Catatonia - a guide for autistic adults
Catatonia is a rare disorder which affects a person’s ability to move, speak or respond. If severe, it can lead to life-threatening issues with eating and breathing. This guide explores signs of catatonia and how it can affect you.
What is catatonia?
“Catatonia is a psychomotor disorder, meaning it involves the connection between mental function and movement. Catatonia affects a person’s ability to move in a normal way.
People with catatonia can experience a variety of symptoms. The most common symptom is stupor, which means that the person can’t move, speak, or respond to stimuli. However, some people with catatonia may exhibit excessive movement and agitated behaviour.
Catatonia can last anywhere from a few hours to weeks, months, or years. It can reoccur frequently for weeks to years after the initial episode.” healthline.com
Catatonia is a rare condition. It does not just affect autistic people, in fact the relationship between autism and catatonia is still little understood or recognised.
What are the symptoms of catatonia?
There are various potential symptoms of catatonia, these include:
- increased slowness
- freezing during actions
- increase in repetitive movements and hesitations
- difficulty in crossing thresholds and completing movements
- marked reduction in speech or complete mutism
- difficulty in starting or limiting certain actions
- increased reliance on physical or verbal prompts for functioning
- increase in repetitive and ritualistic behaviours
- getting locked in postures.
What’s the impact of catatonia?
Catatonia is rare and affects people in very different ways. It can have a major impact on your quality of life and ability to function. If unrecognised and severe, it can present significant issues including:
- incontinence
- mobility and muscle wastage
- physical problems - including potentially life-threatening issues with eating and breathing.
When should I seek help?
Autism and catatonia share some traits including repetitive movements, mutism and echolalia. It can be difficult to differentiate autistic and catatonic signs.
You should seek help if you notice a marked deterioration in your:
- movement
- pattern of activities
- self‐care
- practical skills.
Treatment, medication and support for catatonia
There are no medications specifically for catatonia. When symptoms are severe, psychiatric medication such as anti-anxiety medication may be prescribed.
Electroconvulsive therapy (ECT) has been used to treat catatonia, however this is only recommended by the National Institute for Health and Care Excellence (NICE) as an extreme and last resort. This would be when all treatment has failed and/or if the catatonia is life-threatening. Clinicians must exercise extreme caution when considering ECT for anybody.
Dr Amitta Shah recommends that clinicians carry out a detailed assessment of the person experiencing catatonia. They should consider any autism-related stress factors that could lead to catatonia. Support would then involve making changes where possible to reduce stress.
Autistic shutdowns and relation to catatonia
A shutdown is when someone partially or completely removes themselves from the world around them. It may mean they stop communicating verbally, take themselves out of the situation or curl up or stay in bed.
Dr Amitta Shah refers to shutdowns as a potential early warning sign that can lead to catatonia when prolonged or frequent and with other catatonic signs. If you feel you may be experiencing some of these early signs, speak to family or friends and seek medical support.
