing the scale, I didn’t realize that my hyperactivity that led into my more “traditional” catatonia (at least what I understood it to be-the absent, non responsive, mute state) actually might have been part of the catatonic episode. I would go from a panic attack, with constant motion and noise to having a light switch moment where my brain didn’t want to deal with anything anymore and so it just “turned off”. So grateful for medications and nearly a decade of therapy now. Things really do get better ❤️
I've had times, in deep depression, when my thoughts and movements have been extremely slowed. But only once have I thought I was catatonic, and only because I watched this video. My Dr and I were trying to switch me from Epilim and Quetipine to Lithium, as over the years I had gained a lot of weight. It didn't go well. Coming off the first meds I went into a deep depression. Going onto the Lithium I reached toxic salt levels well before getting even close to therapeutic levels. I had to cease the Lithium and restart the other two. This is when the catatonia took over. My children were in their teens, so able to look after themselves and me. It was they that realised I was sitting in a chair for 10 hrs at a time, no tv, no book, no food or drink, just sitting staring at nothing, weeing and soiling myself. My daughter worked out that I wasn't going to the bathroom, and started getting me on my feet, taking me to shower me, put me on the toilet, dress me. My son would feed me and keep up my fluids. My children were wonderful, they worked it all out on their own. My daughter is extremely intelligent, but was only 15, and my son has Asperger's and was 17, but he worked it out too.My sister came and was trying to talk to me. By the time I worked out what she had asked, and then formed an answer, she was 10 questions ahead, and my answers made no sense. My kids explained to her, ask ONE question, then wait, wait as long as it takes, but wait. It took 3 weeks to get back to full voluntary movements, and normal rate of speech. In the catatonia I knew what was going on, but I either couldn't do anything about it, or my reactions were extremely slowed and completely out of sync. There were body movements eg. raising my arm, that my brain just wouldn't waste time and energy on, even if I wanted it to. But when my daughter put me in the shower I would stand upright without falling over but not assist in the process in any way. My speech was mainly restricted to yes and no, which I think worried my family the most. I had always been known to have an amazingly broad vocabulary since childhood and have two uni degrees from here in Australia, so being reduced to yes and no at a very slow rate was a very strange thing to experience. It was frightening, wondering if I would recover, a bit like the aftermath of a stroke I guess.
There’s a lady in my town that has had that happen about 3 times. She is taken every time and comes back pretty disoriented and quiet.
My daughter had catatonia for about 7 months and was probably closer to dying than I want to admit.. We are still unsure of what caused it but it started with her being unable to eat and swallow, and resulted in her being unresponsive for 5 months. She was hospitalized, but we had to move to two separate states (we are from the US), to major children’s hospitals, to get her treatment. She didn’t respond to Lorazapam, and the law prevented us from giving her ECT, so we had to move her across the country. It was agonizing because so many US states had laws preventing ECT in children, and the places that did allow the procedure, didn’t have the ability to take us. We had to wait for test after test to rule out neurological and autoimmune causes. Doctors combed case studies for ideas and things to try until we could be accepted at another hospital. In the end, we got into a fantastic children’s hospital and ECT saved her life.
She’s doing well now, a regular kid again, albeit with PTSD, and does have snippets of memories from the time she was fully catatonic. They don’t make sense to her, but I remember. It was an awful time in our lives, absolutely frightening for all of us. I am so very grateful to the wonderful doctors who helped us and advocated for us. Psychiatrists who fought hard to get her treatment and will hopefully fight to change laws to allow ECT for any child who becomes catatonic and doesn’t respond to the Ativan challenge.
This video was a bit hard for me to watch, but I am glad I did. I still hope one day to make sense of what happened to my child and why catatonia had to steal so much of her childhood.
I haven't experienced it personally, but I've seen this first-hand through my nan. She was diagnosed with schizophrenia and I remember when I was a child she used to say "angels" were coming to take her to "pass over". She would fall to the floor, or "act like she died" in the chairs .As a child, we would move her arms and legs to see if she was faking it. but She is to stay in any position we put her in. I didn't know there was a name for this, and since seeing these videos and watching your reactions my childhood and experiences make so much sense now. None of this was communicated to us as a family, we just thought it was a quirk my nan had. This is about 20 years ago now. I'm not 32 years old.
I have experienced Catatonia and it feels like Hell, its like you are in another room and you can hear and see everything from a distance and people are messing with your body but you are so far away in your head that it doesn’t matter. For me I went in and out of a dream like state and went through varying pockets of awareness versus lost in a dream. There is lots of time that I just couldn’t remember. The way you described that it’s like your brain being an overloaded computer with the loading symbol stuck turning was very relatable that is exactly what it feels like when I begin an episode. People with mental illness are treated very badly especially in the United States if you have to go to the hospital under any kind of public funding. I have had doctors and staff members yell in my face and accuse me of being a bad person when I couldn’t respond or defend myself at all. Every time I’ve been treated for my mental illness it has been with an accusatory tone, even though I have done nothing wrong. A huge warning sign that i need some intervention is the echolalia symptom that you mentioned that is something that kind of happens right before the “crash”
Sad. I’ve had a spell of depression 20 years ago or so now. I would find myself sitting on my couch and staring off. Sometimes several hours would pass. I wish that for no one. If you’re having problems get help. I didnt. And it took me several months to shake it off.
