Doctor REACTS to Catatonic Schizophrenia (This is RARE)
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- Опубликовано: 1 апр 2024
- #reaction #drelliott #doctorreacts #psychiatrist #schizophrenia
Check out my Doctor Reacts to Bojack Horseman: • DOCTOR REACTS TO BOJAC...
Doctor Reacts to House MD: • Doctor REACTS to House...
This Doctor Reacts episode is looking at a historical medical video of a mental illness or mental health condition that we don't see as often anymore. This reaction is to catatonic schizophrenia. While we still see lots of catatonia in people with depression or neurological conditions, its much rarer to see it as part of schizophrenia nowadays. This is part of a psychiatric assessment of someone with catatonic schizophrenia where I can explain the symptoms and how we would treat it.
Let me know what you think and what other Doctor REACTS videos you'd like to see.
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I wish the symptoms were called "additive" and "subtractive" symptoms rather than "positive" and "negative ones. It would cause so much less confusion on the part of pretty much everyone
That's a good point. Many conflate positive and negative with being good and bad
That's an anglophone problem only. English being my fourth language, I can tell you nobody else argues for things like that (words being so vague that their use becomes ambiguous or confusing.)
I’ve seen catatonia schizophrenia once. Wild.
THANK YOU, I have been Catatonic and it is so rare to see anything about Catatonia at all and I loved your comments about understanding what helps a person stay well as opposed to just understanding their risk factors.
A little about my story for anyone interested in the Catatonic experience:
I suffered through Catatonic "stupor" for about 2 weeks in 2020. My disgnoses was/is Major Depressive Disorder & Catatonia. I was given put on an antidepressant and Lorazepam, which I have since learned is referred to as the "Lorazepam challenge". Eventually, it was decided my condition warranted an emergency ECT treatment, emergency in the sense that it began immediately on a weekend, instead of the regular ECT treatment days.
ECT was decided on by my Dad and a team of Psychiatrists after my condition deteriorated to the point I wasn't eating, barely drinking water and often needed to be moved into position, eg on one occasion lifted out of a wheelchair into my bed and I had kept the posture and body positioning of someone seated, needing to be pushed into a laying position and have my legs straightened out.
My experience was almost entirely negative symptoms. Waxy Flexibility, Catalepsy, slowed speech if any speech at all; with the occasional positive symptoms, almost exclusively Echolalia.
Please do more Catatonia content. It's a devastating disorder that many nurses and Doctors have zero experience with.
The prescribed benzos for catatonia? Weird.
Do you remember how it felt for you at the time?
@@moonlily1 This is something I’d really like to know as well. Of course, it is completely understandable if you don’t feel comfortable sharing - I have experienced a couple of, let’s say, strange and frightening psychiatric episodes myself, and I know that it’s a lot easier for me to talk about the situations as a whole rather than about my experience of them (partly because there simply isn’t much memory of the experiences to begin with, and partly because the little bits and pieces I do remember are tough to put into words in a way that makes any rational sense - much like trying to describe what happened in a dream).
Sadly you are correct. I had a catatonic patient and the psychiatrist didn't even know how to treat with benzo's and essentially did nothing till the patient needed hospitalization for malnutrition and the hospital started ECT treatment.
I've seen quite a lot of these old psychiatric "interviews" (I don't know a better word for it in English), and I've always wondered how they hold up today. So this is very interesting to see, I would love to see more reactions like this
I adore medical history! Seconded, these are great reacts
This is so interesting. I'm a psych BA who now just deals cards at a casino so I enjoy living my dream vicariously through the real deal ones pft. It's very interesting to hear about things like this, and it helps that it's more media-directed. You seem very sympathetic and thoughtful as you discuss it, too.
My daughter has schizophrenia, it is an awful illness that affects the whole family and friends of the sufferer. We need a cure; keeping the symptoms somewhat at bay with anti-psychotics and their devastating side effects is not good enough.
I agree. We've really struggled to translate our greater knowledge about how the illness works into novel treatments that actually work
I know this is blunt, but there is no cure. Even the treatments are sporadic. Mental Illnesses and issues are beyond our capabilities for all of us including doctors.
@@TheRevWillNotBeTelevised There was no cure for tuberculosis until the 1940s. Just because there's not a cure now doesn't mean there will never be.
