• Quote of the Day
    "Your living is determined not so much by what life brings to you as by the attitude you bring to life;
    not so much by what happens to you as by the way your mind looks at what happens."
    Kahlil Gibran, posted by David Baxter

1210donna

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More and more books are now looking at Catatonic episodes in those on the autistic spectrum.

In the first of my four autobiographical works about my life with autism, Nobody Nowhere, I also wrote of a catatonic state brought on by acute depression and anxiety.

In books like Autism and Sensing: The Unlost Instinct, in Autism: An Inside Out Approach, in Exposure Anxiety: The Invisible Cage, and in The Jumbled Jigsaw, I wrote of body disconnectedness and other system shutdown states, including shutdown akin to what is described in catatonic episodes.

There's a difference between having catatonia and having catatonic episodes triggered by acute anxiety, depression or bipolar and this may be useful to explore in the context of autism for SOME PEOPLE.

These episodes would be catatonic but not Catatonia itself.

Perhaps particularly in Rapid Cycling Bipolar (which can have onset as early as 18 months of age) state where mood fluctuates so extremely (mood extremes can cycle up to ever 45 minutes) then we may well see a stream of catatonic episodes in a day, week, month, year yet the person may never remain completely in the catatonic state.

This is worth a thought, because unlike catatonia in those with chronic anxiety and depression or adult bipolar which may cycle only a few times a year, its possible that with up to 30% of people with autism having undiagnosed (and untreated) Rapid Cycling Bipolar we may be seeing a severely disruptive influence on development of regular catatonic episodes.

It'd be interesting to compare this possibility with acute episodes of what I wrote of as Exposure Anxiety and look a the long term emotional training of such a potential interaction on functioning and self help skills. There's a newly recognised form of Catatonia which is far more active and agitated than the traditional stereotype. What would this look like as 'episodes' rather than Catatonia itself?

If catatonic episodes, in either their still/mute/passive or agitated/active/shouting forms, were severe and frequent, then if they are presumed 'part of the autism' and left untreated, they probably won't lead to collapse or death as in the case of full Catatonia but the impact on learning, interaction, communication, development, family structure and stability, futile and desperate spending on behaviour management programs for a chemically triggered condition not within the individual's control.

It's easily imaginable that the current idea of autism as 'hopeless and untreatable' would become a self-fulfilling prophecy, not caused by 'autism' but of ignorance of some of the things that co-occur with it that we fail to identify or understand.

This failure to identify or understand these things is fueled by organisations and some high profile individuals on the spectrum that continue to publicise autism as ONE THING for all with the diagnosis. It is my hope this will change.

:) Donna Williams *)
Donna Williams
Autistic author of 9 books in the field of autism, consultant, and teacher.

From the National Autistic Society:

The National Autistic Society | - NAS


There is little information on the cause or effective treatment of catatonia. In a study of referrals to Elliot House who had autistic spectrum disorders, it was found that 17% of all those aged 15 and over, when seen, had catatonic and Parkinsonian features of sufficient degree to severely limit their mobility, use of speech and carrying out daily activities. It was more common in those with mild or severe learning disabilities (mental retardation), but did occur in some who were high functioning. The development of catatonia, in some cases, seemed to relate to stresses arising from inappropriate environments and methods of care and management. The majority of the cases had also been on various psychotropic drugs.

Whilst the traditional picture of Catatonia is stillness, catatonic episodes can be far from still...

catatonia (kăt'utō'nēu) [key], mental state generally characterized by statuesque posturing, muscular immobility, mutism, and apparent stupor. The muscles are held in a pliant state called waxy flexibility, and the catatonic person obediently permits himself to be rearranged into awkward positions that he may subsequently hold for hours. Another form of catatonia involves continuous incoherent shouting, psychomotor agitation, and a violent destructiveness which can lead to collapse and death if untreated. Loss of memory or intellect is not necessarily implied: catatonic patients often display excellent memory of their surroundings during the catatonic state. In recent years, drug therapy has been helpful in the avoidance of catatonic disturbances, and the appearance of catatonia is now quite rare. Described by Karl Kahlbaum (1874) as catatonia, the term was subsumed under Eugen Bleuler's concept of schizophrenia in 1911. It has recently been classified as catatonic schizophrenia by the American Psychiatric Association.

A new book coming out with Jessica Kingsley Publishers

How To Be Yourself in a World That's Different: An Asperger's Syndrome Study Guide for Adolescents
Yuko Yoshida M.D.
Foreword by Lorna Wing
Translated by Esther Sanders

How to Be Yourself in a World That's Different is an accessible guide to Asperger's Syndrome (AS) written for young readers who have been diagnosed with AS and other autism spectrum conditions.