That was tough to watch! Always love your analysis and your empathy and compassion always shines through ❤
I have it often under stress, over 3 years now. It's like in "the matrix" were they pulled the plug.
I use "poyvagal theory" to self analyse. Psych said. Never seen it, or heard of poyvagal theory. Ambulance said "seen it often."
Professional help lags in knowledge and is expensive.
TH-cam had provided me all the insites thanks to people like you.
Thank you. 🙏
my sister has recently been diagnosed with Catatonia, she has suffered from Bi Polar for years and a couple of years ago went through a Psychotic episode where she believed she was married to a famous actor and thought she could talk to and hear her dogs,. through her behaviour she alienated everyone who cared for her , she has been out of our life for a year. until recently, I found out she had been hospitalised with Catatonia and visited her. I do hope she can pull out of this and start to enjoy the life we all enjoy, I know she is being treated with Lorazepam and if that doesn't work then ECT...........
I was in the ward with a catatonic person who was receiving ECT over a period of several weeks. At first she wouldn't move or respond, but just stand in one place slightly swaying. After a few treatments she started to do the 'depression shuffle' (that's how I think of it). Head down, walking slowly when prompted to move with feet not lifting off the floor. After that it was like watching a soul slowly move back into a body: wonderful but horrible. She started expressing needs and asking questions, but all in an obsessive loop where she'd kind of reset every few minutes. To be honest her real-life situation wasn't good, and you'd see her flash on that, be sad and scared about it, then fall back into the fog. By the end of a few weeks she seemed normal and the social mask was back on, hiding the turmoil that had been exposed.
I first saw this footage in Sleeping Sickness: The Terrifying Disease that Everyone Forgot by Into the Shadows. I'm now wondering is that being shown or just a different type of catatonia than you know. Thank you for these vids. I am in therapy for CPSTD, depression and anxiety. I the past doctors thought I was bi polar or had BP. Now, they don't think at do anymore. due to the reason which I have seen you say in a few vids they look for why I have these problems and just what i have. that was in the early 2000 to 2010's when I was told this. It feels like mental health care in American is changing for the better slowly. Your vids also help me understand what things my doctors are looking for and see if i can notice my self to help them help me. I noticed you say sorry a lot and you don't need to. Your doing a great job. I also had/ have the problem of saying that a lot. I think it comes from not wanting problems with others for me personally.
I'll never complain about my health again , that is truly heartbreaking. Poor man !!!
I am always more fascinated by the underlying processes rather than the observable symptoms that are at work in these types of situations. It seems that there are many many different conditions that affect the functioning of the brain that are observed as certain forms of mental illness. It is my hope that we can, some day, move beyond discussing treating what we observe and search for clearer reasons for the underlying dysfunction. One day, we might even talk about brain disease (like we do heart disease or lung disease) with behavioural, cognitive and affective characteristics as the symptoms. Chest pain wouldn't be diagnosed as "chest pain" and tylenol prescribed. We would look for the underlying disease and treat that first if possible. And, while we try to do that with mental health concerns, we are often stuck on the symptoms as the only things left to manage.
Is it possible to get into this state caused by a panic attack?
Cause I remember feeling exactly like this a fe times. It was like I was standing on the outside looking at my body in this state. I could speak maybe 3-4 words as a reaction of my former partner talking to me trying to help me while I was stuck in this stiff body not being able to move anything anymore, but with full consciousness and awareness of what was happening. It lasted rougly an hour. Throughout I had cried multiple times because I was scared to death of what was happening to me.
I had this a few times and it felt always the same.
Tbh your video is the first time I ever heard of this a a condition. I always thought it was just a heavy heavy panic attack.
When I broke up with my boyfirnd those episodes ended and I never had them again until this day. I wonder if it was a severe reaction to the trauma he gave me in that horrible relationship.
I love watching these old videos, shows me how much Psychology has changed over the years.
In the early 90's I used to work as a mental health worker and I remember a patient who held her head a couple of inches above her pillow and the doctors tried medicating her but nothing worked and she ended up having an anaphylactic shock. It went well in the end but it was quite scary. This was, as i said, in the early 90's, in Sweden, so I guess the treatments have evolved.
