WAGblog

On Catatonia

With apologies to J and L, from a letter to whom I have taken this, edited of course-- a description of my personal experience with catatonia.

To me, two things happen when I become catatonic. One is that I enter a state of profound indifference so extreme that I, ordinarily an extremely modest person preferring never be seen naked, refusing even to have the usual female medical exams/tests, can be stripped of all clothing and have all sorts of catheters inserted and even be toileted by strangers without the slightest reaction, either internally felt or externally apparent. I no longer care what happens to �that body� everyone is fussing over, and feel an almost Buddhist-like detachment from it, from all the concern and bother going on about me.

The other thing is that along with this indifference comes the more obvious slowing down, even to the point of immobility. While I may seem immobile and non-responsive to those trying to elicit a reaction, in fact my experience is one of reacting quite appropriately, just in glacial time, which to me feels perfectly normal. In fact, other people seem to be moving way too fast and only the clock tells me that I am the slow one rather than the reverse.

My indifference allows me to perceive all of this without distress, merely a detached curiosity, like a scientist observing natural phenomena, while my �psychomotor retardation� doesn�t feel particularly slow except in comparison to others. It does prevent me from communicating quickly enough to be heard though, and no one notices that I am answering a question, am performing an action, because they are in such a hurry!

Meanwhile, whether my actions truly make sense or not, that is, whether they are motivated by psychotic thoughts, they are purposeful. I am, for example, reaching out to wipe my nose, even when my arm seems "stuck" or "posturing" in mid-air apparently nowhere near my nose. It just hasn't gotten there yet, and it's extremely frustrating when others, trying to be helpful, replace my arm "more comfortably" down on the bed, because then I have to start all over again. Though they can't see it or hear it, I *am* moving, I *am* answering, only in a time frame they do not perceive or won�t wait for.

Does this sound familiar to any of you? Supposedly it's a rare state, yet I've heard many people with sz say they've been catatonic. A recent New Yorker article by neurologist Oliver Sacks fascinated me because I never knew that coming out of it abruptly, then launching into the opposite state was fairly typical. A friend has often warned hospital personnel that when I come to, I will �go wild.� But I thought that was just me, a peculiarity unknown in other cases.

Instead, Sacks talks about this kind of �bipolar� switch from catatonia to frenzy so precisely it amazes me...I �flip� completely, and without warning. Nurses caring for me sometimes believed I had to somehow have been faking the catatonic state, (though how that could be done I don�t know) because they couldn�t understand how I could go from immobility to agitation without any switching of gears. Understandably they wanted something � anything � indicating that the changeover was coming. Instead, I woke up, so to speak, and immediately went bananas.

All this remains a curiosity to me, but even now I cannot feel distress remembering it, only the same detachment from my body, as well as a pervasive perplexedness that any of it mattered. The only time I felt upset was after being given IV Ativan, which according to the doctor often relieves catatonia, though no one is sure why. Then I �knew� something was supposed to happen, and suddenly, before I could physically move, I finally cared. I wanted the bolt of electricity to hit and arouse me, whereas before then I couldn�t have cared less. It suddenly mattered that I could not, or at least did not, move properly...and it felt for the first time like the �eternity� it was, for me to begin to react.

It wasn�t that I wanted to please the doc, though I admit I felt like he was showing off in front of his students and residents,by coming back the way one might in a TV movie, but it was certainly what I expected. (By the way, for those of you who don't know this, in such a state, the brain, the mind is nonetheless aware of everything, one just doesn�t react or respond to the world. But one hears and sees just fine, a warning to those who talk in front of people in catatonia as if they were zombies.) Soon after he injected the Ativan into my IV, I *felt* the slowness of my actions and understood how awful it must have seemed that I lay there completely motionless for so long.

Finally, the drug began to take effect on my body, several minutes after my brain felt it; that is, I wanted to move before I actually could. Anyhow eventually I could feel my muscles returning to me, could feel the impulses at the neuromuscular junction connecting normally, and soon I found myself able to blink on command, or give a feeble squeeze of the doctor's fingers. Then slowly, over a couple of days, I became able to talk and walk on my own again.

Mind you, all this is what happens under the effect of IV Ativan; if however I �wake� on my own, then it is to frenzy with no agonizing or gradual coming to. Even with the help of Ativan by IV, I usually flip into a super-reactive state, but at least then there is some warning before it happens, however slight.

As I said, all this still fails to disturb me. I�ve often wondered how other people felt when catatonic, or whether they too have no emotional recall of the state, not caring about it now, just as perhaps they did not when in the midst. Paranoia and such often seem an extreme exaggeration of feelings everyone can relate to, but catatonia seems to me to be a state with which there is no ordinary analogy.

Anyhow, that's -- briefly -- my story. Anyone with comments about their own experience is welcome to add them here.

Posted by pamwagg at August 28, 2004 06:27 PM | TrackBack