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Recognizing Catatonic Schizophrenia: Signs and Behaviors

Reviewed by Aaron Horn, LMFT · December 03, 2020 ·

When most people think of schizophrenia, they imagine someone hallucinating or behaving in a delusional way. These are two of the more common symptoms experienced with schizophrenia, but it doesn’t satisfy this mental illness's full definition.

One of the lesser-known symptoms is catatonia, which is also present in other mental illnesses (depression, bipolar disorder). It used to be known as a subtype of schizophrenia -- catatonic schizophrenia -- but has since been demoted to a symptom.

Nevertheless, it’s one of five major symptoms of schizophrenia, and many people still, unofficially, refer to it as a type. Many people consider it its own disorder due to how unique it is compared to other symptoms -- especially with schizophrenics.

So, what is catatonic schizophrenia?

Catatonic schizophrenia is when an individual suffering from schizophrenia displays periods of both hyperactivity and hypoactivity. Not every schizophrenic is a catatonic schizophrenic, but it’s more common than you’d think and has a long-term negative impact on the individual’s life.

The periods of hyperactivity (increased motor activity) and hypoactivity (decreased motor activity) are characterized in various ways, including more than a dozen symptoms. Let’s take a look at some of the most common:

  • Uncontrollably repeating someone else’s movements, also known as echopraxia.
  • Expressing disgust, disapproval, or pain (grimacing), despite not having a reason to.
  • Uncontrollable or repetitive movements that occur randomly (stereotypy), as opposed to mimicking someone else’s.
  • Forcing yourself to hold a certain posture (posturing or catalepsy), despite it being viewed as an ‘awkward’ position to be in.
  • Not being able to speak for periods of time, also known as mutism.
  • Uncontrollably repeating someone else’s sentence, also known as echolalia.
  • Extreme agitation and irritability, despite not knowing why.
  • Behaving in strange, exaggerated, or unusual ways, also known as mannerism.
  • Having limited-to-no response to your external surroundings, also known as negativism.
  • Not being able to move your body from a certain position if placed there, at least until it’s moved again -- also known as waxy flexibility.
  • Being in a sense of near-unconsciousness or insensibility, also known as a stupor.

In addition to the many symptoms experienced with catatonic schizophrenia, various complications can occur due to the mental illness. These complications are often worse with individuals that don’t receive proper treatment early on in the healing process.

To ensure you’re given the full scope of what catatonic schizophrenia does to an individual’s life, let’s take a look at some of the most harmful complications:

  • Difficulty maintaining proper hygiene daily, including brushing the teeth, showering, and washing clothes.
  • Depressive behavior, suicidal behavior, and suicidal thoughts deplete the individual’s quality of life.
  • Many catatonic schizophrenics often turn to drugs, tobacco, alcohol, or medication to relieve their symptoms, leading to addiction.
  • Unhealthy eating habits, including malnutrition, due to not eating enough.
  • Conflicts with family members, friends, coworkers, and classmates.
  • Poverty, prison, and homelessness are common in those suffering from catatonic schizophrenia.
  • Many schizophrenics are victims of hate crimes and being made fun of.

It’s important to note that individuals suffering from catatonic schizophrenia aren’t dangerous and don’t mean any harm to their surroundings -- including the people they interact with. Some experience delusion, others hallucinate, and some might experience disorganized behavior.

At the end of the day, individuals suffering from this disorder are in search of happiness. They’re scared and being held back by something they don’t have control over, which is why it’s extremely important they find the right treatment as soon as possible.

What Causes Catatonic Schizophrenic Symptoms?

Much like most mental illnesses that exist today, doctors and researchers are unsure of the direct causes of catatonic symptoms experienced with schizophrenia. However, a majority of their research is geared towards brain function, brain activity, environment, and genetics.

As far as brain activity goes, it’s believed that several neurotransmitters play a role in these symptoms -- more specifically in the areas of the brain responsible for motor and speech functions (frontal lobe, cerebellum, Broca’s area, and Wernicke’s area).

Some neurotransmitters that hold a lot of weight here are dopamine and serotonin. Individuals might experience an imbalance of neurotransmitter production, release, synthesis, or reception, which leads to unusual movements and speech.