I’ve been having Catalonia off and on for a few years. My body will contort into odd positions that will hold then sometimes jerking movements and then stillness. Pretty much every part of me is doing something weird like my eyes. I’d get foot cramps now and then. I was having a lot more lately and a new psychiatrist prescribed me lorazepam and I’ve been taking that every day so far I’ve gone from a few hours of Catalonia a day to just some weird movements. I hope it stays away. It’s always hard to express how bizarre it is to experience and scary it is. You just learn to cope. I’m thankful it never lasted for a day or more that sounds like torture. Forgetting to take the lorazepam once I was reminded how bad it was. Like when ur sick and dream of being better but then when you’re better you just forget how thankful you are
Hi Dr Syl, as usual,.. so interesting. and i so appreciate your compassion. My son was not catatonic to this extent at all, but before he was treated with medication, ( risperidone and eventually Clozapine, his movements were very stiff, and he would just stand, rocking from one foot to another, or hoverning behind me... He doesn't remember this thought.... I do have something I'd LOVE you to do a video on - Treatments beyond medications.... the continuum of care from Hospital to Therapeutic Communities to outpatient programs. I realize that it's hard to do a video on though because these vary so much from region to region,... but I have done a tremendous amount of research on this and would be happy to share.
I'm grateful to see medicine and psychiatry in general is slowly entering the appreciation for holistic care - that our minds are intrinsically influenced and connected to our body. It may actually be less helpful to obsess over a singular, hyper specific form of treatment when our ailments certainly are felt and experienced through our entire bodies and minds.
I don't know the nature of your research or what you've learnt, but certainly in my experience my ailment is not just a singular problem like a loose nail in my scaffolding. So holistic care, appreciating our ailments are multidimensional, seems a good future
Terrific to watch. 😢
I just found your channel and I'm obsessed already! Thank you for the great content and educational context . I have a bachelors in neuroscience so this is fascinating to me
Amazing content! Very educational, we REALLY appreciate these types of videos. Thank you so much for what you do.
I suspect my Dad had periods of catatonia when he had UTI delirium. Sadly doctors were really clueless during that time. His mind has never recovered unfortunately to ask him what he was feeling or thinking.
That must have been really difficult to watch. 😢
Thank you it was very insightful, and that you wanted them to be more kind says alot about your manner if treatment
I'm enjoying your You Tube video especially breaking down diagnosis and sighting examples about each psychiatric diagnosis or traits. Thank you for taking "stigma out" of psychiatric illnesses. Your helping individuals with mental illness or not to better understand the world that "we" all live in.
This is so difficult to watch. Thank you for your compassion. 😪
I find your videos fascinating. I do not have any conditions except depression and anxiety which I am keeping controlled but looking at the rigidity of that man’s limbs in those awkward positions puts me in mind of my husband who is epileptic and has tonic clonic seizures, his arms raise up in a rigid position like that but he also shakes. His arms went so rigid once that he broke the bones in one and had to have a shoulder joint replacement, in fact his bones were so smashed they considered amputation. I know epilepsy is a completely different condition though, it just reminded me of it because of the odd positions being held.
Thanks thinks explains a lot.
I just figured this was normal to “shutdown” or to “overload”
Your voice is so soothing ❤ you would make a great audiobook narrator or meditation guide
Just found your channel they are still trying to figure out what I have it’s been a long journey for me. I actually experienced catatonia when I was tapering off of Ativan and it really feels like sleep paralysis but you’re aware of everything going on around you. I was not as rigid as this patient but I could not move my arms or anything on my own.
Thank you so much for showing this video, it actually helped me learn a lot about my own experiences with catatonia. While I have several MH diagnoses (bipolar 1, bpd, ptsd, adhd, etc.), my satanic states are usually brought on by high anxiety or sensory overload (probably due to adhd). Before benzos, my sacatonia was much worse. I experienced almost an episode a day of ~30-60 minutes episodes. I can usually feel it coming on and get on the floor quickly lying face down or a relaxed fetal position. I can hear, but barely see what's happening around me. The "worse" the people around me respond, the more overload and guilt in my brain and the longer the episode typically lasts. I'd be unable to move, talk, or even get out of a situation if I wanted to. No one's ever tried to touch or move me when im catatonic, so i cant attest to those symptoms. Now, I still physically shut down and have selective mutism, but I can usually *force* myself to move or use simple phrases within a few minutes to calm people around me. After an episode, I'm usually exhausted and feel kind of hungover and require rest to get my energy back.
The human condition and all that can go wrong is so fascinating to me. As this video has already shown, I hope that our understanding of the underlying pathways of diseases and our options to treat them continue to increase. So we can take better care of those that need it.
Dr Syl I had Catalonia for 3 days straight according to my poor partner who didn’t know what to do. I vaguely remember it but was in one position in bed with urinary incontinence & no intake. Paramedics arrived, moved me, legs in the air until I finally moved enough for them to get me on trolley. I was begging them to stop the whole time. My next memory was being ramped & still catatonic flat on my back. The treatment was not appropriate & I spent a week in hospital without proper psychiatric care. I am terrified it will happen again. The rigid legs still happen whenever I’m in bed but I can control them eventually. I wish I could be seen by you 😢
Thank you. It didn't really help me understand anything but always glad to get more information. I would be more interested in watching a video on some of the mild symptoms that you talked about to understand better. Most of the symptoms I have heard about can be explained other ways and with different reasonings.
