Catatonic Depression; Definition, Symptoms, Causes And Treatments.

The depression catatonic , now known as major depressive disorder with catatonic features, is diagnosed when a person suffering from major depression develops physical symptoms such as inability to move, speak or respond to external stimuli.

Catatonia is not a separate disorder, rather, is a psychomotor disorder that can be triggered by various things such as infection, certain medications, disorders neurological, autoimmune disorders, overly abrupt withdrawal from alcohol or benzodiazepines and other psychiatric disorders, especially schizophrenia and other major mood disorders.

What is catatonic depression?

It is a type of depression that causes someone to remain speechless and immobile for an extended period, although it used to be seen as a distinct disorder, the American Psychiatric Association (AAP) no longer recognizes it as a separate mental illness, now considers it to be the Catatonia is a specifier for several mental illnesses, including depression, post- traumatic stress disorder, and bipolar disorder . Catatonia is characterized by an inability to move normally.

The term catatonic is not a separate disease in itself, but is considered an additional part of an already present diagnosis, other diseases such as post-traumatic stress disorder, bipolar disorder and schizophrenia can also have catatonia has a distinction. Those affected may not be able to perform simple tasks, such as sitting up in bed or changing clothes, they can also sit quietly for hours without moving a muscle.

The catatonic depression has symptoms of depression at the time including Neurogenetics motor disability, when a case is presented like this, medical professionals need to identify the root cause of depression to improve mental stupor. It is estimated that less than 10 percent of psychiatric patients develop a mental disorder with catatonic characteristics, which makes its appearance quite rare.

Types of catatonia

There are many different presentations for catatonia.

Stupor

It is a state where there is no evidence of external connection to the environment, with little or no psychomotor activity. Those who suffer from stupor make little or no eye contact, and the patient may remain in one position for a long time and then abruptly “freeze” in a second position.

Catalepsy

It causes the body and limbs to become stiff, with a lack of responsiveness, loss of muscle control, and decreased bodily functions, including breathing.

Waxy flexibility

Causes mild resistance and even resembles a change in position initiated by a physician; Catalepsy allows a patient to maintain a position after it has been changed by the doctor.

Mutism

Produces little or no verbal response.

Negativism

Shows opposition or does not respond to external instructions or stimuli.

Ecolalia

It is the unconscious repetition or imitation of the speech of another.

Ecopraxia

It is the imitation of the movements of another.

Stereotypy

They are repetitive random movements, abnormally frequent.

Agitation

(Not influenced by external stimuli) People who experience this form or catatonia are extremely hyperactive, with seemingly purposeless movements, the patient may also experience delusions and hallucinations.

The further diagnosis of catatonia is made when at least two of the above manifestations are present.

Symptoms of catatonic depression

Major depressive disorder itself has a large subset of variable symptoms that must first be labeled catatonic depression. These preliminary symptoms may include:

• Sleeping problems.
• Trouble getting out of bed
• Feelings of restlessness.
• Loss of interest in previously enjoyed activities.
• Loss of energy.
• Feelings of sadness almost every day.
• Sudden weight changes, loss or gain.
• Irritability.
• Difficult to focus.
• Difficulty making decisions.
• Changes in appetite
• Feelings of worthlessness.
• Fatigue.
• Thoughts of suicide .
• Previous suicide attempt.

Once the diagnosis of depression has been confirmed, further recognition of catatonia can be identified if the following are also present, if so, the diagnosis of catatonic depression can be made. Catatonia symptoms can include:

• Agitation.
• Inability to move
• Usual movements.
• Refusing to eat or drink.
• Difficulty speaking
• Extreme negativism: Lack of response to stimuli or other opposition to stimuli

Imitating someone else’s speech or movements (echolalia / echopraxia)

Additional symptoms of catatonic depression can include:

• Abnormal speech: It  can be monotonous and / or repetitive.
• Automatic  obedience : Obeying all instructions without question.
• Dislike:  Rolling over when spoken to.
• Forced grasping:  Holding hands repeatedly tightly.
• Obstruction:  Stopping all movement suddenly for no reason.
• Hypokinesis:  Being extremely rigid and unable to move.
• Stereotypy:  Performing ritual or repeated movements without purpose.
• Waxy flexibility:  Holding awkward positions for long periods of time. The limb of the patient can move to a certain position and they could support it.

For a person to meet the criteria for catatonic depression, they must have at least two of the symptoms of catatonic depression in addition to having a major depressive disorder.

Causes of catatonic depression

The exact cause of catatonic depression is not known, but it is believed to be the result of an imbalance of chemicals in the brain called neurotransmitters, when working normally, these endogenous chemicals transmit signals across a chemical synapse, such as junction. neuromuscular, from one nerve cell to another, or between muscle cells. Neurotransmitters play an important role in regulating everyday functions.

Catatonic depression patients are believed to suffer from excessive fear leading to an imbalance of neurotransmitters in the brain. Intense fear can cause the body to freeze, possibly as a defensive maneuver to avoid detection. The neurotransmitters dopamine, gamma aminobutyric acid, and glutamate have been linked to catatonic depression.

Treatments for catatonic depression

The following treatments are available for catatonic depression:

Benzodiazepines

Benzodiazepines are a class of psychoactive drugs that potentiate the effect of the neurotransmitter gamma-aminobutyric acid. In most people, these medications are effective in quickly relieving catatonic symptoms, such as anxiety , muscle spasms, and insomnia . However, benzodiazepines are also highly addictive, which is why they are generally used as a short-term treatment method.

Electroconvulsive therapy

Electroconvulsive therapy is the most effective treatment for catatonic depression, it involves attaching electrodes to the head that send electrical impulses to the brain, causing a mild seizure. Although it is now considered a safe and effective treatment for a variety of mood disorders and mental illnesses, there is still a stigma surrounding it. As a result, it currently lags behind benzodiazepines as the primary treatment for catatonic symptoms, however a combination of benzodiazepine and this therapy may be the best treatment for catatonic depression.

N-methyl-D-aspartate

There is increasing evidence showing that N-methyl-D-aspartate can also be used to effectively treat catatonic depression. It is an amino acid derivative that mimics the behavior of the neurotransmitter glutamate, although it appears to be a promising treatment method, more studies are needed to address its efficacy and side effects adequately.

Repetitive transcranial magnetic stimulation

Other treatments that have shown promise include repetitive transcranial magnetic stimulation and certain atypical antipsychotics, particularly those that block dopamine D2 receptors, however more research is needed to determine how effective these methods are in treating people with depression. catatonic.