Catatonic Depression: Causes And Treatment

There are a few types of depressive disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Some are situational and pass with time and treatment. Others may be severe and have long-term symptoms. For some people, depression may be resistant to treatment. Although not an official diagnosis, catatonic depression is one of the more severe types of depression. In the DSM, it may be referred to as major depressive disorder with catatonic features. 

Catatonic depression can cause individuals to feel so depressed that they remain speechless or motionless for long periods. This catatonic state can be concerning for the family and friends of those with the condition. There are a few reasons someone may become catatonic and several treatment options for those experiencing this state.

What's catatonic depression?

Catatonic depression refers to a type of major depression (major depressive disorder) where an individual goes into a catatonic state. This catatonic state may be characterized by a lack of movement or speech for long periods. In addition, the individual may not eat, drink, or care for themselves. In the past, catatonic depression was considered a unique disorder, but an understanding of the condition has changed over time. 

Catatonic depression and symptoms of catatonia

In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), catatonia was considered a subtype of schizophrenia. In the DSM-V, however, catatonia can be diagnosed as a specifier of other mental health conditions, including depression. Individuals with catatonia may show reduced gamma-aminobutyric acid (GABA) receptor density, contributing to these symptoms. People who have catatonic depression are often diagnosed with other mood disorders, such as bipolar disorder or clinical depression. These states of catatonia may also be associated with post-traumatic stress disorder (PTSD). 

Several symptoms can help you identify catatonic depression. Persistent feelings of sadness are often present, which may occur daily and happen several times a week. It may require psychiatric care.

Symptoms of catatonia similar to depressive disorders

Other symptoms of catatonia may be shared with depression symptoms. For example, a loss of interest in activities that used to appeal to someone is a common symptom of depression. Problems maintaining an appetite or a persistent urge to eat can lead to sudden weight changes or other physical health concerns. Substance use, feelings of worthlessness and guilt, and trouble concentrating are other symptoms worth noting. Catatonic depression is also often associated with thoughts of suicide. 

If you are experiencing suicidal thoughts or urges, call or text the 988 Suicide & Crisis Lifeline. Help is available 24/7.

Catatonic depression causes

Catatonic depression is often a result of other mental health disorders and medical conditions. The cause of catatonic depression may be examined from various angles. For example, the root of depression and the root of the catatonic state may differ. Looking at each of these root causes together, medical providers may get a clearer overall picture and understand why they’re occurring.  

Catatonic depression: traumatic events, biological factors, and more

The cause of depression on its own can vary. Traumatic events, like the loss of a loved one, could be a contributing factor. Some people are prone to depression due to biological factors. Side effects from medications, abuse, illness, chemical imbalances in the brain, substance misuse, and other factors can also cause depression.  

If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available 24/7 for support. Call 1-800-799-SAFE (7233) or text “START” to 88788. You can also use the online chat. 

Treating catatonic depression with medication, electroconvulsive therapy, and more

If you have been diagnosed with catatonic depression, consider finding support and treatment to manage your symptoms. The types of treatment often effective for severe depression may include inpatient facilities, outpatient interventions, medication, talk therapy, and support groups.  If you believe you’re living with catatonic depression, consider consulting with a mental health or medical professional, who can provide you with screenings and determine whether further testing, a diagnosis, treatment, or other steps are necessary.

Medication 

Pharmacological solutions are typically a first-line treatment for catatonic depression symptoms. Medication may be combined with other forms of treatment depending on the person and the severity of their condition. Before starting, changing, or stopping medication, consult your primary care physician or a psychiatrist for guidance.  

Electroconvulsive therapy (ECT) 

In some cases, electroconvulsive therapy (ECT) is used as a treatment method. During electroconvulsive therapy, electric shocks are administered under general anesthesia to send electrical currents through the brain, which causes a brief seizure. This seizure can shock the brain out of the catatonic state it’s in. Electroconvulsive therapy is often viewed as an effective treatment, but many people only choose it as a last resort since it causes a seizure and may have side effects. However, many experts in the medical community see ECT as one of the safer options for treatment-resistant depression. 

Transcranial magnetic stimulation (TMS) 

Another medically reviewed treatment for catatonia and depression is transcranial magnetic stimulation, also known as TMS. In TMS therapy, wellness professionals utilize gentle magnetic pulses to stimulate parts of the brain that are inactive or underactive. These areas may be responsible for causing depression, as they can change how the individual responds to challenging situations. 

TMS therapy can be a safe alternative to medication as it has virtually no side effects compared to alternative treatments. It has also been proven to have long-lasting results without requiring long-term treatment. The general treatment plan consists of five sessions a week for six weeks.

Talk therapy and treatment with mental health professionals

Coping with depression may be more manageable when you lean on a professional for guidance. If you’re struggling with symptoms that continue to hold you back, confiding in a professional about what you’re experiencing may be valuable. You can connect with a licensed therapist through a local mental health clinic, a one-on-one practice, or an online platform like BetterHelp. If you are experiencing depression, getting out of bed and attending an appointment can be difficult. In these cases, an online mental health professional can attend to you no matter where you’re located, as long as you have a smart device and an internet connection.  

Internet-based interventions for bipolar disorder

In addition, internet-based interventions have been shown to be effective for treating various mental health conditions including mood disorders like depression and bipolar disorder. One study assessed the efficacy of a multimodal digital psychotherapy platform on adult depression. Researchers found that online platform users experienced significantly reduced depression symptom severity three months after beginning treatment.