A catatonic episode is a medical emergency because of risks like dehydration, malnutrition, or self-harm.

See a Psychiatrist and or a Neurologist for more information.

Catatonia (or being catatonic) is a psychomotor syndrome — meaning it involves a disruption of movement and behavior that arises from a psychiatric, neurological, or medical condition. It’s not a disorder by itself but a state that can occur in various conditions such as schizophrenia, mood disorders (especially bipolar disorder and major depression), or medical/neurological illnesses.

Here’s a breakdown to help you understand it clearly:

 What Catatonia Is
Catatonia is a state of psychomotor disturbance characterized by abnormal movements, behaviors, or postures. A person in a catatonic state may appear frozen, unresponsive, or oddly repetitive in their actions.

⚙️ Common Symptoms (You Only Need 3 for Diagnosis)
According to the DSM-5, catatonia is diagnosed when three or more of the following symptoms are present:

Stupor — No psychomotor activity; not actively relating to the environment.

Catalepsy — Passive holding of a posture against gravity (e.g., arm remains raised when lifted).

Waxy flexibility — The person’s limbs stay in whatever position someone else places them.

Mutism — Little or no verbal response.

Negativism — Resistance to instructions or attempts to be moved.

Posturing — Voluntary assumption of bizarre or inappropriate postures.

Mannerisms — Odd, exaggerated actions of normal behavior.

Stereotypy — Repetitive, non-goal-directed movements (e.g., rocking, hand flapping).

Agitation — Excessive movement not influenced by external stimuli.

Grimacing — Strange facial expressions.

Echolalia — Mimicking another’s speech.

Echopraxia — Mimicking another’s movements.

🩺 Causes and Associated Conditions
Catatonia can occur with:

Schizophrenia (especially catatonic type)

Bipolar disorder (especially manic or mixed episodes)

Major depressive disorder

Neurological or medical conditions (e.g., encephalitis, metabolic disorders)

Substance use or withdrawal

 Treatment
Catatonia is a medical emergency if severe (especially if the person stops eating or drinking).

Common treatments include:

A catatonic episode is a medical emergency because of risks like dehydration, malnutrition, or self-harm.

See a Psychiatrist and or a Neurologist for more information.

Treating the underlying condition (psychiatric or medical cause).

Example
A person with bipolar disorder may suddenly stop speaking, stay in one position for hours, and resist movement. Despite appearing “frozen,” they may still be aware of their surroundings — this is a catatonic episode.

Shervan K Shahhian

Catatonia is a medical emergency if severe (especially if the person stops eating or drinking).

Catatonia (or being catatonic) is a psychomotor syndrome — meaning it involves a disruption of movement and behavior that arises from a psychiatric, neurological, or medical condition. It’s not a disorder by itself but a state that can occur in various conditions such as schizophrenia, mood disorders (especially bipolar disorder and major depression), or medical/neurological illnesses.

Here’s a breakdown to help you understand it clearly:

What Catatonia Is

See a Psychiatrist and or a Neurologist for more information.

Catatonia is a state of psychomotor disturbance characterized by abnormal movements, behaviors, or postures. A person in a catatonic state may appear frozen, unresponsive, or oddly repetitive in their actions.

Common Symptoms (You Only Need 3 for Diagnosis)

According to the DSM-5, catatonia is diagnosed when three or more of the following symptoms are present:

Stupor — No psychomotor activity; not actively relating to the environment.

Catalepsy — Passive holding of a posture against gravity (e.g., arm remains raised when lifted).

Waxy flexibility — The person’s limbs stay in whatever position someone else places them.

Mutism — Little or no verbal response.

Negativism — Resistance to instructions or attempts to be moved.

Posturing — Voluntary assumption of bizarre or inappropriate postures.

Mannerisms — Odd, exaggerated actions of normal behavior.

Stereotypy — Repetitive, non-goal-directed movements (e.g., rocking, hand flapping).

Agitation — Excessive movement not influenced by external stimuli.

Grimacing — Strange facial expressions.

Echolalia — Mimicking another’s speech.

Echopraxia — Mimicking another’s movements.

Causes and Associated Conditions

See a Psychiatrist and or a Neurologist for more information.

Catatonia can occur with:

• Schizophrenia (especially catatonic type)
• Bipolar disorder (especially manic or mixed episodes)
• Major depressive disorder
• Neurological or medical conditions (e.g., encephalitis, metabolic disorders)
• Substance use or withdrawal

Treatment

Catatonia is a medical emergency if severe (especially if the person stops eating or drinking).

 Common treatments include:

See a Psychiatrist and or a Neurologist for more information.

