What is depression coma (a complete guide)

In this guide, we will discuss what is depression coma or catatonic depression, its signs and symptoms, causes,  treatment and recovery options for the individual.

What is depression coma

Depression coma is also known as catatonic depression in the clinical terms.

Catatonic depression is a form of depression that leads anyone to stay speechless or motionless over a prolonged period of time.

The catatonic disorder is a subgroup of depression marked with not speaking and being somewhat in dizziness for an extended amount of time. An individual with catatonic depression will not react to whatever is happening all around them and can be mute and immobile.

Catatonia is a category of conditions that typically include a lack of mobility or speech, but can also involve anxiety, distress, and disorientation. Until recently, it has been thought of as a form of schizophrenia. And nowadays physicians realize that other mental disorders and diseases that give away the body’s metabolism will also make you catatonic. Around 1 in 10 people with serious mental disorders will have catatonia at a certain point.

Catatonia may even be managed, but if it is not, it can cause long term complications.

What are the signs and symptoms of depression coma

Catatonia is a condition that involves several common clinical symptoms, most of which are relatively wide in nature. Possible symptoms could include:

• Stupor: Probably the most common symptom is that of stupor. Stupor is associated with a lack of communication and responsiveness.

• Posture: Individuals experiencing catatonia were able to stay in the very same posture for a substantial amount of time.

• Waxy Flexibility: The physician who is treating anyone with catatonia is able to place the client in a very awkward position that the patient will have to hold for a long time.

• Negativism: Efforts to shift one of the limbs of the catatonic individual are resisted proportional to the amount of pressure applied.

• Automatic obedience: People with catatonia immediately follow all orders given to them.

• Ambitendency: The individual with catatonia switches between agreeing with and refusing the orders of the physician.

• Psychological pillow: The catatonic entity lays down with his neck a few inches off his bed, much like an imaginary pillow lying beneath his head. This state can be held for an extended length of time.

• Forced grasping: the person constantly and forcefully holds the hand of the investigator when it is provided.

• Obstruction: The catatonic person abruptly ceases in the midst of a step with no clear excuse to do so.

• Echopraxia: This includes imitating the acts of the person talking.

• Aversion: A person with catatonia looks away when he is talked to.

• Mannerisms: This symptom requires repetitive, purposeful gestures (e.g., shaking hands).

• Stereotypies: People with catatonia often participate in repetitive, non-purpose gestures (e.g., rocking).

• Engine perseverance: Individuals with catatonia may keep making a specific movement sometimes though it has lost its initial significance.

• Excitement: Other characteristics of catatonia entails intense and purposeless movement that is not driven by external stimuli.

• Speech abnormalities: Speech can display certain anomalies, including imitation of what other people are saying or tiresome talking.

Catatonic depression can also be described by other signs of depression, such as low energy, feeling helpless, decreased focus, and sleep disturbance.

What are the causes of depression coma

Doctors don’t understand what causes catatonic depression, but there are several hypotheses. Many scholars suggest that the signs of catatonia and depression are due to the absence of dopamine. Dopamine is a mood-related neurotransmitter in the brain.

Depression can be caused to a mixture of many causes, including:

• Shifts in brain development or activity may make the mindless receptive to such hormones.
• Family medical history of depression or other psychiatric disorder 
• Life-changing events, such as the loss of a loved one or a separation.    
• Ongoing medical disorders, like psychological disorders, severe pain, chronic disease, or ADHD.

Studies have concluded that depression is partially caused by the erratic development of neurotransmitters. Neurotransmitters are brain chemicals that cause cells to interact with one another.

Serotonin as well as norepinephrine are the most important neurotransmitters related to depression. Antidepressants including certain selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) operate by working on these two unique chemicals.

Catatonia is assumed to be induced by abnormalities in the dopamine, gamma-aminobutyric acid (GABA), and glutamate neurotransmitter systems. It is also caused by severe neurological, mental, or physical disorders.

