Catatonia vs. inertia

I held another discussion group at Autscape. I forgot to put a 'non-confidential activity' sign on the door, so I can't refer directly to anything said there. Last year's group had about 45 people. That was fine because at that point I was looking to get a good breadth of input to help me start defining the problem. This year I made it at the same time as one of them main presentations and invited specifically those who have experience of more severe manifestations. It partly worked.

I am trying to work out if there is a difference just in degree or also in kind between what I experience and more ordinary 'executive function' type problems. I think there is a difference and that I have both, but that my executive dysfunction is not as pronounced as it is for many neurodivergent people.

One characteristic that I think is essential and important about the catatonic episodes, and this was confirmed in the discussion, is a lack of subjective distress. The person may become annoyed about the things that aren't getting done and realise there will be negative consequences, but this never gets intensity behind it. It's not like pushing against a wall, it's a lack of the ability to get the will to push at all. My analogy of wading through treacle is wrong in this respect, although that fits better when I have 'slow downs'.

There is also a lack of perception of time. Not like getting absorbed in something and forgetting to check the time - being able to sit still and make no progress for hours, even when physical symptoms of strain are happening, without noticing (or caring) that so much time has passed.

There isn't a dominant feeling of anxiety, overwhelm, frustration, or anything else. It's just like someone has stopped time, although awareness of time hasn't gone to that degree.

I think this emptiness may be a key distinction between catatonic-like lack of initiative and more typical autistic inertia. Inertia seems to be related to hyperfocus, overload, disorganisation or difficulty prioritising. Autistic inability to care about the things other people think are important (i.e. motivation) is also often a factor.

People who do have episodes of catatonic freezing also seem to have residual effects between episodes so that they will be very much lacking in the ability to initiate tasks on a lower level all or almost all of the time. This tends to look more like typical inertia and I don't have a strong feeling at this point whether it is the same thing or not.