• Treating the underlying condition (psychiatric or medical cause).

Example

A person with bipolar disorder may suddenly stop speaking, stay in one position for hours, and resist movement. Despite appearing “frozen,” they may still be aware of their surroundings, this is a catatonic episode.

Shervan K Shahhian

See a Psychiatrist and or a Neurologist for more information.

Catatonia is a neuropsychiatric syndrome that affects a person’s movement, behavior, and responsiveness. It can occur in various mental and medical conditions — most commonly in mood disorders (like bipolar disorder or major depression) and schizophrenia, but also due to neurological or medical causes (such as infections, metabolic problems, or drug reactions).

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Core Features

Catatonia is characterized by a cluster of psychomotor signs — meaning abnormal or absent movement and speech patterns. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), catatonia is diagnosed when three or more of the following symptoms are present:

• Stupor: No psychomotor activity; not actively relating to the environment.
• Catalepsy: Passive induction of a posture held against gravity (e.g., holding an unusual position for long periods).
• Waxy flexibility: Slight, even resistance to positioning by the examiner, as if the body were made of wax.
• Mutism: Little or no verbal response.
• Negativism: Opposition or no response to instructions or external stimuli.
• Posturing: Spontaneous maintenance of posture against gravity.
• Mannerisms: Odd, exaggerated actions that seem purposeful.
• Stereotypy: Repetitive, non-goal-directed movements (e.g., rocking, hand-flapping).
• Agitation: Not influenced by external stimuli.
• Grimacing: Fixed or inappropriate facial expressions.
• Echolalia: Mimicking another’s speech.
• Echopraxia: Mimicking another’s movements.

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Types of Catatonia

1. Retarded (Stuporous) Catatonia:
   The person is immobile, mute, and unresponsive, often appearing frozen or statue-like.
2. Excited Catatonia:
   Marked by excessive, purposeless movement, agitation, and sometimes aggression.
3. Malignant Catatonia:
   A severe, life-threatening form with autonomic instability (fever, high blood pressure, rapid heart rate) that requires emergency medical care.

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Causes and Associated Conditions

Catatonia isn’t a diagnosis by itself—it’s a syndrome that can appear in:

• Mood disorders (especially bipolar disorder)
• Schizophrenia
• Autism spectrum disorder
• Medical or neurological illnesses (e.g., encephalitis, epilepsy, lupus)See a Psychiatrist and or a Neurologist for more information.
• Substance withdrawal or intoxication

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Treatment

See a Psychiatrist and or a Neurologist for more information.

Catatonia could be treatable, maybe when it is recognized early?

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 Clinical Importance

Catatonia may appear puzzling or dramatic, but it’s a reversible condition when identified early. Left untreated, it can lead to dehydration, malnutrition, or even death (especially in malignant catatonia).

Shervan K Shahhian

Crisis support: Please Get Immediate help if suicidal (911 in the US, or 988 Suicide & Crisis Lifeline).

Severe depression — often called major depressive disorder (MDD), severe type — is the most intense form of depression. It goes far beyond feeling sad or “down.” It’s a serious mental health condition that can significantly impair daily functioning, relationships, work, and even physical health.

Here’s a clear breakdown:

Core Features

• Persistent, overwhelming sadness or emptiness nearly every day.
• Loss of interest/pleasure in activities once enjoyed (anhedonia).
• Marked changes in sleep (insomnia or hypersomnia).
• Major changes in appetite/weight (loss or gain).
• Severe fatigue or loss of energy.
• Difficulty thinking, concentrating, or making decisions.
• Feelings of worthlessness, guilt, or hopelessness.
• Psychomotor agitation or retardation (moving or speaking slower, or appearing restless).
• Thoughts of death or suicide (this is a medical emergency).Crisis support: Please Get Immediate help if suicidal (911 in the US, or 988 Suicide & Crisis Lifeline).

To meet the diagnosis of severe depression, the symptoms are usually:

• Intense (stronger than in mild or moderate depression),
• Persistent (lasting most of the day, nearly every day for at least 2 weeks),
• Impairing (significantly interfering with work, school, social or personal functioning).

Specifiers & Variants

• With psychotic features: delusions or hallucinations (e.g., believing you’re worthless beyond reality).
• Melancholic features: profound lack of pleasure, worse in the morning, early awakening.
• Catatonic features: severe motor slowing or unusual movements.

Why It Matters

Severe depression carries the highest risk for suicide and physical complications. It’s not simply a mood issue; it’s a medical condition requiring prompt and effective treatment.

Treatment Options

Typically involves a combination approach:

• Medication: See a Psychiatrist.
• Psychotherapy: Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), or others.
• Advanced interventions: See a Psychiatrist.

