Catatonic Depression: Symptoms, Risks and Treatment

Published: 16 May 2026. Last reviewed: 27 June 2026.

Clinically reviewed by Robin Lefever, Therapist and Registered Manager. Last reviewed: 27 June 2026.

What is catatonia? Catatonia is a serious condition that affects movement, speech, and responsiveness. A person may become unable to move or speak normally, hold unusual postures, or stop responding to the world around them. It can develop alongside severe depression, bipolar disorder, psychosis, or a physical illness, and it needs urgent professional assessment.

What is a catatonic state? A catatonic state is the period when these symptoms are present. Someone in a catatonic state may appear frozen, rigid, mute, or withdrawn, or at the other extreme may be highly agitated and unable to settle. It is not the person choosing to shut down, and it is not something they can will themselves out of.

When catatonia occurs together with a depressive illness, it is often called catatonic depression. This page explains what catatonia and catatonic depression look like, why assessment matters so much, how the condition is treated, and how to get help quickly.

When to seek urgent help: Catatonia can become a medical emergency. Call 999 or go to A&E if someone is not eating or drinking, cannot be roused, is rigid or immobile, very confused, severely agitated, psychotic, or at risk of harming themselves. Do not wait to see whether it passes.

What catatonic depression can look like

Catatonic depression involves low mood and emotional distress accompanied by significant changes in movement, speech, responsiveness, or behaviour. Individuals may appear frozen, withdrawn, unable to speak, rigid, agitated, or emotionally disconnected. The presentation can shift, so someone who is immobile and silent one hour may become restless and agitated the next.

Common signs include:

• Minimal speech or complete mutism
• Marked immobility, stiffness, or holding a fixed posture for long periods
• Staring, with reduced or absent facial expression
• Repetitive movements, or resistance when someone tries to move them
• Agitation, pacing, or purposeless activity
• Poor self-care, or an inability to eat, drink, or complete daily tasks

Because some of these signs overlap with severe depression itself, catatonia is easy to miss. That is one of the reasons a proper clinical assessment is so important.

Why assessment matters

Catatonic symptoms can occur alongside severe depression, bipolar disorder, psychosis, trauma, neurological conditions, medication effects, substance use, and physical health problems. The same outward signs can have very different causes, and the right treatment depends on identifying the cause. Professional evaluation is essential before deciding how to respond.

Assessment also screens for the medical risks that can accompany catatonia, such as dehydration, not eating, blood clots from prolonged immobility, and complications that can become dangerous if untreated. This is why catatonia is treated as a condition that needs prompt clinical attention rather than something to manage at home.

If you are worried that depression has become this severe, our confidential assessment is a clear first step toward understanding what is happening and what helps.

Treatment for catatonic depression

Catatonia is treated medically, and many people respond well once it is recognised. Management may include urgent medical intervention, psychiatric assessment, medication, close monitoring, and treatment of the underlying depression.

The most common first-line treatment is a benzodiazepine, usually lorazepam, which can produce a rapid improvement and also helps confirm the diagnosis. Where catatonia is severe, persistent, or does not respond to medication, electroconvulsive therapy (ECT) is a well-established and effective treatment. Throughout, the underlying depression or other condition is treated alongside the catatonia, and physical health is monitored closely.

Severe cases may require inpatient hospitalisation so that the person can be kept safe, supported with nutrition and fluids, and stabilised under supervision. Decisions about medication, ECT, and admission are made by the treating clinicians based on the individual's needs.

At Promis we provide formulation-led care across two inpatient clinics, in London and in Kent, with weekly psychiatric input as part of a multidisciplinary team. Where someone needs the kind of acute medical care described above, the right step is urgent assessment through the NHS or emergency services first, with clinics like ours supporting longer-term recovery from the underlying depression once the person is stable.

How families can respond

If you are with someone who may be in a catatonic state, the priority is safe, calm support while you get professional help. Keep the environment calm and quiet, reduce noise and stimulation, and stay with the person. Do not try to force them to move, eat, or speak, and do not attempt any technique to snap them out of it. Catatonia is a medical condition, not a behaviour that can be talked or pushed away.

Seek professional help immediately. Call 999 or go to A&E if the person cannot be roused, is not eating or drinking, is rigid or immobile, severely agitated, or at risk. If you are unsure how urgent it is, call 111 for advice, or contact their GP or mental health team.

When you reach a clinician, it helps to share as much detail as you can: when the symptoms started, what changed beforehand, any medications the person takes, whether they have been eating and drinking, and any history of depression, bipolar disorder, psychosis, or previous episodes. This information speeds up assessment and treatment.

Frequently asked questions

What is catatonia?

Catatonia is a serious condition that affects movement, speech, and responsiveness. A person may be unable to move or speak normally, hold unusual postures, repeat movements, or stop responding to the people around them. It can occur with severe depression, bipolar disorder, psychosis, or a physical illness, and it needs urgent professional assessment.

What is a catatonic state?

A catatonic state is the period during which catatonic symptoms are present. Someone in a catatonic state may seem frozen, rigid, mute, or withdrawn, or at the other extreme may be intensely agitated and unable to settle. It is a medical state, not a choice, and the person cannot simply will themselves out of it.

What are the symptoms of catatonic depression?

Catatonic depression combines low mood with marked changes in movement and responsiveness. Signs include little or no speech, immobility or stiffness, staring with a blank expression, holding fixed postures, repetitive movements or resistance to being moved, agitation, and an inability to manage everyday tasks such as eating, drinking, or self-care.

How is catatonia treated?

Catatonia is treated medically. The usual first-line treatment is a benzodiazepine, typically lorazepam, which often brings rapid improvement. Electroconvulsive therapy (ECT) is used when catatonia is severe or does not respond to medication. The underlying depression or other condition is treated at the same time, and physical health is monitored closely, sometimes in hospital.

How do you help someone in a catatonic state?

The most important step is to get urgent medical help. Call 999 or go to A&E if the person cannot be roused, is not eating or drinking, is rigid or immobile, very confused, severely agitated, or at risk. While you wait, keep the environment calm and quiet and stay with them, but do not try to force them to move or use any technique to snap them out of it. Catatonia needs professional treatment, not a do-it-yourself approach.

Getting help

If depression has become severe, or you are worried that someone you love is showing the signs described here, do not wait. In an emergency, call 999 or go to A&E. For mental health advice, call 111, or contact a GP or mental health team.

For confidential support around severe depression and recovery once someone is stable, you can contact us or arrange an assessment.

Contact Promis: London: 0207 581 8222 | Kent: 01304 841 700