What are the types of depression coma

There are three kinds of catatonia:

Akinetic catatonia

This is the most popular thing. Someone with akinetic catatonia sometimes looks blankly and doesn’t respond when you talk to them. If they answer, it can only be to reiterate what you have just said. Often they sit or lay in an odd spot and they’re not going to move.

Excited catatonia

For this sort, a person can walkabout, but their action appears futile and hyperactive. They may appear distressed, hostile, or hallucinating, or they may copy the gestures of those attempting to reach them.

Malignant catatonia

This form arises when conditions cause other health issues, such as harmful blood pressure changes, skin temperature, or pulse or breathing rhythm. Person who has been catatonic for a over a period of time may be more susceptible to severe conditions such as dehydration, blood clots, or renal failure due to complications.

How to diagnose depression coma

Sometimes, an individual with catatonic depression is unable to answer questions that the psychiatrist may ask. As a result, a psychiatrist can begin an evaluation by asking his family and friends about the signs. The therapist asks when the signs first developed and what made them worse or better. Your psychiatrist would likely want to rule out any psychiatric problems that have signs similar to catatonic depression. For instance, a disorder called neuroleptic malignant syndrome can occur when an individual has an allergic reaction to antipsychotic drugs. This disease has signs identical to catatonic depression.

The physician may also request mri scans to ensure that the person also doesn’t have a brain hemorrhage or some other disorder that may induce catatonia.

The physician will also analyze the posture of an individual, listen to any contact they might make, and monitor their movements.

What are the treatment plans for depression coma

To treat catatonic depression, the appropriate medications and treatment plans available are:

Benzodiazepine

Benzodiazepines is a class of psychoactive medications that improve the activity of the GABA neurotransmitter. In several patients, these treatments are beneficial for immediate relief of catatonic symptoms, like agitation, muscle spasms, as well as insomnia. That being said, benzodiazepines are often extremely addictive, so they are typically used as a short-term recovery tool.

Electroconvulsive therapy

Electroconvulsive therapy (ECT) seems to be the most appropriate treatment for catatonic depression. It requires connecting electrodes to the brain that transmit electrical signals to the brain and cause a seizure.

While ECT has been recognized as a safe and successful medication for a variety of mood disorders and psychiatric conditions, there’s still some general fear. As a result, benzodiazepines are generally the preferred therapy for catatonic symptoms.

N-methyl D-aspartate

Many studies have shown that N-methyl-D-aspartate (NMDA) could also be used to control catatonic depression significantly. NMDA is an amino acid analog that imitates the action of the neurotransmitter of glutamate. While it looks to be a potential form of therapy, further researches are required to resolve its feasibility and health risks properly.

Repetitive magnetic stimulation of the transcranial (rTMS)

Other therapies that have been shown to be promising are repeated transcranial magnetic stimulation (rTMS) and some atypical antipsychotics, especially all those who block dopamine D2 receptors. Even then, more analysis is needed to establish how beneficial these approaches are in helping patients with catatonic depression.

What are the complications in depression coma

Individuals with catatonia will be at risk of various risks if they are not treated.

Potential risks involve blood clots, contractures, or reduction of muscles or tendons, decubitus ulcers, dehydration, malnutrition, and possibly pneumonia.

What to do when someone has a depression coma

An individual with catatonic depression needs acute psychiatric treatment. A loved one will need to contact a mental institution or get urgent care services to help an individual get treated as rapidly as feasible.

If a person believes that their loved one is in a catatonic condition, they should call their primary care doctor or seek emergency medical treatment.

Although catatonia can be severe or life-threatening, the prognosis is good with adequate medication. There is a deficiency of scientific research trials evaluating existing therapeutic options, the available evidence confirms the efficacy of both benzodiazepines and electroconvulsive therapy (ECT).

Prompt diagnosis and care at the outset of the catatonic condition are important for the higher results.

In this guide, we discussed what is depression coma or catatonic depression, its signs and symptoms, causes,  treatment and recovery options for the individual.

FAQs: What is depression coma

References

https://www.healthline.com/health/depression/catatonic-depression

https://www.medicalnewstoday.com/articles/322199

https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/coma