Crisis support: Please Get Immediate help if suicidal (911 in the US, or 988 Suicide & Crisis Lifeline).

Shervan K Shahhian

Compulsive Buying Disorder (CBD):

Compulsive Buying Disorder (CBD), also called oniomania, is a behavioral addiction characterized by recurrent, excessive, and uncontrollable shopping or spending, often leading to distress, financial problems, or social/occupational impairment. It’s more than just enjoying shopping; it’s driven by a psychological urge that can feel irresistible.

Here’s a detailed overview:

1. Key Features

Preoccupation with buying: Persistent thoughts about shopping or planning purchases.

Loss of control: Inability to resist the urge to buy, even when aware of negative consequences.

Emotional triggers: Shopping often provides a temporary mood boost, distraction, or relief from negative emotions like anxiety, depression, or boredom.

Post-purchase guilt: Feelings of regret, shame, or guilt after spending.

Financial and social impact: Accumulation of debt, conflicts with family, and social withdrawal.

2. Psychological and Emotional Factors

Often associated with impulse control disorders or other mental health conditions like:

Depression

Anxiety disorders

Bipolar disorder

Obsessive-compulsive tendencies

Shopping can serve as emotional regulation, a way to cope with stress or low self-esteem.

3. Causes & Risk Factors

Biological: Possible dysregulation in brain circuits related to reward, impulsivity, and decision-making.

Psychological: Poor coping skills, low self-esteem, perfectionism, or need for social approval.

Social/Cultural: Consumer culture, advertising, and easy access to online shopping can exacerbate symptoms.

Trauma or stress: Childhood neglect, abuse, or financial insecurity may contribute.

4. Consequences

Financial: Debt, bankruptcy, unpaid bills.

Emotional: Guilt, shame, depression, anxiety.

Interpersonal: Conflicts with family/friends, secretive behavior, social withdrawal.

Legal: In extreme cases, theft or fraud to sustain buying behavior.

5. Treatment Approaches

Psychotherapy: Cognitive-behavioral therapy (CBT) is most effective; focuses on:

Identifying triggers and patterns

Developing coping strategies

Challenging dysfunctional thoughts about shopping

Medication: SEE A PSYCHIATRIST

Self-help and support groups: Organizations like Shopaholics Anonymous provide peer support.

Financial counseling: Practical strategies to manage money and prevent relapse.

CBD is considered a real psychological disorder, not just “bad spending habits,” and early intervention improves outcomes.

Shervan K Shahhian

Constant need for adrenaline rush, can it be dangerous:

Yes, a constant need for adrenaline rush — often called sensation-seeking behavior — can be psychologically and physically dangerous, especially if the individual consistently engages in high-risk activities to fulfill that need.

Potential Dangers:

1. Physical Risks (Seek the advice of a medical doctor)

Injuries or death: High-adrenaline activities like extreme sports, reckless driving, or drug use can lead to serious harm.

Health consequences: Chronic stress from frequent adrenaline spikes can lead to heart problems, high blood pressure, and weakened immune response.

2. Psychological Risks

Addiction to risk: Some people develop a dependency on thrill-seeking, similar to addiction, needing greater intensity over time to feel the same “high.”

Impulsivity and poor judgment: This can lead to dangerous decisions or antisocial behavior.

Underlying mental health conditions: Sensation-seeking may be linked to ADHD, bipolar disorder, or borderline personality disorder, where impulsivity and emotional dysregulation are common.

3. Social and Occupational Consequences

Damaged relationships: Repeated risky behavior can strain personal relationships.

Job instability: If the thrill-seeking spills over into the workplace, it can lead to job loss or legal issues.

What to Do If You or Someone You Know Is Experiencing This

Psychological assessment: A mental health professional can help determine if there’s an underlying cause.

Channeling the need safely: Adrenaline-seeking can sometimes be redirected into safer outlets like martial arts, obstacle races, or adventure sports done responsibly.

Mindfulness and regulation training: Techniques like meditation, CBT, and biofeedback can help manage impulses.

Psychological strategies to manage it:

To manage a constant need for adrenaline from a psychological perspective, the key is to understand the underlying drive and develop healthier coping mechanisms that fulfill the same need for stimulation — without the danger. Here are effective strategies:

 1. Understand the Root Cause

Is the adrenaline rush a way to escape boredom, avoid emotional discomfort, or feel alive?

Is there an underlying condition (e.g., ADHD, PTSD, bipolar disorder) contributing to impulsivity? (Seek the advice of a medical doctor)

 Journaling or working with a therapist can help clarify patterns and triggers.