The book features a clear explanation of the condition, including symptoms that are common to people on the autism spectrum, such as a hypersensitivity to touch and difficulties with balance and coordination. The characteristics and symptoms of other syndromes that often coincide with AS are also discussed, for example AD/HD, learning disorders, and tics, as well as the temporary states of mental dysfunction that people with AS tend to be predisposed to, including depression, anxiety, obsessive and compulsive behaviors, and catatonia.

This informative and encouraging text highlights the positive aspects of autism spectrum conditions, such as diligence, fairness, and a knack for unique ideas, but it also acknowledges the daily challenges faced by young people with AS and, crucially, offers strategies for dealing with these. Using case examples, Yoshida explores the difficulties of disclosing a diagnosis, takes readers through the stages of practicing key social skills, and offers advice on seeking support.

Other definitions and descriptions of Catatonia:



Catatonia in those with autism

 

Roy H.

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You know, I've been searching my entire adult life (20 years) for an answer for what I have been horrifically condemned with. And I think I might finally be getting some answers on my horror.

Can you explain this more fully?:

catatonic episodes triggered by acute anxiety, depression or bipolar


I swear it on my life I feel like I'm finally getting an answer(s) on my horror for the last 20+ years.


What do I do now?...I don't know how I can explain this, or who to see about it, or if there is no SURE answer or just vagueness regarding this state of mind that seems to freeze me up when I'm in social environments.


I feel like for the first time in my adult life I might finally be on the cusp of some answers regarding what has plagued me...
 

David Baxter

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This was posted by Donna Williams some 14 years ago now, Roy. I have edited her post to provide links to the materials she cited and to her own website.

Donna Williams was her pen name. Her birth name was Polly Samuel and unfortunately she passed away in 2017.

To your specific question, I don't pretend to know a lot about catatonia but you may find more information here:

catatonic episodes triggered by acute anxiety, depression, or bipolar disorder - Google Search

Are you saying that you have experienced catatonia personally triggered by anxiety, depression, or bipolar disorder?
 

Roy H.

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Are you saying that you have experienced catatonia personally triggered by anxiety, depression, or bipolar disorder?

Is "catatonia" an experience/episode where you feel like your eyes/mind/brain "freeze up" (so to speak) when you are communicating or attempting to communicate with another person?

---------- Post Merged at 11:23 AM ---------- Previous Post was at 11:19 AM ----------

I don't think I have autism, I am almost certain of that. My mother was bi-polar, though, and committed suicide not long ago.

My father has always been very shy.

I have always felt I had some form of paralyzing anxiety (I won't go outside so as to avoid communicating with neighbors or friends or family, for example, even at times when I desperately want to) and the eye contact thing was another symptom of that extreme anxiety, though I have never been able to find answers to any of this trauma I've self-medicated since I was probably 21 years old.
 

David Baxter

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Is "catatonia" an experience/episode where you feel like your eyes/mind/brain "freeze up" (so to speak) when you are communicating or attempting to communicate with another person?

No it's a bit more extreme than that. It's not just your brain freezing up... it's a freezing of the muscles, lack of movement.

You might find these helpful:

catatonia dsm 5 - Google Search

catatonia - Google Search






I don't think I have autism, I am almost certain of that. My mother was bi-polar, though, and committed suicide not long ago.

My father has always been very shy.

I have always felt I had some form of paralyzing anxiety (I won't go outside so as to avoid communicating with neighbors or friends or family, for example, even at times when I desperately want to) and the eye contact thing was another symptom of that extreme anxiety, though I have never been able to find answers to any of this trauma I've self-medicated since I was probably 21 years old.

To me, this sounds more like agoraphobia or severe social anxiety (NOT a diagnosis, just an observation).
 

Roy H.

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No it's a bit more extreme than that. It's not just your brain freezing up... it's a freezing of the muscles, lack of movement.

You might find these helpful:

catatonia dsm 5 - Google Search

catatonia - Google Search








To me, this sounds more like agoraphobia or severe social anxiety (NOT a diagnosis, just an observation).


When I look at the symptoms of agoraphobia, I don't think that describes me. Though I could be wrong about that.


Is "severe social anxiety" an official term, or something that can be defined by specific symptoms, and a term that is officially used to describe people with a certain kind of mental health issue?
 

Roy H.

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There's a chance I might go on the street, if/when my dad dies. I just struggle so much with social anxiety that bad.


I wish it wasn't that way, and I swear on my Mother's life I never wanted it to be this way, but are there any resources for me if I wind up on the street with a mental health crisis? Do I have to be officially diagnosed as mentally ill to have access to any resources?
 

David Baxter

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are there any resources for me if I wind up on the street with a mental health crisis?

I don't know how it works in the US. In Canada, some (albeit limited) resources are available in ER if you're in crisis.