I have known someone how have experienced Catalonia. She was stuck with her back to an electric heater. Her case was do to a severe depressive state while cycling bipolar depression.
I still see a lot of catatonia in inpatient psych settings I work in and benzos usually effective but not always.
Another great video from you Dr. Syl! Thanks and keep on spreading the good word for psychiatry.
Psilocybin containing mushroom saved my life. it drastically reduced my benzodiazepine withdrawal allowing me to quite illicit pill addiction after three years of heavy daily use before it would had became medically dangerous to quit. it has also helped me to survive depression
I feel like they are overwhelmed so long that freezing is all they can do.
Oh! I've done this before. I thought I was just heavily dissociating. I was burnt out and called sick to work because I had a terrible panic attack driving there. When I got home, I sat down and couldn't stop shaking. My head was cocked and moving back and forth. I was aware of what my body was doing but I couldn't control it. I was kinda aware of my surroundings but also kinda in a blank space
I learned about catatonic states from the American soap opera "Days of our Lives". A main character Marlena was in a catatonic state due to evil Stefano giving her some kind of drug. I thought, at 16, that it was the most crazy fiction yet (and this show killed characters and sent them to an islsnd where they undied, Marlena killed them all under another spell by Stefano). Imagine my surpirse to learn catatonic states were REAL!😱😱😱😱
I do echolalia with myself sometimes, like I’ll say something (usually to myself) and then whisper it after saying it, I sometimes don’t do it for years then just start doing it again, sometimes I don’t even notice myself doing it, it doesn’t really bother me but it’s interesting to know that it’s similar to a symptom of catatonia lol
Thank you for sharing this video, it was very difficult to watch, that poor man. It was very confronting and upsetting to watch the way they man handled him.
Like some other comments here could you cover Catalonia in Autism. It seems to be quite common but under diagnosed / not recognised by professionals possibly due to the varied symptology of Autism.
That's really horrible to watch. I was catatonic for 6 months in my 20's (so early 1990's). Now have well managed Bipolar Disorder. I don't remember much about that time, but I do remember it was as though my brain was 'trying' very hard to understand what was going on but couldn't. Your idea of a computer 'buffering' was EXTREMELY accurate! My brain was trying to re set re set re set and could not get there. I was treated with Fluoxetine and left until I came out of it. Thankfully treatments are now better.
Hello, thank you very much for all your content, I think you have many teaching skills and an ability to simplify things that allows understanding for everyone. Personally, I would just like to contribute with a concept that I have learned during this first year of training as a psychiatrist. That's right, I'm also a doctor in the specialization stage haha, correct me if I'm wrong, but at least in Chile, South America, my mentors have taught me to use the word hyperkinesia and hyperactivity differently, understanding that the first term It is just an increase in movement without a defined objective. However, the second is an increase in movement involving will and sense, with direction to objectives. Taking that for granted, we could say that item numbers 1 and 2 of the Bush-Francis scale Should they be corrected? I don't know, perhaps it is irrelevant for some, but if the idea is to emphasize the alteration of the will, hypo or hyperactivity should be restricted to the phenomenology of mood disorders mainly and not to catatonia.
I was working in a nursing home with a stroke patient. A young woman came in the room and took all of her clothes off and “posed” in a very awkward position; like a statue. She stay that way for the my whole session. I didn’t know what to do.
My cousin was diagnosed with catatonia for about a month. She looks immobile for long hours but she knows how and when to go to the restroom though and know how eat (though she doesn't eat much anymore).
We also would like to help her too but we're kind of afraid of her because most of the time she reaches out to bite or pull our hair if wrle come closer.
I do some of these. I get so overwhelmed sometimes that I'll just repeat a word that I was thinking of until my thoughts work again. Often a word I just read. I did it during an ADOS interview but I don't know if they noticed it because it was during the "break" so they weren't with me. In my head, it just feels like trying to think but I can't for some reason and if I try to fight it a lot I will repeat words.
The mutism too. It sometimes becomes incredibly hard to speak. It feels like an incredible effort to me and I just don't, sometimes, I'll gather up some willpower and manage to grunt something, whisper, but it's usually just one word. I had an ambulance driver get angry at me because of that. I also have offended a doctor during the covid vaccine waves because of it. My birth name is english even though I'm not english at all and she kept speaking to me and asking questions and I just didn't answer and she started assuming I didn't understand anything so she tried to speak english to me. Then she understood that I'm not english because I did some grunts to indicate I understood and she went "you just don't want to talk to me."
Stereotypies are very present too.
Echolalia, I sometimes do it at the end of a thought block. Not sure it counts though. My thoughts usually block when I'm talking to someone so I repeat the last question said.