2. Cognitive Behavioral Therapy (CBT)

CBT helps reframe thoughts like:

“I need a thrill to feel normal.”

“If I’m not on the edge, I’m wasting life.”

Through CBT, you can:

Identify and challenge distorted thinking patterns.

Learn to replace risky urges with constructive alternatives.

Practice delayed gratification and impulse control.

3. Mindfulness-Based Stress Reduction (MBSR)

Adrenaline junkies often seek intense external stimulation because they’re uncomfortable with internal stillness.

Mindfulness:

Builds tolerance for calm states.

Teaches you to observe impulses without acting on them.

Reduces emotional reactivity.

Try body scans, breathwork, or guided meditations daily.

4. Channel the Urge Safely

Find safer forms of stimulation that activate your nervous system without causing harm:

High-intensity workouts (HIIT, martial arts, rock climbing).

Cold exposure therapy (ice baths).

Time-bound challenges (escape rooms, tactical training).

Create a “thrill menu” of safe activities to turn to when urges hit.

5. Build Frustration Tolerance

The inability to sit with boredom or delay gratification is a common driver of risky behavior. You can strengthen this by:

Doing boring tasks on purpose and resisting the urge to escape.

Practicing “urge surfing”: Notice the wave of desire, ride it, don’t act on it.

Using delayed response techniques: “I’ll wait 10 minutes before deciding.”

6. Develop a Grounding Routine

Balance your highs with calming, routine practices:

Morning grounding (yoga, journaling).

Evening wind-down (reading, candlelight, slow music).

Daily nature exposure.

Consistency builds emotional resilience and reduces compulsive thrill-seeking.

7. Therapeutic Support

If the need for stimulation feels compulsive, or you’ve faced consequences from it:

Psychotherapy (especially DBT or ACT) can help regulate behavior and emotion.

Medication (Seek the advice of a medical doctor) may help if there’s an underlying disorder driving the pattern.

Shervan K Shahhian

Understanding Elderly Persons Mental Health Disorders:

Understanding mental health disorders in elderly persons is crucial for providing appropriate care, improving quality of life, and ensuring early detection and treatment. 

Here’s a clear overview of the key aspects:

Common Mental Health Disorders in the Elderly:

Depression

Often underdiagnosed in older adults.

Symptoms: persistent sadness, fatigue, sleep disturbances, loss of interest, weight changes.

May be triggered by isolation, loss, illness, or medication side effects.

Anxiety Disorders

Includes generalized anxiety disorder, phobias, panic disorder.

Often co-occurs with depression.

Symptoms: excessive worry, restlessness, tension, sleep issues.

Dementia

Includes Alzheimer’s disease and other types (vascular, Lewy body, etc.).

Progressive cognitive decline: memory loss, confusion, personality changes, impaired judgment.

Early detection is key for care planning.

Delirium

Acute and sudden onset of confusion.

Often caused by medical illness, medications, or surgery.

Reversible with timely treatment.

Substance Use Disorders (“Please Seek Medical Advice”)

Includes alcohol or prescription drug misuse (especially benzodiazepines or opioids).

May be overlooked due to stigma or misattributed to aging.

Late-Onset Psychosis

Can include schizophrenia-like symptoms or delusional disorder.

May be related to neurodegenerative diseases or underlying medical conditions. (“Please Seek Medical Advice”)

Contributing Factors to Mental Health Issues in the Elderly:

Biological: Chronic illness, pain, neurodegenerative conditions, medication side effects.

Psychological: Grief, trauma, fear of death, loss of autonomy.

Social: Isolation, loneliness, lack of social support, elder abuse.

Environmental: Institutionalization, poor housing, or inadequate caregiving.

Diagnosis and Assessment:

Comprehensive assessments should include:

Medical history and current medications

Mental status exams (e.g., MMSE, MoCA)

Functional assessments (daily living skills)

Family and caregiver input

Treatment Approaches:

Psychotherapy

Cognitive Behavioral Therapy (CBT), reminiscence therapy, supportive counseling.

Medication (“Please Seek Medical Advice”)

Antidepressants, anxiolytics, antipsychotics — but with caution due to sensitivity and side effects.

Social Support

Day programs, community involvement, family therapy, support groups.

Lifestyle Modifications

Physical activity, good nutrition, sleep hygiene, cognitive stimulation.

Integrated Care

Collaboration between primary care, mental health professionals, and caregivers.

Prevention and Early Intervention:

Promote social engagement and meaningful activity.

Regular screenings during routine medical visits.

Educate families and caregivers on warning signs.

Encourage open conversations about mental health.

Shervan K Shahhian