Do I have to be officially diagnosed as mentally ill to have access to any resources?

For longer term services, probably yes. Does it bother you to have a diagnosis?
 

Daniel

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By the way, if you live in Hennepin County, they seem to have one of the most progressive county mental health systems:

Mental health relief without having to wait | Star Tribune

In any case, you seem to be living in a good area for accessing mental health services. Usually, the key is using them before it becomes a crisis since prevention is always better.
 
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David Baxter

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How do you mean?

Am I afraid to have the label of "mentally ill" following me around for the rest of my life?

"Mentally ill" is not a diagnosis.

"Generalized Anxiety Disorder" is a diagnosis. So is "Social Anxiety Disorder" or "Panic Disorder".
 

Roy H.

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"Mentally ill" is not a diagnosis.

"Generalized Anxiety Disorder" is a diagnosis. So is "Social Anxiety Disorder" or "Panic Disorder".

I don't know. I guess I would like to have some sort of definition for why I have irrational actions like I do (staying inside when someone is outside that I do - or in some cases don't - want to avoid). I'd like to have some answers to that.
 

Daniel

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By the way, with any anxiety disorder, the resulting chronic avoidance becomes a habit in and of itself. So the disorder takes on a life of its own, such as with self-reinforcing habits leading to a depressing lifestyle. So even little changes, such as with cognitive behavior therapy, can have a big positive impact over time.

An example of behavior therapy for anxiety:

FEAR

Do what you are afraid of doing....OVER AND OVER AND OVER.
Approach events, places, tasks, activities, people you are afraid of.
Do things to give yourself a sense of CONTROL and MASTERY.
When overwhelmed, make a list of small steps or tasks you can do. DO the first thing on the list.

Opposite Action
 

Daniel

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Similarly:

David Baxter said:
No, you're not "to blame" for your anxiety any more than you are "to blame" for your hair color or eye color.

But depending on how you react to anxiety triggers, you can either make the anxiety better or worse - that in fact is the basis for cognitive behavior therapy (CBT).

Am I to blame for my anxiety?
 

Roy H.

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This fellow seems to sort of be describing some of the issues I'm having. I don't know how to navigate this page so I can't see what the original poster was saying/asking.


As the son and former caretaker of someone with extreme mental illness, I feel I should weigh in here.

What you describe sounds similar to mind catatonia or catatonic state, sometime considered a form of schizophrenia, though this is dependent upon other comorbid symptoms.

Have you talked with psycho-therapist or psychiatrist regarding this problem? If so, what was their suggestions? What, if any, was their diagnosis?

I don't believe this is something that can simply be handled like a bad habit that needs to be broken... neurological disorders don't often respond well to being handled in that way.

Nor do I agree with the suggestion to 'deliberately look people in the eyes'. While this is generally considered a body-language descriptor action of 'honesty' when one is engaged in discussion, at a more primal level, it's considered aggressive, sort of akin to a dog staring down another dog. At the primal level of the mind, staring makes people uncomfortable for this exact reason, and so inappropriate eye contact can actually illicit a violent response from someone that is, for example, mentally attuned to their instincts more than to conscious thought.

The suggestion of sunglasses is a good one actually, especially if these episodes occur without you realizing that it's about to happen. At least your eyes would be concealed and make others less uncomfortable, which I believe is what you were asking.

The reality of problems like this are that while they can be managed, there's no real cure or even a treatment that will abate the behavior if the behaviour has an underlying subconscious trigger mechanism. First, the underlying condition causing or leading to the undesirable behavior will need to be addressed, which in turn will lead to a better understanding of yourself, and what leads to these episodes... what triggers the 'blank state', as you've described it.

It's not the first I've heard of this condition though... friends of mine used to call it 'zoning out', but really, I think it's more than that... I think one becomes so immersed in their thoughts that ocular stimuli processing by the brain takes backseat to what the brain is otherwise focused on.

How to deal with my disorder so that I dont make other people uncomfortable - Quora


The bolded above literally seems like they're describing what I go through.
 

Daniel

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Some of the other responses there seemed more appropriate, e.g. normalizing.
 

Roy H.

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Some of the other responses there seemed more appropriate, e.g. normalizing.

The "Zoning out" thing - some times when I'm looking someone in the eyes or something or whatever...I've never been able to articulate what happens but some times I can just feel peoples' stomachs turn. It's like I'm looking at a ghost or when they are looking into my eyes they are looking at a ghost or looking into my soul or something.


I just wish I could articulate what they hell is going on with me. To this day I can't...going on 25 years now.
 

David Baxter

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Roy, seriously, if this concerns you request a referral to a qualified mental health practitioner. Trying to diagnose yourself online is pointless and will do nothing for you except increase your anxiety. This is one area where Google is NOT your friend.
 

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