Often found in people who also have mental disorders (most commonly bipolar disorder and schizophrenia), catatonia is a temporary physical and mental state in which an individual is extremely unresponsive, lethargic, and immobile. Catatonic states include twelve main symptoms, of which three must be present for a diagnosis to be made. The clearest-cut symptoms are mutism; grimacing or making pained facial expressions; stupor; agitation; and negativism, which is the psychological term for refusing any outlook other than a negative one.
The less well-known symptoms include echolalia (repeating sounds and words the person hears); its cousin, echopraxia (mimicking movements they see); catalepsy (a trance or seizure state in which the body is completely rigid); waxy flexibility, (limbs being able to be moved by someone else and remaining in the new position); mannerism (carrying out strange and exaggerated actions or poses); posturing (moving from one unusual position to another); and stereotypy (frequent repeated small movements).
Another temporary mental state that some people experience is acute confusional state. It’s also called delirium, which is where the term “delirious” comes from. Delirium is characterized by restlessness, lack of awareness, incoherence, and delusions, and it can be caused by many different things, including intoxication, metabolic imbalances, dehydration, surgery, and medication changes. The two types of delirium are hypoactive and hyperactive: the former is a slow, unresposive, and lethargic kind of delirium, while the latter is the restless and energetic kind that is more likely to include hallucinations and delusions.
Similar to delirium, psychosis is an altered mental state where the brain loses its connection with reality and detaches from the world around it in a dangerous and sometimes frightening way. Usually caused by neurological instead of physical symptoms, psychosis is not as easy a fix as delirium can be, and often lasts longer. Additionally, while a delirious person will often have periods of lucidity where they aren’t be considered delirious, psychosis tends to be a more consistent experience for the length of time it’s occurring.
The last few states I want to talk about are depersonalization, derealization, and dissociative amnesia. Less likely to seem like they “just happened,” these dissociative disorders are often responses to trauma or uncomfortable situations designed to protect the brain and body from potentially harmful situations. Depersonalization causes an individual to feel disconnected from their thoughts, feelings, and physical body, while derealization is a disconnect from someone’s environment. Both can be sudden and scary and are likely to occur more frequently in people who have experienced significant trauma.
Dissociative amnesia is less of a state than it is something that happens to a person. The easy explanation of DA is that it’s something that occurs in the brain during a traumatic event that causes an individual’s memory of the event to be blocked from their general conscious, causing the memory to be unable to be accessed. These memories may or may not be recovered; when they are, there’s often a trigger, such as a phrase, sound, or something in the person’s environment, that brings the memories back. It’s also common for memories to be recovered in therapy, as licensed therapists are trained to help people recall dissociated memories if the client so desires.
There’s a lot of things we don’t know about almost every mental state and disorder out there. We’ve come a long way from bleeding people out and blaming everything on the four humors, but that doesn’t mean people are always going to know what to do or how to react when someone they love is experiencing the symptoms of a debilitating disorder. The best rule of thumb for reacting to these situations is the same thing people say for almost everything: be kind, listen well, and have compassion for what people are experiencing and have been through. Oftentimes, these three tenets are the initial requirements for people to begin their recovery; only after we’re shown kindness can any of us truly begin to heal.
Author: Rose McCoy