I hope you don't mind me jumping in, but I just wanted to say that even though schizophrenia is chronic, like any chronic illness it goes through relapses and remissions. My mum has schizophrenia and was really bad for most of my childhood and 20s, but she is now on a medication regime that is mostly working for her, and her non-psychotic mental health is way better than when I was younger (anxiety and depression), and she has friends and a paid job for the first time in years. She still has symptom flares, particularly when she's stressed, but it's not her whole life any more. There are still challenges - she doesn't understand that she has schizophrenia, and she has to be on a depo shot for compliance - but I want you to know that it can improve. Not go away - again, it's a chronic illness and will always be there - but it won't always be the totality of the sufferer's life.
I know that my mum is not your daughter, and I know that my mum has other factors that influenced her symptoms that improved when they were addressed (e.g. starting to heal from trauma, anxiety improving, being in a better living situation). I just wanted you to know that it CAN remit, and it CAN improve, particularly once a tolerable medication regime is found, and particularly when the whole person is being treated, not just the disorder. Don't lose sight of your daughter in the disease - she's still in there too, I promise.
I hope I'm not overstepping, and I'm not trying to make light either - it really can be hell, believe me I know. It's just that TheRevWillNotBeTelevised's comment was so definitive, and I wanted you to know that it's not all hopeless.
@@csharpmajor4810 I think TheRevWillNotBeTelevised is on some kind of religious high horse
I loved this guy from the first day I saw him. I am 31, and spent some days in a mental facility in 2012 over a psychotic outbreak. The respect that you, doctor, show for this guy in this video is what is warranted from every doctor but not always found.
I learned from this video, aside from many interesting facts, that my autism is not the worst scenario as I so selfishly pitied myself and blamed doctors for it.
Time to keep growing.
Great video ❤ greetings from Argentina
The analysis of this man's speech reminded me that, many years ago, I knew a linguist who did some really interesting studies regarding the psychiatric diagnostic criteria relating specifically to speech. The work she was presenting at the time involved testing the speech patterns of hospitalized schizophrenic patients, using both patients hospitalized with major depression and a group with no known psychiatric disorders as controls (sadly, due to how long ago this was, I can't remember the specific methods she used to test the speech patterns of the subjects).
Anecdotally, in that particular study, I remember she found one patient diagnosed with schizophrenia whose linguistic abnormality did not fit with the rest of the subjects, which caused her to suspect they might have been misdiagnosed. Sadly, that patient committed suicide soon after, and we'll never know whether or not she was correct or if her methods might have helped them.
Still, I believe that having scientists whose field of study is (in this case) language take their specifically created tools and attempt to apply them to this one aspect of psychiatry (or, really, any field where language plays a part in diagnoses) could potentially really help professionals in that field fine tune the process. I haven't been in academia in many years now, but I hope more people are doing such work, as it really was in its infancy at the time.
Wow. What you described re: catatonia sounds very much like an autistic shutdown with selective mutism. I describe it as being blank - it’s just like a white page with a blinking cursor in my brain. The internal narrator is gone and words are gone as well. Fascinating!
This is so interesting. There's a similar video of that time about bipolar I believe. Really fascinating as well. Both illnesses are so severe and often misunderstood. I have bipolar.
I really want you to react to the psychiatrist in Terminator 1 & 2, the scenes are great, especially in Terminator 2, but when I watched T1 recently I was like, man, he's awful. Yea he thinks he's delusional, but he's mocking him to his face, which is probably the worst way to approach that.
i agree! I recently watched T2 and was stunned by the way he talked to Sarah and about her in FRONT of her. I was like no fucking way
Babe wake up, new Dr Elliott Carthy video just dropped
:D
@@DoctorElliottCarthy :3
I recognize a part of the symptoms that I sometimes have when I have a lot of stress and anxiety. I am then unable or have a hard time moving, also speaking is very hard or just not possible. so far I had it just for a short period of time and human contact seems to help to get out of it. I don't have psychosis and never had but am autistic and have ocd
It always sticks out to me when I hear MH professionals talk about chlorpromazine no longer being commonly used in the UK. I was given it a decade ago when I was 17 to treat psychosis/ mania during an inpatient admission and was shocked later to hear that is rarely reached for nowadays. I find it a little uncomfortable that they were so quick to treat me with it when I was under 18 and would be interesting to know if anyone has had similar experiences
This was incredibly educational! Thank you
We watched this video in a lecture about Schizophrenia recently, so it's super cool to see you reacting to it!
I'm also writing my bachelor's project on Schizophrenia, so this is a gold mine for general understanding😊
Thanks, I really like your takes on these sorts of "old interviews".
