Schizophrenia is a severe mental health issue that can cause many different symptoms, including psychosis, hallucinations, and delusions. Catatonia is a disturbing mental health symptom that can occur with psychological and physical problems. Mood and psychotic disorders can cause catatonic symptoms, but brain injuries and tumors can also cause them. When catatonia is caused by schizophrenia, it may indicate a severe psychotic episode.
Learn more about catatonic schizophrenia and how it can be treated.
What Is Schizophrenia?
Schizophrenia is a potentially serious mental health disorder that affects your perception of reality. Schizophrenia is associated with psychosis, which is a break from reality that can cause two major symptoms: psychosis and hallucinations. It can also cause lesser-known symptoms like disordered thinking, flat emotions, and other issues. Schizophrenia can be severe and significantly inhibit your life. In many cases, schizophrenia is a chronic disease that requires long-term care and treatment.
Schizophrenia is also complex. Two people with schizophrenia may have extremely different experiences with their symptoms and challenges. Because schizophrenia can cause many different symptom profiles, it’s often separated into subcategories based on the symptoms you experience.
The disorder isn’t as common as depression or anxiety. It affects less than 1% of people in the United States. Still, that accounts for millions of people each year. However, many people with the disorder don’t reach out for help. Because schizophrenia affects your perception of reality, many people with the disorder don’t realize they need mental health treatment. People with disorders that seek treatment often do so after a period of lucidity or with help from loved ones.
Schizophrenia may also increase a person’s risk of a substance use disorder, homelessness, anxiety disorders, and depression. It’s estimated that around 12% of people with schizophrenia have a co-occurring substance use disorder.
What Are the Symptoms of Schizophrenia?
Schizophrenia can cause various problems with emotions, thinking, and behavior. If drugs are involved, symptoms may vary across different people. The most common symptoms of schizophrenia are:
- Negative symptoms. Negative symptoms include a loss of interest in daily activities, loss of motivation, withdrawal from loved ones and social life, difficulty showing emotions, and inability to function normally. The person may avoid eye contact, seem to lack emotion, speak in a monotone voice, never change their facial expression, and neglect their personal hygiene.
- Abnormal behavior. Abnormal behavior can manifest in several ways, such as strange posture, resistance to instruction, unpredictable agitation, childlike behavior, excessive, useless movements, and lack of response. The person may experience difficulty focusing on goals and completing tasks.
- Delusions. Delusions cause people to believe something that is untrue or illogical. For example, they may believe they’re being watched, that gestures or comments are directed at them, or that they’re famous.
- Hallucinations. Hallucinations involve seeing and hearing things that aren’t real. However, they have the full impact of a real event on someone with schizophrenia.
- Disorganized thinking and speech. Disorganized thinking inhibits the ability to think coherently and logically, which can cause disorganized speech. This can prompt the person to change the subject randomly, give unrelated answers to questions, and string meaningless words together, which is known as word salad.
Symptoms can vary in type and severity. There may be periods of intense symptoms, followed by remission. However, some symptoms may never go away.
What Is Catatonic Schizophrenia?
Catatonia is a symptom that sometimes occurs in people with schizophrenia. A state of catatonia is one in which a person doesn’t move or react to stimulation. It can be a disturbing symptom of a serious mental health problem, even for people who are observing catatonia in another person. Catatonia often causes a lack of movement, but it can also cause odd movements like facial contortions or agitated movements. In a catatonic state, people often don’t appear to be aware of their surroundings.
Catatonia was once categorized as a subcategory of schizophrenia. But it’s a symptom that can occur in anyone that has severe schizophrenia. Catatonia can also occur with severe mood disorders. People who experience catatonia may feel like they are in a trance-like state, and they may have other psychotic symptoms at the same time, like false beliefs and delusions. Some may experience frightening hallucinations or delusions that cause them to freeze. Others experience a dream-like state.
