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Ever the arty Autie

Catatonia in those with autism?

February6

Moving House by autistic artist Donna Williams 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’s 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 in autistic individuals 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 *)
www.donnawilliams.net
autistic author of 9 books in the field of autism,
consultant and teacher.

From the National Autistic Society:

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=298&a=3346&view=print

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.

another article
whilst the traditional picture of Catatonia is stillness, catatonic episodes can be far from still…..

catatonia

http://www.questia.com/library/encyclopedia/catatonia.jsp?l=C&p=3

catatonia (kĂ„Ć’t”utĂ…ÂŤ’nÄ“u) [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

Paperback, ISBN: 9781843105046, 112pp, 2006, Ă‚ÂŁ9.99, $14.95

BIC: JCD VFPD YXRH
description contents

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:
http://en.wikipedia.org/wiki/Catatonia
http://www.emedicine.com/neuro/topic708.htm

Catatonia in those with autism

http://bjp.rcpsych.org/cgi/content/full/177/2/180
http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=298&a=3346&view=print
http://www.neurodiversity.com/inertia.html
http://www.psychiatrictimes.com/Children-and-Adolescents/showArticle.jhtml?checkSite=psychiatricTimes&articleID=193005692

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10619284&dopt=Abstract
http://www.jkp.com/catalogue/book.php/isbn/9781843105046

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Donna Williams *)
Ever the arty Autie.
http://www.donnawilliams.net  http://www.auties.org
posted under Autism, Donna Williams