The Conversation website published a text by psychiatrist Jonathan Rogers about catatonia and what is happening in the brain of people affected by this disease. Although their bodies are motionless, the brain – contrary to appearances – is still working. There are cases where the behavior of patients may be a defensive reaction to a possible threat.
- Catatonia is a group of systemic and motor disorders. Symptoms include unnatural body position, keeping the body in one position (catatonic stiffness) or total numbness, excluding contact with the patient
- Although the bodies remain paralyzed, the brain may still function, writes psychiatrist Jonathan Rogers
- Patients often experience intense feelings. It is fear, pain or the necessity to save life – the doctor says
- More current information can be found on the Onet homepage.
Catatonia – what is happening in the patient’s brain?
Jonathan Rogers is sometimes asked to visit an emergency room, which is “completely mute”. Patients sit there motionless, staring at one place. They don’t respond when someone raises their hand or takes a blood test. They don’t eat, they don’t drink.
The question is whether this is a brain injury, or is it somehow controlled behavior, writes Rogers.
«I am a psychiatrist and researcher specializing in a rare disease called catatonia, a severe form of mental illness in which people have severe problems with movement and speech” – explain. Catatonia can last from hours to weeks, months, even years.
A psychiatrist talks about the condition with doctors, nurses, scientists, patients and caregivers. One question most often arises in interviews: what is going on in the minds of patients?
When someone is unable to move or speak, it is also easy to assume that the person is not conscious, that their brain is also not working. Research shows that this is not the case. It is quite the opposite – emphasizes Rogers. «Catatonic sufferers often express intense anxiety and say that they feel overwhelmed with feelings. It’s not that catatonic people don’t have thoughts. It is even so that they have too many of them»- writes a psychiatrist.
Fear and pain
Rogers cites a study he and his team recently conducted, published in the trade journal Frontiers in Psychiatry. Hundreds of patients were examined and shared their feelings after recovering from catatonia.
Many of them were unaware or did not remember what was happening to them. Some, however, revealed that they experienced very intense feelings. «Some have described experiencing overwhelming fear. Others felt the pain of staying in one position for long periods, but were nonetheless incapable of any movement»- writes a psychiatrist.
Rogers found the most interesting stories to be those of patients who had a similar “rational” explanation for catatonia. It describes in detail one case of a patient who was found by the doctor kneeling with his forehead on the floor. As the patient later explained, he assumed the position of “saving life” and wanted the doctor to check his neck. For he had the impression that his head was about to fall off.
“If you were really afraid that your head might inevitably fall off, it wouldn’t be such a bad idea to keep it on the floor,” comments Rogers.
Pretend death
Rogers mentions other similar cases. Some patients were told by imaginary voices to do different things. One “found out” that her head would explode if she moved. “This is probably a good reason not to leave your seat,” writes the doctor. Another patient later related that God told him not to eat or drink anything.
The psychiatrist writes that one theory of catatonia says that it is similar to “apparent death”, a phenomenon observed in the animal world. When faced with the threat of a stronger predator, smaller animals “freeze”, pretending to be dead, so the aggressor may not pay attention to them.
As an example, he mentions a patient who, “seeing” a threat in the form of a snake, assumed a position designed to protect him from a predator.
“Catatonia is still an unexplored condition, halfway between neurology and psychiatry,” concludes Rogers. Understanding what patients experience can help provide them with better care, therapy and safety.
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