What is waxy flexibility?

Waxy flexibility is a rare condition in which people can move, as if made of softened wax, into different positions which they then hold for an extended period of time. The positions can be quite extreme or uncomfortable, but the person will hold them and remain still. Waxy flexibility is one of a variety of symptoms associated with the condition of catatonia. Catatonia and waxy flexibility can occur in people who have mental health problems like depression and mania. Sometimes catatonia can be associated with the serious mental illness known as schizophrenia, in which case the illness is described as catatonic schizophrenia.

Although commonly recognized as one of a range of symptoms of catatonic schizophrenia, waxy flexibility occurs most often in people who have a catatonic behavioral mood disorder. Catatonia symptoms, including waxy flexibility, can also be caused by medications, problems in the brain, and medical conditions such as low sodium levels. How waxy flexibility develops in the body is not fully understood, but some researchers think it may arise after chemical changes in the brain. Others think it could be a throwback to the days when humans were hunted by predatory animals, resulting in extreme fear. In this type of situation, involving dangerous animals that are alerted by movement, standing still like a wax figure could be a very useful way to avoid being eaten.

People with waxy flexibility adopt a stationary posture and show a diminished stimulus response, which means that they seem to be unaware of what is going on around them. Even when a doctor moves one of their limbs, patients do not respond, but simply take the new position and hold it. Unfortunately, this extreme lack of mobility can have serious consequences.

Complications can arise when patients are not moving for long periods, the most obvious being extreme lack of food and fluids. The skin can also suffer, with constant pressure and possibly incontinence causing ulcers. Immobility can also cause blood clots to form in the legs and lungs, and these can sometimes be fatal. Pneumonia and heart attacks can also occur.

Treatment of waxy flexibility and catatonia can be difficult. Medication can be helpful in some cases, but nursing care is also important. Food and liquids can be given through a vein. Most patients recover, but catatonia often recurs, especially in people who have the condition associated with a mood disorder.

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