Other research points towards genetics and family history. Many people with family members suffering from catatonic schizophrenia are at an increased risk of developing it themselves. Fetal malnutrition, having children at an older age, and childhood abuse are other risk factors for this disorder.

Lastly, researchers are interested in learning more about the effects of drug abuse, viral infections, and even stress on the development of catatonic schizophrenia, all of which are believed to increase development risk.

How Is Catatonic Schizophrenia Diagnosed?

Most people suffering from catatonic schizophrenia won’t seek help themselves. They’re often suggested to seek help from loving family members, friends, or even primary care physicians that suspect the onset, development, or worsening of the disorder.

Due to this being a severe mental illness, healthcare professionals need to be extremely diligent when diagnosing catatonic schizophrenia. Since catatonia symptoms (movement issues) and schizophrenia symptoms (delusions, hallucinations, disorganized behavior) are different, they need to ensure both are present.

Healthcare professionals will likely order a combination of tests or exams to analyze when diagnosing catatonic schizophrenia. A physical exam and complete blood count (CBC) are two of the most basic ones, but they might also want an MRI, CT, or EEG scan.

Finally, a psychiatrist is sure to be involved at some point. A psychiatric evaluation helps give the doctors a better and deeper understanding of the symptoms the individual is experiencing and what might be causing it.

In many cases, the process for diagnosing a schizophrenia catatonia type -- let alone schizophrenia in general -- takes a long time, and patience is needed by everyone involved. Since the symptoms are synonymous with other illnesses, they need to be thorough with their diagnosis to ensure the right treatment is recommended.

Can Catatonic Schizophrenia Be Treated?

While there isn’t a cure to catatonia symptoms found in individuals with schizophrenia, several different treatments are available to help reduce the symptoms. For the most part, these treatments aim to help the individual live as close to normal life as possible.

Let’s take a look at some of the most popular and common forms of catatonic schizophrenia treatments -- or treatment for any kind of schizophrenia:

  • Medication - your physician might recommend you be placed on benzodiazepines, barbiturates, or antidepressants to help relieve the symptoms.
  • Electroconvulsive Therapy (ECT) - some patients are given ECT when electrical currents are sent through the brain. This is only performed when other treatments don’t work and are rare to see.
  • Psychotherapy - a more traditional form of therapy that often includes various forms of talk therapy. This is generally reserved for the less-severe cases of catatonic schizophrenia.
  • Skills Training - in addition to psychotherapy, individuals might require additional skills or vocational training to help them mesh into society like the rest of us.
  • Hospitalization - if the individual is experiencing an episode that puts themselves (or others) at risk, hospitalization ensures they’re under the right supervision. It also ensures they receive the right food, sleep, and hygiene throughout the episode.

One of the most prominent things you can do for yourself or a loved one when suffering from schizophrenia is to stay dedicated to getting better. Many people might feel the treatment is impossible, and others might feel like they’re alone throughout this process, but neither is true.

This is where listening and trusting your healthcare professionals is extremely important. Learning to deal with the effects of catatonic schizophrenia can take years, and it’s an uphill battle for most people, but it’s one anyone can win with the right support and guidance.

Mind Diagnostics’ Pledge To Help

At Mind Diagnostics, we understand that nearly 1 in 100 Americans is at risk of developing schizophrenia -- if they’re not already suffering from the disorder. While not everyone experiences catatonic symptoms, they certainly make the illness harder to cope with.

It’s widely believed that early detection is one of the best things you can do when battling catatonic schizophrenia. That’s why we believe in the power of awareness and the power of guidance, especially during these critical moments in an individual’s life.

With our comprehensive online schizophrenia test, you’ll be asked a series of questions that are designed to determine whether or not you’re at a high risk of developing schizophrenia. If the test concludes you’re not at high-risk, we have a wide variety of other mental health tests that might point to the real answer.

Of course, we also assist individuals with what happens once you learn you’re a high-risk individual. We ensure you’re matched up with a therapist trained in the field and has experience dealing with individuals going through similar difficulties in life as you.

Together, more healthy and balanced life is right around the corner. Together, your quality of life has never been more achievable.

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