Hi there, Dr Syl and other commenters. Im so glad I found this video, I have seen the raw video shown a long time ago as well as others like it. I appreciate you breaking down this horrible syndrome and I just wish there was more recent and I guess up to date footage on this topic. I’ve thought about having my mom record me while having an episode and posting it to bring more awareness. As you mentioned it is not too common. I have made a couple videos on my TikTok however trying to show some insight. Maybe one day I will post on this platform. I’m not sure. Anyway I am diagnosed with a few things but the major is bipolar 1 disorder and with that comes the catatonia. My first catatonic episode was when I was 23, so 7 years ago. I’ve been hospitalized 4 times because of it along with severe depression due to bipolar disorder.. and have to go to the ER too many times to count. And yes they will give me IM Ativan 1-2x and I come out of it. Sometimes when I get back home it’s not too long before my brain starts to go back in that mode which usually results then in hospitalization. Catatonia is the worst. So is bipolar as well but having to be stuck in the same position for hours or days at a time is debilitating. I honestly can’t even count the number of episodes I’ve have over the years. But I do know that I HATE being on benzos and I’ve have to be on klonopin specifically since I was 23. Ativan as well, but that was in the beginning of my diagnosis. But I have been tapering off of klonopin I’ve gone from 6mg a day to now 2.5 a day. So that makes me happy. TBH it’s hard to explain to others. I feel like there’s different levels or stages to it. I can be basically immobile, mute, and have cataplexy and waxy flexibility as shown in this clip. Or other times I guess before it progresses to that stage I experience the echolalia or repeating random words or phrases and I will walk around very robotically or walk in circles aimlessly, say numbers randomly etc. the only way I can describe it is I have all these symptoms but my mind is…. Blank. Autopilot. Sometimes I cry and panic/hyperventile while saying random things when somebody is moving me around or try to get me to a hospital etc. it doesn’t last long and I can’t control it. Though I don’t feel scared or panic. My mind is so blank and kind of just content, like nobody’s home. Yes I’m aware of what’s going on around me and now that I’m aware of this condition, I just try to go with it because thankfully I have a good support circle. I will say though that even though I am aware, most of what happened during the episode I won’t remember for some reason. My thought is that I was staring at the wall for so long I didn’t notice.. and yeah I’ve been dealing with these episodes for a long time now. I’ve only read a couple of comments so far and I’m gonna continue on to see who else out there deals with this condition. ❤
Omg amazing video but two requests I have:
1. Would love if u explained briefly why benzodiazepines are so effective at reversing catatonia, or is it still unknown?
2. You were saying “gosh they’re a bit rough with him” and “I hope they’re being kind” and like,,, I think it’s also necessary to remind the audience of how cruel and ethically dubious much of the field of psychiatry was not even 100 years ago. Like yeah me too girl I hope they were being kind but,,, probably not, right?
Your video is very helpful. I have child suffering from this condition, is there a way I can reach out to you for more insights on the management of the condition. Thank you
everyone has catatonia all humans have catatonia.
I find it quite disturbing the way the doctor/examiner is forcibly moving the patient's head. I understand that you need to assess ability to move, but why not start with the arms or the legs? In any situation it would be very distressing to have a stranger try to move your head like that, and I also worry about physical injury to his neck.
Wow...thank you. I think you have helped point me in the right direction. I wonder if catatonia would have a possible effect on bowels. Its like a section of my colon is asleep but scopes show no issues. I do live with ongoing shadow work and have not had an easy go from an early age. Now in my late 40s I've been learning all I can about C-PTSD (see Dr. Gabor Maté) and healing from trauma. I see my specialist again soon though we are in agreement that my issue lies in the brain. I have to wonder if a little shock therapy could jump start the nerves which do work with help but not really. TMI, though my thoughts may help another, so I shared. 😅
Digging through your videos and subscribed. Thanks for your contributions to the world. You just reached me in Canada 🇨🇦 😊❤
Stress and a state survival have a direct effect on the colon - cessation of energy and function so resources can be directed to more immediately required parts of the body for said fast response survival. Digestion is a long process whereas survival is immediately required.
I'm still waiting the video so maybe this has all been said! Apologies if so!
Oooo so this is what I had from time to time before my trauma therapy started. Ans I also had one of these episodes at therapy but they gave me medication to relax. I stared and could sit like thwt for a looooong time. And thqe last one I had both of my legs straight out in the air and just staired out into nothingness....
I have also autism.
When we came to catatonia we know that line between normal and supernatural is thin
CGJung said all psychosis and neurosis are different lowering of consciousness ( Janet- abaissment du niveu mental).
Psychology of dementia praecox or Sch show elements narrowing of consciousness and activation unconsc. automatism( complexes- emotional toned contents).