I have severe depression, AVPD, cPTSD, chronified eating disorder and lots of anxiety. About thoughts, I rather have the opposite issue, often having them bombarding me mercilessly. I sometimes stuggle with speak blockage though (meaning I have the words in my brain but I just can't say them for a while) and/or word finding problems. I hate it with a passion. I am generally really bad at "tolerating the silence", which does not help me at all, because stressing myself makes it only harder to get these words out. If it gets really bad all that comes out is "eh...eh". It's like watching myself from outside and wanting to madly push myself to get things going.
Just watching this video and the poor man makes me only gain more respect for the profession of the psychiatrist. To tell the difference between a brain that is overflown with thoughts or a barin that has thought blockages, when from outside you just see a person taking a lot of time to say something must need very good observation skills. Not even to mention the patience and ampathy with patients.
ABout the lack of movement, rather recently (since a few monts) I found to have moments where I cannot move a single muscle for a while. It somehow similar to the thought blockage in the way that its light obeserving myself from outside, yelling at myself and calling me names. Like "Just move that arm NOW...". It most often happens when getting up from bed, where I'm half sitting, sometimes in uncomfy positions and just need to shout at me internally for severel seconds until I finally get to move. Often then it's sudden, like "hep" and the whole body "overmoves" almost. I guess it's linked to my depressive state, but it's annoying. And scary too. Also, as I live alone, I don't really know how long they last. The watch hardly helps, since I can't predict them I have no "starting point" for a reference.
I can't help but wonder how is the psychological strain for the patient in the video about his symptoms?
As I said, I am painfully aware of my "mute" and "immobile" moments and they freak me out.
Sorry for digressing.
I did not know of that sort of complete absence of thoughts before. So I learned that exists too.
I really enjoy these types of videos , we can learn so much about mental health and the symptoms people experience with these type of illnesses. Truly educational and to understand the workings of the mind. ❤ very very complex and we need to get better at understanding mental health in general. ❤
Your enthusiasm and general demeanor makes me want to have a beer with you and discuss life! Hope you're well and keep up making the world a better place ❤
Fascinating, what really stands out to me as an amateur, is how well spoken and articulate this individual is, yet its still hard to follow his reasoning. I was really impressed how quickly you were able to dissect his behaviour, and the therapists as well.
I noticed in your videos, you spoke quite often of delusions. In the show 'Legion' they have this great narration by Jon Hamm on the nature of delusion, reality and madness. There even are compilations of all the monologues on RUclips. I really like the one 'facets of delusion', a 16 min video, I think it would provide some great topics to talk about on your channel.
Pleb here, but I watch this video before and was not aware of the symptoms of this diagnosis. Therefore I was left thinking he was an odd fellow but nothing overtly concerning and was confused where schizophrenia was on display. I also thought catatonic was similar to being in a coma.
These videos are truly fascinating. Thank you Elliot. I wish I was 20 years younger as this field would be great to work in. I’m currently helping a friend who is struggling with severe personality disorder and off his meds. Found it so interesting how the symptoms seem like bipolar. When I actually get thru to my mate ( it’s like he has masks ) he has so much disgust for himself. Doesn’t understand why we all love him. He was adopted, so I guess this would have been attachment disorder as a child?
I learned something! Thanks for the SAPROF recommendation keen to look into this more
A little addition - something I've seen a few times in our MH service is catatonia which is later diagnosed as severe burnout related to ASD (level 2). Curious whether the same pattern emerging in the UK
It is very interesting the overlap between conditions. I have FND. When I have a dissociative episode or after a seizure by behaviour is very similar to what you can see in the video. I am sat very still and very stiff. Often my upper lip will curl up. My speech is very delayed and strained if I am able to talk at all.
Please do more of these videos.
I was wondering if this was an actor for the training video, because the presentation seemed a bit off when comparing it to when my mum was dealing with these symptoms. But based on the comments, it seems this is a real patient, and I realise I'm a) comparing it to literally just one other person, and b) my mum was never treated with benzos, she just cycled out of it, and I'm assuming a medication that strong would definitely affect the presentation. A good lesson for me to not generalise too much.
Thanks for these videos. I'm ashamed to say encountering depictions or discussions of schizophrenia/psychosis is triggering for me because of my mum, but I'm working on it by giving myself the choice to engage when I'm feeling safe. If you're doing any more videos on the topic, it might be interesting to look at neologisms/word salad, because I think that that's a symptom a lot of people aren't aware of if they haven't experienced or seen it. Separately, I saw several comments on this video from people about the similarity of thought-block and inactivity symptoms during periods of high stress, so maybe it would be interesting to have a video on how executive dysfunction and dissociation and/or overwhelm can manifest during the fight-or-flight response and why these are different from catatonia?
