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Sudden development of abnormal behavior with stiff and shivering body. Required treatment?

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Posted on Mon, 21 Jan 2013
Question: My wife behaves in strange manner when i disagree with her on some small family issues. Ours is arrange marriage and its almost 3 years now. By gods grace we have never fought or argued so far. Though she is my wife, i call and pamper her a pre school baby as she is happy to the XXXXXXX in this mood. During these years, twice i have seen her behaving very strange whereby she is very scared that i might leave her alone and walk away from her life. She weeps and keeps on repeating that she will walk out of home all alone and sometimes she adds that she will also end her life. She folds her body to the smallest size and is very stiff. I politely try to free her and after some time she opens up i could feel the stiffness and also her shivering. Both the times it has happened at night in bed when we are about to sleep and iam scared if she really walks out of home in midnight when iam asleep.

Iam not sure but doubt she is suffering from "Hysteria". Also i heard that she has undergone love failure during her college days.
Kindly advise as what to be done.
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Answered by Dr. Srikanth Reddy (27 minutes later)
Hello,

Thanks for using health care magic.

A sudden development of abnormal behavior like the one you described nicely - occurring occasionally and lasting for a short period can have 2 most common possibilities:
1) Conversion reaction (hysteria as you have suggested)
2) Both these clinical conditions are very intricate and presentations can be confusing many a times.

EEG (Electro encephalography) is a diagnostic test which can differentiate between both the conditions. If the EEG is showing seizure like discharges, then it is a form of epilepsy arising from the temporal area of the brain resulting in such micro-psychotic like episodes. And if the EEG is normal, then in that case it could very well be a conversion reaction.

The fact that it has occurred only twice before suggests that it is not that serious.

If it is hysteria, it occurs mostly due to some distressing thoughts occurring in her mind and she may or may not want to discuss those thoughts with you. You should consult a good psychiatrist who would like to do an EEG and also talk to the patient to evaluate any stress if present.

There are various psychological tools such as sentence completion test, thematic apperception test, etc., which can put forth the stress that is not appearing during the routine interviews.

Correction of underlying depression is the first line approach in the treatment. She needs to learn some coping strategies and learn how to handle stress. Cognitive Behavioral Therapy and Brief Psychodynamic Therapy will help her if given by a good psychiatrist.

I understand that you are from Jharkand and CIP Ranchi will be a good place to get evaluated properly by some good experienced psychiatrist.

One word of caution: People may advise you to take her to various faith healers, please try to be away from it as it will complicate the issue further.

Hope this answer is comprehensive and useful. I would be happy to help you if you have any further queries.

Dr. Srikanth Reddy

Above answer was peer-reviewed by : Dr. Prasad
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Sudden development of abnormal behavior with stiff and shivering body. Required treatment?

Hello,

Thanks for using health care magic.

A sudden development of abnormal behavior like the one you described nicely - occurring occasionally and lasting for a short period can have 2 most common possibilities:
1) Conversion reaction (hysteria as you have suggested)
2) Both these clinical conditions are very intricate and presentations can be confusing many a times.

EEG (Electro encephalography) is a diagnostic test which can differentiate between both the conditions. If the EEG is showing seizure like discharges, then it is a form of epilepsy arising from the temporal area of the brain resulting in such micro-psychotic like episodes. And if the EEG is normal, then in that case it could very well be a conversion reaction.

The fact that it has occurred only twice before suggests that it is not that serious.

If it is hysteria, it occurs mostly due to some distressing thoughts occurring in her mind and she may or may not want to discuss those thoughts with you. You should consult a good psychiatrist who would like to do an EEG and also talk to the patient to evaluate any stress if present.

There are various psychological tools such as sentence completion test, thematic apperception test, etc., which can put forth the stress that is not appearing during the routine interviews.

Correction of underlying depression is the first line approach in the treatment. She needs to learn some coping strategies and learn how to handle stress. Cognitive Behavioral Therapy and Brief Psychodynamic Therapy will help her if given by a good psychiatrist.

I understand that you are from Jharkand and CIP Ranchi will be a good place to get evaluated properly by some good experienced psychiatrist.

One word of caution: People may advise you to take her to various faith healers, please try to be away from it as it will complicate the issue further.

Hope this answer is comprehensive and useful. I would be happy to help you if you have any further queries.

Dr. Srikanth Reddy