In merely weeks, a 15-year-old boy no longer cracks jokes, dances or even utters a word. What's going on?
At first, his parents thought Marcus was just being a typical teenager — reticent to talk, preferring to stay in his room and blare loud music. Then he started talking to himself and refusing to eat. His family became desperate, and brought him to our pediatric emergency department.
“I’m pretty sure he’s experiencing psychosis,” the psychiatric social worker told the emergency physician. “He seems to be responding to internal stimuli — voices and hallucinations.” “He’s been here about a day or so, but it’s gotten weird,” she told me. “He’s refused all food or drink for the last 12 hours, and he’s not really talking. He’s been calm and cooperative, so we just let him be tonight.”
Catatonia can be a complication of psychiatric illnesses, as well as other conditions, such as autoimmune encephalitis, thyroid disorders, epilepsy and effects on the brain from some cancers. It seemed Marcus’ hospitalization was not going to be the straightforward wait for a psychiatric bed as we had initially thought. We had to investigate the cause of his catatonia and treat whatever we found, to bring him out of his statuelike state.
We started Marcus on a benzodiazepine, adjusting it daily. Soon thereafter, I heard a voice coming from his room. Marcus’ parents had played R&B superstar John Legend’s latest album in his room constantly, but only now did we hear Marcus singing along. That day, I walked in to find his parents sitting agape nearby as Marcus crooned along with every word, even subtly tapping his foot to the beat. He was reawakening.
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