Will I ever write a short comment? Deep sigh :P
Fascinating.
On a complete aside, what's your thoughts on Prophet Song and The Bee Sting. I met both authors in Dublin recently and have finished Prophet Song and working my way through the other. I assume you're a fan as they're prominent behind you!! :)
I get thought block often, typically while under any kind of stress.
I learned that there is such a thing as catatonic schizophrenia, I learned that thought blocking is a thing, and a thing which I (and probably most people) have experienced to a tiny degree
These videos were made to present a 'standard" patient for medical students to learn from. So the interview wasn't necessarily what you would expect in actual therapy, but simply to elicit the behavior and responses that are diagnostic of the illness. Thought blocking, slow response, paranoid and grandiose beliefs, rigid posture. Benzos were known as the treatment for catatonia since the 30s, so it is safe to assume after 3 months in hospital his catatonic symptoms would be significantly improved, while the antipsychotic medications were still very new at this time so the patient is still dealing with significant symptoms of his schizophrenia.
I just did me a learn: At first I thought it strange describing some of these symptoms as “positive”, I’d never heard symptoms which are additional to normal neurotypicality described as “positive” and the the reverse as “negative”
I used an audio clip from that video once to mash up with a song from Chris Bear/Daniel Rossen from the "Past Lives" soundtrack
As a forensic psychiatrist it would interesting to hear your opinions on video by channels like Explore With Us or School of Life.
Can thought blocks be due to absent seizures? I deal with these regularly and I’ve always wondered whether it was my epilepsy or my mental health
That's interesting. I'm pretty much unable to think when I have a migraine. I wonder if they're related.
I like you're thinking here but we don't know the answer to that. Interestingly we know that some seizures (tonic clonic ones not absence ones) can improve the symptoms of psychosis so the relationship between conditions like schizophrenia and epilepsy is really interesting.
You've possibly answered this somewhere else but where's the yellow guy in your lego display? is he missing or taken away?
as a doctor is it easy to differentiate between thought block and being guarded or paranoid?
It might take some time and a few conversations but yes when you look at the broader symptoms that someone has you can usually tease them apart without too much difficulty
I know thought block isnt a positive thing for a human being, but as someone who suffers from cPTSD and ADHD, my brain is LOUD! Like, constantly filled with hundreds of different disjointed thoughts, varying from light and happy interest to dark moments from trauma. Constantly. All day. All night. I only get a mild break when sleeping, but that comes with its own issues (night terrors). I'd love just a day of silence in my brain.
I wish meds were an option, but my insurance has made it a struggle. They have many steps before they'll test me, which is hell considering the ADHD x_x
i love these videos! I upload them to create an archive for people to be able to watch and learn from the past
Hahah here (The Netherlands) Haldol is still the first go to drug for many inpatients. Hopefully we also soon are moving on from that medication as first option.
I'm struggling to think of many scenarios nowadays where I would reach for haloperidol
@@DoctorElliottCarthy The mental health care system is just really broken here.
We put still kids and adults in crisis for month's in solitary confinement. (police cells) Just because there are no beds. Is this recommended? Not really. Does it works. Atleast for now? Hmm kinda? 🤷🏼♀️
I'm afraid this is also why Haldol is still used here as much as it is.
I've watched heaps of these apparent training vids & its so much better watching you explain them. For example, i didn’t know the psych was probing this guy to suss out the delusions. I thought he just didn't understand what was being said 😂
My autistic ability to understand what's actually happening in any given moment is so subpar 😂
I hope you do many more of these! It's great having the education on what's going on in the educational vids 😁
Please react to the episode "Fishes" from the second season of The Bear!
Totally unrelated, but your hair looks awesome.
Thanks 😅
I wondered if the long pauses could be related to hallucinations being distracting and he's attempting to separate reality from hallucinations
i have seen this long time ago. and thought since he is catatonic when he plays piano to sit he thinks he is play the piano, but actually just sits in front of piano and do nothing.
does anyone know what he did to get the diagnosis? or is it just him talking and acting that way defines him as catatonic?
lots of internet rumor on this, but one claim by a supposed family member matches nearly 100% with what doctors would expect of a person with this diagnosis. The claim was the patient would sit or stand motionless for hour to days without eating or drinking. His family would put him in the nicest inpatient facilities they could and the patient would improve until he could be safely discharged home. Eventually he would get delusions that the medication was bad or wasn't helping him and he would stop taking it. He would then develop pretty severe paranoid delusions before he would wind up again in a catatonic state. Eventually around 40 years old he self harmed while in a psychotic episode and ended up dying.