Pierre Janet and Charcot demonstrated catatonic state at normal or hysterical person in hypnotic trans that is element of outer suggestion. Catatonia is organic proses- endogen.psychosis ( x metabolit or endotoxin paralyses conscious functions in form primary simptoms 4A?) bring abisment( Janet) an autohypnotic state and constellation schizophrenic complexes that is causes secondary symptoms ( manirism, stereotype movement, delusions, halucinations, attitude..).
Can you talk about ECT? I didnt realize we still used this method. How is it done today vs then? How does it change their behavior? Thank you!!!
I’ve done ECT. It’s done in a hospital under general anesthesia so the patient is not awake. They direct a small electrical current into your brain which causes a seizure. (You’re also given medication to prevent your muscles from contracting during the seizure which prevents injuries and can help with muscle pain.) During the seizure the brain is flood with chemicals and neurotransmitters. This can help open neural pathways that have shut down, help open new ones and encourage the growth of new neurons (neurogenesis). ECT is usually done as a series of treatments, usually three times week during the intensive phase which lasts from 12-20 treatments. For me the side effects have been short term memory loss and retrograde amnesia. Honestly it’s been one of the most difficult things I’ve done but nothing else was helping me. I still do ECT every 6 weeks as maintenance. Hope that helps.
ETA: I’ve done ECT as treatment for depression.
When you showed the list of symptoms, many are things I experienced a lot in my life. I'm diagnosted with ASD (autism) and PTSD. I remember very vividly several moments of my life when I was in whatever kind of cognitive overload (sensory-caused, too much verbal information, too much requests in time too short for me to process, physical pain, etc.) when I couldn't either talk, make any noise or move. Even recently, but I also have very early childhood memories of these moments. In fact, one of the events that caused me PTSD is from a very violent s*xual agression I was victim of while being in that state. I'm also someone who all her life has done a lot of stereotypies (both movements and several types of echolalia, but nobody ever recognize it before I had a severe mental breakdown after the violent agression at 37 and was finally properly evaluated and diagnosed with autism, PTSD diagnosis only came 5 years after the agression, mind you... if Ilook frustated with mental health care, it's because I am, I have desperately needed help all my life, but only had some in the last few years). Nobody ever told me the term catatonia, even if I described being stuck unable to move or talk for hours at a time, to all psychiatrists I've spoken to. I imagine it's like all the other stuff I've told them I experience : they never believe me until they actually see it happening in front of them ("you look so articulated and intelligent, how could I imagined you could have this deficit or experience this difficulty" is a phrase I've heard way too many times from psychiatrists and other healtcare professionnals... like my logic ability had anything to do with my other cognitive faculties...). To answer your question, what it feels like to me when I'm unable to move (and believe me I would desperately want to be able to move or talk, like that time I ended up with the police being really agressive towards me because "I would not comply", not answer their questions and not do the movements they were asking, because, well, I couldn't!!!) it's always when I' m already in some form of cognitive overload and so I'm already several gigabytes of data late in processing sensory inputs, thoughts, emotions and all else. So there's so really bad lag in my mind, it's foggy, it often feels like I'm on a tiny boat on a very bad weather day with huge waves (even if I'm actually sitting on a hard floor not moving at all), I often can't see anymore (I suspect it's more a problem of the lag, treating sensory inputs like I said previously), I can hear sounds, but can't process their meaning anymore (which is VERY frightening when the policeman, ambulanceman, nurse, doctor or whoever else is getting impatient and you can hear their tone of voice becoming menacing and you KNOW there will be bad consequences, but you absolutely can't do anything to get you out of the situation). It's hard to remember all that happened, because the amount of cognitive overload was so bad that not all was stored in memory (I usually have a very accurate and precise memory, I have been main witness for 2 major crimes and policemen suspected me each time being involved in the crime because of how acurately I could remember details and sequence of events and was very lucky both times that physical evidence and other people's testimony did prove I was not involved, because otherwise I could have ended up convicted on policement "feeling that I can't have that good of a memory as a simple witness"). So not saying I'm experiencing catatonia, because never had that diagnosis, but sure have a lot of the symptoms on your list, a lot of times in my life, sometimes multiple times a week. Worse in frequency, length and intensity of the episode when I have stressfull stretches of life. I would so much like to have some doctor who's willing to talk with me about my symptoms, believe them, adress them, knows medication (you wouldn't believe all the absurdities I've been told, like that clonazepam isn't addictive, you're right, that's why tapering off of it has been a 2 years long nightmare of withdrawal symptoms : headaches, involuntary movements, more episodes of not being able to talk/move, and much more).
Yes I have 3xs in hospital. Is it normal for laughter? I couldn't stop laughing so they thought I was pretending. It was awful and they denied it ever happened because they gave me Morphine for chest pain and it threw me into a full seizure. Also, every night my lower jaw expressly goes round and round, knawing down. I had Encephalitis in 1989.
