Catatonic Depression

Just recently I came across a case of Catatonic Depression. I had never encountered one before. To give you a good idea of what it is like I shall transcribe some of the dialogue that took place between the patient’s mother and myself:

MOTHER: “Hi Alfred, my daughter and I are now in Coffs Hospital while she has ECT to treat a sudden onset of catatonic depression, I am so distressed o read that the drugs they are treating her with can lead to clinical worsening of her condition and to neuroleptic malignant syndrome do u know much about this? I have to confront her Dr tomorrow to voice my concerns.”

ME: “Hi Jillian. All drugs have potential side efects and there is always a possibility of one or more of these occurring. Ask the doctor about the known statistics associated with occurence of side effects and make your best judgement. I would also enquire about success rate with ECT and possible side effects to be sure. Sorry to hear about your daughters condition. There is also a more recent treatment called Trans Magnetic Stimulation (TMS) though I don’t know how appropriate it would be in this case and if it’s yet available.

MOTHER: “Thank you Alfred. Jessie had her 3rd ECT treatment today, it is very stressful as we don’t know if she will respond & return to her happy self.  I read a bit on TMS last nite.Drs in Newcastle told me about its future use back in 1998. Jess was ok this morning & I was able to sit with her beforehand. She still has another 3 to 9 more sessions of ECT depending on how quickly she responds. I’ve read that people can recover from depression when they learn to accept the unpleasant things that life challenges us with and to learn how to navigate our way thru them and of course try to engage in as many pleasant activities as possible.I so admire ppl like u who take the time to write books about depression. One thing I learnt when Jess became helpless at Christmas and could not think or eat was to take myself down to her level and meet her at her point of need. I watched a male Indian nurse feed her water with a spoon when she finally by instinct opened her mouth a little and cupped her tongue to indicate that she was very desperate for water and he told her to swallow and was able to get half a cup of water into her within half an hour then taught her how to use a straw it was so incredible as he saved her life because the drs and nurses were procrastinating over giving her a drip. If she wasn’t classified as a mentally unwell person she would have been treated 36 hours beforehand without any stigma or hesitation and I am going to do my best to try and raise awareness to this problem and change the protocol and stop treating mental illness as . non-emergency healthcare. She has been left too long in a state of floundering and has suffered so unnecessarily while drs have experimented with changing her medication. Last week they finally admitted at the tribunal that they should have done ect back in November instead of letting it progress to a critical stage. I think other cynical psychiatrists got in the way of jessies treatment – one said we had brought it on ourselves!! Strangely one of the workers who hounded me in A & E was brought to Jessies ward at the end of December and sent to a private hospital, I knew she wasn’t treating me correctly and turns out she is an unsound person herself so who can we trust to help us in our time of need. Now everyone is helping us but I just hope Jessis condition isn’t reversible. Anyway I’ll keep posting Jessica’s progress as she hopefully recovers soon. Keep smiling Alfred”

ME: “Thank you Jillian. I’m glad things seem to be turning for the better.”

Then the patient had another downturn. I heard from her mother that she had slumped back into catatonia again. I replied:

ME: “Sorry to hear about the recent downturn. What is your daughter’s name? Good to have a name when extending healing to someone.”

MOTHER: “Jessica after not eating since brekkie yesterday I coaxed her eating her lunch today by feeding her myself!!! Seems I am teaching the nurses how to help people like Jessica as I’ve had same experience with her once before. So she is OK at the moment but she changes from day to day. I’ve learned with conditions like depression that we need to go down to their level and meet them at their point of need and throw away our perceived expectations of what WE think they are capable of and think about what they are capable of and to be prepared to do things for them, in western society we are sometimes not in touch with the reality of a persons inability to perform and we neglect to help them by thinking everyone is able to help themselves. We have so much pride. We had a nurse a few weeks ago who feed Jessica some water with a spoon when she opened her mouth as she could not manage to even pick up her cup, he taught me humility – he came from India & had probably feed his family members like this before and wasn’t fussed about protocol when it came to saving someones life.”

ME: “Thank you for your detailed account of Jessica’s struggle Jillian. This is my first exposure to a case of catatonic depression and it has made me very aware of the difficulties you, Jessica and the other carers are facing. I wish the best to you all.

MOTHER: “I will be writing an article once Jessica is home recovered.