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Cataplexy: When emotions paralyze you

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And not figuratively, either. Sometimes people have found that certain emotions literally cause their muscles to unhook from their brains. They collapse entirely. This is not some strange disease, or weakness — tt's the misapplication of a necessary function.

The emotion and physical responses occupy the same body. They both flood the body with chemicals, so it makes sense that they influence each other. Most emotion-triggered physical responses are so commonplace that we take them for granted — nobody raises an eyebrow when sadness or emotional upset causes a person's eyes to water. Tiredness or boredom causes people to open their mouths very wide, stretch their jaw, and make sea lion sounds and nobody's surprised—- although a few people are offended. And when someone dissolves into paroxysms of semi-shrieks after a joke, it's expected.


But if those semi-shrieks stop and the person freezes and crumples to the ground, then people get all excited. They shouldn't. Laughter is one of the more common triggers of cataplexy. Cataplexy can pop up at any time during a person's life, and though it is treatable, it isn't curable. The condition can't be cured because it isn't a solitary condition — it seems to be an unnecessary application of a very necessary function.


Before we slip into REM sleep, we experience something called muscle atonia. Muscle atonia is why, after a dream about wandering in the desert, you don't wake up five miles from your house walking into the sea. It's why a dream about boxing results in no more than a twitching of your eyelids and fingers, rather than a full-scale fight with whoever is nearby. At some point, your brain unhooks your muscles and paralyzes them, so they can do no more than twitch through the most vivid dreams. When you wake up, the muscles come back online. If the brain doesn't get the timing right, there are quite a few problematic things that can happen. Sometimes people experience 'sleep paralysis,' waking from a dream only to be unable to move their body. Because the mind is still waking, sleep paralysis often coincides with hallucinations, some of them terrifying. A less traumatic disorder of muscle atonia happens when the brain starts dreaming before disconnecting the muscles completely, so a dream about falling will lead to the dreamer jerking upright in bed and waking themselves up.

Cataplexy is more serious than that. When a person experiences the trigger, their muscles stop functioning, just the way they would during sleep. Sometimes they freeze, but more often they hit the ground. The condition itself offers no danger, but because it could happen almost any time, there are obvious hazards. Driving is generally off-limits, as are sports like swimming or skiing. Cataplexy sufferers also tend to be leery of stairs or cooking over a hot stove. The difficulties add up.

Triggers are also a problem. One of the most common triggers is laughter — which is not known to provoke sympathy in those people who witness an attack. Others are extreme anger — again, not a good emotional time to need help. People with cataplexy find themselves constantly having to guard against certain emotions. This is difficult when the emotional triggers are bad, and torturous when they're good.

There are a few medications that help control cataplexy, but they are expensive and relatively rare. Doctors generally give patients pills meant to combat fatigue. Cataplexy and narcolepsy, which often coincide in patients, are both related to sleep disorders and both brought out by extreme fatigue and over-tiring situations. They're essentially sleep following people into their waking life.


One last note — there is one patient out there that has an attack every time he feels extremely smug. This makes me feel extremely smug. How bad should I feel about that?

Top Image: David Tribble

Second Image: Eric McGregor

Via Journal of Neuroscience, American Physiological Society, NCBI, The Guardian.