I'm hearing anecdotes in the comments once or twicing reporting laughing. I'm very curious and I hope psychiatry keeps developing to confinue treating people who need this support
I am autistic and I have similar episodes after some of my meltdowns. I usually call them shutdowns and the feeling is that I am half there. I am normally stuck in a thought or something sensorial, maybe in an infinite loop. I also have mini zone-out moments during the day the feel the same but last for a minute or so. In these episodes I stare at the void and cannot answer or move, but I am aware of my surroundings. They are normally caused by sensory overload (like spicy food). People start shaking me and calling my name and eventually I just gradually come back.
Sounds familiar as an autistic person. I would hate it if people would start to shake me during a shutdown. 😨
What I find interesting about that rating scale is that I have autism and a certain number of those items are things that coincide with autistic symptoms (not making eye contact, echopraxia/echolalia, stereotypy, mannerisms, verbigation, sometimes negativism). Based on that list, I don't know whether I actually have catatonia as well or if it's just autism!
I thought of this as well and it is interesting. I think it demonstrates a specific type of neurodiversity that is taking place that corresponds to a similar diversity in the brains of those on the autism spectrum. But I truly don't know.
Maybe the structures of the brain and mind are similarly affected in both experiences?
Hello could you take a look at the movie Awakenings…it was an amazing movie….id like to know how much of it was factual.
I have to ask, i don't remember if this has been answered before, but can a person with an Autistic meltdown get Catatonia? Because i do experience immobility when i kinda get extremely overwhelmed and "shut down" it have been so bad my partner had to drag me across the floor (gently) to a bigger area to start moving my whole body to get me back..
I also know it happened some what frequently as a child where i could sit "locked" in the same position for hours not really moving, barley breathing, staring into space, like a deer in infinite headlights..
Its kinda scary to think about as i weren't able to get myself out of it back then (i didn't have my parents around a lot either) today i am sometimes able to shake out of it before it begins, but i dont know what would happen if i didn't have my partner to help me.. It really feels like rainbow wheel of death to be honest..
The experience for me felt like, kind of an out of body experience, i hear everything, feel everything, think clearly, but at the same time I'm heavy, tired, foggy.. It feels like i am screaming at my body to make it move but there is no connection, maybe a slow blink, or some drool escaping my mouth.. It feels like my body is weighing several tons, impossible to move, my thoughts are clear but somehow also far away, it kinda depends on the situation..
As a child it happened a lot after a really bad cry, i would be wailing, sobbing like crazy, my chest would hurt with the most intense pain, i felt like screaming and screaming, although i didn't scream, nothing would feel as horrible and painful as the feelings i had while crying... And then i would almost just.. Snap.. My brain would just turn off, the crying stops, i would sit cross legged, head down hanging in an uncomfortable position, back curled in on myself, snot drooling out my nose over my mouth down on my legs, the last tears would dribble down my cheeks and onto my thighs, my breathing would calm down and be almost non-existent, and i would just sit there, sometimes it was only 15 minutes, other times it would last up to 2 hours or more..
I would be in pain the entire time, extremely hungry or thirsty, needing to pee, but unable to move, talk or anything else.. I learned myself how to slowly reconnect, by trying to make noises, didn't matter what noise, just any noise, then try to focus on my breath or blink a few times, then wriggle my fingers slowly, or toes, then i would smack my mouth or move my tongue around as it would be dry.. suddenly I would be able to move again, but i would take it slow, stretch an arm, a leg, get my head up, slowly move and blow my nose or whatever i needed..
Most often i would need a nap, as my whole body would be in pain, i would be cold and hungry, and a nap kinda always resets me and gives me time to eat before i get nausea.
My partner is playing CSGO.. It made me think, that the flash-bang kinda illustrates how it *can sometimes* feel like to me: That white bang is like the "snap", everything is out of focus, peoples voices are far away and jumpled, "confusion" makes you not move not answer, there is this continues white noise in the background and i can only focus on my own thoughts if even that.
Again i have had it a lot and it kinda differs from situation to situation, i taught myself how to get back, as i didn't have anyone around me to help me back in my childhood years, and today when they happen i have my partner who is aware that if i don't answer him he needs to test my movement and help me unstuck.
When someone is in a catatonic state, who consents to things like ECT? Would that be the choice of like next of kin? Just curious
What are your thoughts on long-term Zolpidem use Dr Syl?
I’m on Zolpidem, but I’m only allowed 7 tablets a month, so I get around 7 nights of decent sleep a month. When I was on more (sometimes 14 tablets a month), I found that my body got used to the medication and the more often I took it, the less effective it was. Now I take one every 3-5 days and they are more effective. Some people do develop an addiction to sleeping tablets, which is why many doctors don’t like to prescribe them or won’t give they as a daily prescription. I’ve never been addicted to them, as for me, they don’t work if I take them every day, but everyone is different and some people they work for on a daily basis, but that’s when addiction can occur, as they cannot cope/sleep without them.