There is more than one kind of catatonia. Withdrawn catatonia involves a lack of movement, speech, and reaction to stimulation. However, you can also experience Excited catatonia, which is when you move compulsively during a catatonic state. Movements may be repetitive and purposeless. You may also compulsively mimic the movements of people around you.
Catatonic states may occur suddenly, even in public places or when you are in the middle of something potentially dangerous like driving. Catatonia is often a severe expression of schizophrenia and may require hospitalization, especially if the catatonic state is long-lasting and you become unable to take care of yourself.
What Causes Schizophrenia?
The root causes of schizophrenia are unknown, despite years of research. Many mental health professionals believe that a combination of genetics, brain chemistry, and environmental risk factors contribute to the condition.
Other risk factors may also increase the chances of developing schizophrenia, such as:
- A family history of schizophrenia
- Being exposed to viruses or toxins during pregnancy or birth
- Experiencing malnutrition, which impacts brain development
- Using psychoactive or psychotropic drugs during the teen years or young adulthood
Neuroimaging studies have found that there is a difference between the central nervous system and brain structure of those with schizophrenia versus those without. While it’s unclear what the reason is, researchers think this indicates that schizophrenia is a brain disease.
What Are the Catatonic Symptoms of Schizophrenia?
Catatonia is a complex complication of schizophrenia that can come with several symptoms. Catatonic schizophrenia was once more common, but improved treatment options have made it a bit rare. Catatonia often manifests as a symptom of severe schizophrenia. With the development of medications that are able to treat schizophrenia more effectively, it’s possible that catatonia will be made less common.
Still, many people with schizophrenia report catatonic symptoms.
The DSM-5 doesn’t identify catatonic schizophrenia as its own diagnosis, separate from other mental health disorders. However, catatonia can be a feature that occurs alongside many other mental health disorders, including schizophrenia and bipolar disorder. To qualify as catatonia according to the DSM-5, you must experience three of 12 common symptoms.
The symptoms of catatonia are as follows:
- Stupor. This refers to a lack of psychomotor activity. There’s a disconnect between environmental stimulation and your reaction.
- Catalepsy. This is when you hold a pose against gravity. Muscles will be rigid, and you may hold your arms or legs. It’s common to hold arms above your head in a random position.
- Waxy flexibility. A person with this symptom will hold a position that another person put them in. For example, you may lift a person’s hand out to their side, and they will maintain the position.
- Mutism. Speaking very little or not at all in a way that is out of the ordinary.
- Negativism. Resisting imposed changes in movement or resistance to all external stimuli.
- Posturing. This is random and active maintenance of a posture against gravity.
- Odd mannerisms. Strange behavior that seems to mimic normal actions.
- Stereotypy. These are repetitive, purposeless movements that are frequent.
- Agitation. Agitation may not be caused by any external stimuli.
- Grimacing. The person’s face may be kept in a fixed position, often a frown or grimace.
- Echolalia. Mimicking another person’s speech.
- Echopraxia. Mimicking another person’s movements.
In many cases, these symptoms may continue for hours, days, or weeks without treatment.
How Is Catatonic Schizophrenia Treated?
Schizophrenia is a disturbing and severe mental health disorder that can be treated with medications and therapy. Medications are often necessary as a first step since someone in the middle of schizophrenia symptoms is often unable to participate in other forms of treatment. There are several medications that are approved to treat schizophrenia.
There are two generations of antipsychotic drugs. First-generation drugs were used to treat hallucinations and delusions, but they often made negative symptoms like flat affect worse. Second-generation antipsychotics are better at treating both sides of schizophrenia.
If catatonia was an expression of severe schizophrenia, medications might help to avoid or improve your symptoms. If another physical or mental health issue causes catatonia, antipsychotics might be less effective.
Therapies include individual, group, family therapy, behavioral therapies, and psychoeducation can help you manage schizophrenia. In many cases, the best treatment is a combination of medications and therapy.