A State Of Trance
Catatonia is a state of abnormal movement and behavior arising from a disturbed mental state, typically from schizophrenia. But catatonia can also occur independently of schizophrenia. When a patient is in a catatonic state, it is very obvious. They may demonstrate mutism, negativism, resistance to passive movement or repetitive and purposeless movement.
Some patients who are catatonic urinate and defecate on themselves. They have no logical explanation as to why they do it. They may say that they “didn’t have enough time to get to the bathroom.” That being said, you would think that they would at least clean up after themselves. Wrong. Catatonic patients can remain soiled in feces for hours at a time if undetected by staff or family.
You may repeatedly instruct a catatonic patient to shower because they are soiled in feces, but they will not react. They may enter the bathroom and just stand there, giving no logical reason as to why they are refusing to shower. Often, Ativan 2 mg IM must be given to catatonic patients; it helps them to snap out of it.
Some catatonic patients can be observed to be non-responsive in bed for hours at a time. You can ask them how they are doing and try to help them get out of bed, but they will just stare back at you with an expressionless face as if they just had a stroke. But no stroke has occurred. They are just in a mental state called catatonia.
Catatonia can occur unexpectedly. One minute a patient is sitting in a chair and talking with you, and the next minute he or she is down on the floor unresponsive. Patients with catatonia will continue to blink, but they’ll appear expressionless; you’ll call their name and attempt to comfort them, but they won’t budge.
It is important to remain patient with catatonic patients and to not lose your composure. It can become frustrating to have a catatonic patient not react to your verbal commands, but just be cognizant of the fact that catatonia is a mental illness. Many patients cannot even explain to you what catatonia feels like.
It just happens. So do your best to remain composed, professional and supportive. We are all in this together!
Are you Ready? (This is Defeating Stigma Mindfully)