@@Spicy-Nugget937 thank you so much for replying. I appreciate it more than you could ever realise. Thanks again ❤️
Hello Dr Syl! As a psychology student that currently studies the DSM, I don't understand the difference between akathisia and catatonia (hyperactive type) and also dystonia and catatonia (hypoactive type). Do all these movement disorders have similar causes and are all associated with the basal ganglia? As non medical student the professors don't really give much explanation. It would be great if you could briefly explain them or suggest articles. Thank you!!
One way to conceptualize it can be that catatonia encompasses a complex alteration in the person's mental status whereas akathisia and especially dystonias are more-so purely motor phenomena with otherwise normal mental status - they're aware of what's going on, you can communicate with them. In psychiatry, dystonia and akathisia are most commonly seen as a side effect of antipsychotic drugs. Dystonia involves sustained or repetitive muscle contractions - it can be more focal or global, involve different groups of muscles, but besides being unpleasant, painful, or life-threatening if for example the larynx is affected, it is not in itself accompanied by changes in mental status. Akathisia involves an inner restlessness and persistent urge to move, depending on the severity these people might engage in repetitive and seemingly purposeless movement, but they do this in attempt to relieve this urge.
Catatonia can happen in depression, bipolar disorder, schizophrenia, or various medical conditions. It can involve various complex psychomotor phenomena, such as not talking, not responding to one's environment, purposeless resistance to commands or attempts to move the patient, automatic and purposeless obedience to commands, maintaining purposeless and strange facial expressions or postures, purposeless hyperactivity with no concern for one's surroundings, stereotypical or manneristic movements, or copying the movements or speech of the examiner.
@@markus4698 Thank you so much for your response, it is really helpful. Appreciate it!
@@despinatsolissou1614 Happy to help. If you search "bush francis catatonia rating scale" on TH-cam, there are teaching videos explaining the various symptoms of catatonia and how to assess for them.
So traurig 😢😢😢
Hello Dr Syl,
What primarily comes to mind for me, watching this and hearing your discussion, is if there are similarities or some cross over in the neurological processes or something between this, at various stages/levels, and the likes of the freeze trauma response (esp. seeing how his head was first resistant, then gave in to movement; arm floppy, then freezing position) and likewise, mutism and shutdown symptoms in autistic spectrum conditions.
I'd be really interested in hearing your response and thoughts on this.
Also, you mention that these days it would be more unusual to come across this extreme level, so I wonder what are the symptoms :
a, commonly seen in inpatient scenarios,
and
b,what may be lower level indicators both for the person, and those around them, that they may be dipping towards catatonia and thus need support, treatment.
Thank you, take care, K
I’m pretty sure I have experienced catatonia. My diagnosis is Major Depressive Disorder with Psychotic Features.
At one point, when my son was still in diapers, my husband had to leave us in my mother’s care for several days because my depression was severe and I wasn’t functioning. Mum was a Registered Nurse and I heard her tell my dad that she thought I was catatonic.
We didn’t really know what to do about mental health problems then, but shortly after this, I started antidepressants for the first time.
I remember being able to hear and see everything, but feeling so overwhelmed that I was completely unable to sum up a response. I stared at the wall for hours. My parents reminded me to eat. The only thing that got me moving was if I needed to use the bathroom, I think. But, they may have reminded me to do that too.
I felt vaguely guilty for ignoring my son, but quite removed. Speaking was extremely difficult. I just felt tired and sad. I remember feeling tears on my face, but not having enough energy to wipe them away. People would talk, watch TV, play with my child, answer the phone around me, but I was slow to respond to any stimulus and couldn’t concentrate on the storylines of TV shows, so I just stared into space. It was quite distressing for my family, especially for my toddler.
Mercifully, I haven’t experienced those symptoms in a couple of decades now, but watching the video reminded me of my mum lifting my arm into the air like that doctor did & me holding it in place for a while before my arm slowly went back down. Weird experience.
It seemed strange at the time too, but it also took too much energy to think about for any length of time.
Must be like torture
My daughter diagnosed with BPD and bi poplar has had extreme emotional anger that would lead her to immobility where she couldn’t get out of a car for 45 or so minutes or move off the ground. Her brain basically wouldn’t release her. But I still am not sure if this would be catatonia or something else.
Usually with BPD, it isn’t catatonia, but often things like intense, overwhelming emotions that renders a person unable to think straight or do anything at all. It could also be a form of dissociation too.
@@Spicy-Nugget937 Thank you so much for the response! Makes a lot of sense to me. Usually if it happens I just sit with her and speak calmly to until she “comes around”. I haven’t found anyway to make it go quicker for her which is difficult.
@Drsly kindly assist with my request below
How long does a catatonic episode last, Because I have dissociative disorder, and people around me say it looks like catatonia. Dissociation has been diagnosed by a Psychiatrist, but not catatonia.
Feels like like sleepwalking. There's an answer for you.
I don't mean to make light of the condition, but Catatonia sounds like the name of a country the Marx Brothers made up.