What should you know about catatonic depression?

A person may become very still, stop speaking, stare, resist instructions, hold a posture, or appear unaware of surroundings. Others may show restless, repetitive, or purposeless movements. Depression can also involve fatigue, sleep disturbance, difficulty concentrating, anxiety, irritability, loss of interest, and changes in appetite. Catatonia is a medical and psychiatric emergency because immobility can interfere with drinking, eating, toileting, and recognising illness. It is not simply tiredness, insomnia, or a lack of cooperation, and the person may be unable to explain what is happening.

Arrange urgent medical assessment rather than leaving the person alone to recover without support. Stay calm, use short reassuring sentences, and reduce noise and demands. Offer fluids only if the person is awake and can swallow safely; never force food, drink, or medication. Note when the change began, medicines or substances taken, fluid intake, sleep, and any recent illness. A clinician may need to check physical causes as well as assess depression and other mental health conditions.

Call emergency services if the person is unresponsive, cannot drink, has breathing difficulty, develops a seizure, has severe confusion, or may harm themselves or someone else. Emergency help is also needed for a sudden change with fever, neck stiffness, or marked physical deterioration. Do not transport someone who is immobile or unsafe without medical guidance.

Ask what immediate risks need monitoring, whether medication or another treatment is suitable, and how to support eating, drinking, movement, and personal care. Discuss a safety plan, follow-up, warning signs, and who should be contacted if responsiveness worsens.