- Catatonia is halfway between the specialty of psychiatry and neurology.
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| Distant staring is typical in patients with catatonia. / Pixabay |
The clinical picture of catatonia is a very particular one. The patient seems to remain frozen: motionless, silent, with his eyes fixed on one point, without reaction. A few hours, a few days, a few months... or even for years.
It is a rare and complex disorder about which many mysteries still persist. It is halfway between the specialty of psychiatry and neurology and consists of an affectation that prevents speech and movement. In such a state, it is easy to assume that the patient is not conscious; however, the evidence seems to point in just the opposite direction.
"The voices told me that my head was going to explode"
This is the subject of a study carried out by a group of British researchers and published in the scientific journal Frontiers in Psychiatry, which reviews the case reports of hundreds of patients with the condition, searching for references to what each person felt or thought while in a catatonic state.
Individual experiences turn out to be very varied. It is true that many said they were not aware of what was happening or did not remember it afterward, but on the contrary, many were able to describe sensations such as the pain of staying in the same position for so long. There were even some who had a 'rational explanation' for catatonia.
For example, a patient maintained the belief that his head "would fall off his neck", so he adopted a strange posture (resting it on the ground) until he was seen. Others said they heard voices ordering them to remain still for various reasons: in one case because otherwise "his head would explode", and in another, it was a divine mandate.
Tonic immobility
One of the theories explaining catatonia is that it resembles, in some respects, a phenomenon known as tonic immobility. This is a reaction seen especially in animals (but also in people) when confronted with particularly large and dangerous predators: effectively, they stay 'frozen', which sometimes makes them go unnoticed by the enemy.
In fact, some of the experiences described by the catatonic patients in the study could support this hypothesis, at least for some cases of the disease. Thus, the document collects the case of a person who claimed to see a snake that was also talking to her and highlights the vividness and realism of this particular hallucination.
What is observed, as a whole, is that the subjective experience of catatonia is very varied, as are the symptoms of each patient and the possible origins of the problem. However, these testimonies serve as a reminder, among others to the professionals who treat patients with these characteristics, of the need to show understanding and empathy with people who suffer from this peculiar disorder.