Component 6. Early identification

6. Dr Shah points out that it's really critical to catch catatonia early, if possible, and to keep watching out for potential signs of regression. It's important to remember that catatonia-related breakdown is usually gradual and starts "mildly," to use her word. Here are some early warning signs that someone should be assessed for catatonic breakdown:

* "slowness--this can apply to movements or actions or speech"

* "having brief 'freezing' or 'shutdown' episodes"

* "decline in engagement and interest"

* "deterioration in any aspect of functioning or skills"

* "an increase in passivity"

* "becoming more withdrawn and less communicative"

I am getting tired, so I am paraphrasing less and quoting a bit more, but I did want to reframe. Speaking personally, as an autistic person--if I was at risk of a medical emergency every time I dealt with one of the symptoms above, I would never be out of the ER. But the commonness and frequency of the symptoms, above, is the problem, and also the point. A lot of experiences that we normalize as autistic people can actually be signs that something serious is wrong. It's important, for this reason, to really take an inventory of where you are on your best days, and pay attention if you seem to be falling too far off from that place, especially if you feel like you're on a long, slow slide. Much of the treatment for catatonia is a little bit different from the normal advice for burnout. It's worth treating your symptoms as possible signs of catatonia to see if you improve. (And if you're really noticing a notable change in your symptoms, especially, it's important to talk to a doctor).

I will add some warning signs from my own experience (all mentioned in the literature, but not from the list in Chapter Seven, above):

* inexplicable night sweats

* elevated heart rate

* marked deterioration of speech, especially over a longer period of time than usual




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