Once upon a time, schizophrenia was just a convenient diagnosis for a host of conditions that today are better understood and more elegantly categorized.
Feel bad for this gentleman this is no way to live a life... thank God for the injections I take
Hello Doctor,
Was this mans' name Christopher?
Regards,
L.R.
Update: indeed. Christopher is mentioned at 08:00 in the free documentary Pennhurst Asylum on RUclips.
really? I treated a tire catatonic schizophrenia pt in Philly when I was an intern, really smart human wanted to go to medical school. They were mute for the longest time till there ws like 3 weeks of 15 mg of Ativan daily.
This is a little longer interview for funsies ruclips.net/video/6uPWatkbzJs/видео.htmlsi=gYIeMpuaEtk-010z
The approach was so cold back then. No bedside manner at all.
Benzo’s and anti psychotics. He’ll be a cool ass piano instructor I’ll give you that.
There is actually a comment on that video from somebody who claims that this was their uncle. Comment is below.
This is an old comment about this man that seems to have been lost: "This man was my uncle. I'm not going to give any names, but for those of you who are concerned with how things turned out for him, not well. There's so much to address here. First let me say that he was being treated in this video with meds. Without the medication his mood ranged from complete delusion to catatonic. As for being gay, I don't think he had much of a sex drive at all. With or without meds. As for the idea that he was put here because he was gay by some unloving family, that's ridiculous. I don't have time to say all the things my family tried just to make his existence somewhat peaceful just for his own sake. My family had a couple of openly homosexual and lesbians in it even back in the sixties and with the exception of my mother's father no one gave a shit. My uncle suffered with meds and even more without. After forty some odd years, most of which he spent in institutions, he took his own life by way of drug overdose. By the way, the comment about the plot twist, he never had a piano was funny because he didn't. His seeming obsession with piano came and went as did obsessions with religion, especially the Catholic Church and government. As far as I know he couldn't play a lick. He was very ill at his best and a living shell at his worst. I hope that answers some questions because that's all I have to say on the matter. He's been gone since the late eighties and I really hope that other members of my family don't see this video, mostly because of the comments from people that somehow think they understand him better than the people who suffered with him. One last thing, I think people thought that he was talking about sitting or standing effeminately or something. No, he was talking about sitting or standing motionless for hours. Usually not even his facial expression would change but when it did it was usually related to something in his mind only. I really can't begin to tell you all how heartbreaking the whole thing was. He did seem intelligent and with meds he did remind me of a high functioning guy with autism I once met."
Poor guy. Whoever started spreading these videos online clearly had no regard for privacy.
I have catatonic schizophrenia
The guy's skin is phenomenal.
I learned.. that my psychiatrist may be paying attention to the cadence of my speech 0_0
Thanks, doc! This was a really interesting video.
I also think you’d love ‘Please Like Me’! It’s very queer, has many portrayals of mental illness, and is quite short :$
I bet they gave him ECT.
Given the era you might well be right
Well ECT is one of best treatment out there for catatonia after high dose of benzodiazepines...
I feel that looking over presentations such as this with a more contemporary outlook of modern presentations and how this would be formulated if the case was presented today - and how that would be assessed, would lead to different patient outcomes and this case is a perfect example. For the context of my argument, i would pose that this case if assessed today could indicate autistic traits as we explore further the presentation of catatonia in autism thanks to Amitta Shah, the social communication difficulties displayed, the difficulties observed with eye contact and limited tone of voice added to the robotic structure of sentences and posture. Although given this appears to be American and taking into account the likelihood of there been strong sedation for compliance. I would love to see a video of these old recorded interviews or review of well documented clinical cases as a reformulation for entertainment purposes of closed cases. And especially reflecting on the development of the treatments offered.
I think it's important we learn from our history and as you have said, diagnoses and formulations change. The original definition for autism in relation to schizophrenia is v different to our understanding of ASD today
💖
They also had one of a woman with DID. That one was fascinating.
As a forensic psychiatrist it would interesting to hear your opinions on video by channels like Explore With Us or School of Life.
I watch Explore With Us videos and second this! Great content and cases that are covered , it would be interesting to watch a reaction video to EWU case.😊
ooooh I didn't know about this channel. I will most definitely check it out