Catatonic Behavior: What Causes It, And How Harmful Is It?

Medically reviewed by Andrea Brant
Updated February 27, 2024by BetterHelp Editorial Team

You might have heard the term catatonia before, but you may not understand exactly what it entails. If you’re wondering what exactly catatonic behavior looks like, you’re not alone. We’re going to cover what this behavior is, what causes it, its associated conditions, and whether or not it is harmful.

What is catatonic behavior?

The terms "catatonia" and "catatonic behavior" are sometimes used interchangeably. They refer to when a person significantly decreases reactivity to their environment. Usually, when a person is exhibiting catatonic behavior, they will display motor rigidity, negativism (lack of response to stimuli), mutism, or stupor. However, sometimes individuals experiencing catatonia will also show a kind of purposeless excitement with seemingly meaningless motions.

Regardless of the exact symptoms, it can be debilitating for the person who is exhibiting them and frightening for onlookers.

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Is your loved one experiencing catatonia?

Symptoms of catatonia

While catatonia is often associated with other mental illnesses, it is its own diagnosis. However, it is not its own disorder, but rather a part of other mental illnesses. The physical symptoms experienced during a catatonic state can vary between individuals. 

According to the DSM-5, individuals must experience at least three of the following symptoms to be considered catatonic.

  • Stupor: a stack that resembles unconsciousness while the individual is still conscious
  • Catalepsy: rigid body posture
  • Mutism: very little to no verbal communication
  • Waxy flexibility: body stays in a position another person places it into
  • Negativism: a lack of response to stimuli or instruction
  • Posturing: holding a posture against the force of gravity
  • Mannerisms: odd and/or exaggerated movements
  • Stereotypy: meaningless, repetitive movements
  • Agitation without cause
  • Grimacing without cause
  • Echolalia: repetition of another’s words without reason
  • Echopraxia: repetition of another person’s movements without reason

What causes catatonia?

The exact causes of catatonia are not understood, but it can be linked to both psychiatric and physical illnesses. Some researchers believe that issues with neurotransmitters, specifically gamma-aminobutyric acid and glutamate signaling, may be to blame. Even though professionals are not sure of the exact causes of catatonia, it can still be successfully treated.

Illnesses and conditions linked to catatonia

As mentioned above, numerous illnesses and conditions are linked to catatonia. That means individuals who have been diagnosed with these illnesses may be more likely to develop catatonia. In fact, catatonia is observed in approximately 10% of individuals who are receiving inpatient psychiatric care for acute illnesses.

Schizophrenia

Catatonia has long been linked to schizophrenia, and about 10 to 15% of catatonia cases with  psychiatric causes are linked to schizophrenia.

In the past, mental health professionals used the term catatonic schizophrenia to refer to individuals who were living with schizophrenia and also experiencing catatonia. However, with the publication of DSM-5, this term is no longer used

However, catatonic behavior is still considered one possible characteristic symptom of schizophrenia. Additionally, professionals now specify if catatonia is occurring comorbidly with schizophrenia.

Mood disorders

Mood disorders are associated with catatonia more often than schizophrenia is—about 30% of catatonia cases with psychiatric causes are associated with mood disorders.

Depression

Although catatonia does not frequently occur with major depressive disorder, comorbidity is possible. Some research suggests that catatonia may be more likely to occur in individuals who are experiencing depression after birth or the loss of a loved one.

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Diagnosing catatonia

While it is sometimes obvious that someone is experiencing catatonia, a diagnosis isn’t always easy. Sometimes catatonia is misdiagnosed as symptoms of other mental illnesses. This can be detrimental, as catatonia benefits from a specific treatment.

If you are concerned that someone you know is experiencing catatonia, it is best to contact a mental health professional. This professional will use symptom-based diagnostic criteria to determine whether or not this individual is experiencing catatonia. They may also be able to diagnose any mental disorders the individual is living with.

Dangers of misdiagnosis

There is certainly a danger of misdiagnosis with catatonia. Symptoms of catatonia can occur due to physical and mental illnesses, so it can take time to make an accurate diagnosis. The problem is how it wreaks havoc with the motor functions of the human body. This can make catatonia appear like something else, such as Tourette's Syndrome or tardive dyskinesia. A doctor may need to take days or weeks before accurately classifying someone as catatonic.

How harmful is catatonia?

As for how harmful catatonia is, that's not an easy question to answer, since the condition can take several different forms or manifest with multiple symptoms. In and of itself, catatonia does not necessarily cause an individual harm.

However, it is possible for he catatonic person to injure themselves or become injured by outside forces. For example, if someone experiencing catatonia is engaging in a series of repetitive movements, they might run into something and harm themselves. Additionally, someone who is in a catatonic state might walk into traffic or be taken advantage of by others. 

Therefore, it’s best to get professional help for someone who is experiencing catatonia.

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Is your loved one experiencing catatonia?

The effects of catatonia on a family

It can be frightening when someone you love enters a catatonic state. You may not know how to help, and while this is okay, it can also lead to feelings like anxiety, guilt, and helplessness. One of the best things you can do for your loved one during this time is to take care of yourself. By caring for your own physical and mental health, you will be better able to help the individual who is experiencing catatonic behavior.

If the catatonic behavior is new, it is natural to experience confusion as well as grief for the loss of who this person was. While catatonia is treatable and the person may return to their normal behavior, it is still okay to be upset or confused.

Get support with online therapy

One way to support yourself during this time is by speaking with a licensed therapist. They may be able to help you work through your emotions in a healthy way. However, if you are trying to take care of someone experiencing catatonia, it may be hard to find time to attend an in-person appointment. If that’s the case, online therapy may be a more convenient option.

Research suggests that online cognitive behavioral therapy (CBT) may be just as effective as traditional in-person CBT. CBT is a type of therapy that can help you recognize and alter negative thought patterns. Therefore, it may help you deal with feelings of dread or guilt related to knowing someone experiencing catatonia.

Takeaway

Catatonia is a state of being that can be related to both physical and mental illnesses. Although it is not a disorder itself, properly diagnosing catatonia is essential to properly treating it. Along with impacting the individual experiencing catatonia, this state of being can also impact the catatonic individual’s loved ones. Therefore, all involved should be sure to care for their mental health.
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