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Updated: May 13, 2025
The condition, too, was not so completely affectless as one expects a deep stupor to be. The actual attempts at self-injury brought out emotion, for with them she scowled and frowned as well as showing considerable energy. To these may be added the following case. It is not unlike the ordinary stupor in the fact that there was intense inactivity and mutism with great tenseness.
Second, these same ideas, somewhat reduced, continued in an apathetic state while impulsive symptoms developed: She began to shout like a huckster to be taken to Heaven and made numerous affectless, suicidal attempts. Third, came a true stupor and, fourth, a period of recovery when the stupor symptoms all disappeared but insight into the falsity of her ideas was lacking. Celia H. Age: 19.
Again, when asked where her people are, says “At home.” Then she went willingly back to bed and was quiet. In the afternoon she again went to the door and tried to get out. Then again, while trying the door, repeats in the same affectless manner that she wants to go “to the river,” “to the bottom of the river,” “to Heaven to see my mother.” This last was said in a whining tone, with some tears.
We shall later have to mention in detail a patient whom we regard as belonging in the group of stupor reactions, and who for a time made insistent, impulsive and most determined suicidal attempts, yet with a peculiar blank affectless facial expression and with shouting which was more like that of a huckster than one in despair.
December 28: Still constant, impulsive and apparently affectless attempts at suicide, tries to get medicine away from nurses, to get the fire extinguisher bottles, a bottle of ink, etc., struggling when prevented. But when examined quiet, even smiles at a joke. When questioned, denies feeling either worried or depressed. She said she wanted to go home. She gave poor attention to the questions.
At such times she showed an affectless, impulsive excitement. Whether there was an element of perplexity then is not clear from the notes. The topics of which she spoke also changed.
The problem is wider than that of the mere etiology of the stupors we are considering. Their relationship to manic-depressive insanity is so intimate that we must tentatively consider this affectless reaction as belonging to that larger group. A discussion of the basic pathology of manic-depressive insanity is outside the sphere of this book.
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