Canadian psychologist and commentator Jordan Peterson has been battling a recurrence of akathisia, a neurological condition that causes restlessness and mental distress.
His daughter, Mikhaila, posted an emotional video to social media over the weekend, disclosing that the polarizing author’s symptoms started after he was diagnosed with chronic inflammatory response syndrome (CIRS) last August from mold exposure.
A month after his CIRS diagnosis, Peterson’s condition was complicated by pneumonia and associated sepsis, contributing to his worsening symptoms caused by an old neurological injury.
“Akathisia is the worst thing I’ve ever seen anyone go through … it’s catastrophic,” Mikhaila said in the video.
While akathisia is often linked to certain types of health conditions and medications, particularly antipsychotic drugs, Mikhaila insisted that his condition is caused by immune system dysfunction from CIRS.
“Let me be super clear: Dad has not been on a psych medication since January 2020,” she explained. “This recent flare-up of neurological symptoms isn’t due to new medications.”
What is akathisia?
A neuropsychiatric syndrome and movement disorder, akathisia is a condition that causes restlessness and a compulsive need to move.
This can make it extremely difficult to sit still and cause extreme distress if the patient is in a situation where they need to be still.
Akathisia can be classified in different ways based on when symptoms started and how long they lasted:
- Acute akathisia, which lasts for fewer than six months, develops when starting a medication or increasing a dosage.
- Chronic akathisia is when symptoms last more than six months, typically for months or years.
- Tardive akathisia is when symptoms start more than three months after beginning new medications or increasing a dosage.
- Withdrawal akathisia can arise following a reduction in medication dose or cessation of a drug.
What causes akathisia?
Several medications are associated with akathisia, such as antipsychotic drugs (mostly first-generation or “typical” antipsychotics) and antidepressants.
These medications are prescribed for a variety of reasons, including depression, eating disorders, anxiety, OCD, post-traumatic stress disorder and more.
Health conditions like Parkinson’s disease, encephalitis (brain inflammation) and traumatic brain injury are also linked to the disorder.
While the exact cause of akathisia is unknown, doctors believe certain medications block dopamine receptors in the brain that facilitate movement, resulting in unwanted, involuntary movements.
Illicit drugs like amphetamine, methamphetamine and cocaine can also cause akathisia.
What are the symptoms?
This condition is generally described by those afflicted as restlessness with an uncontrollable desire to move.
Signs of akathisia are related to jitteriness or a strong need to move the lower limbs that appears as a persistent fidget to others.
This can result in constantly swinging the legs while sitting, crossing and uncrossing the legs, rocking while sitting, shifting from one foot to the other, pacing or marching in place.
How is akathisia diagnosed?
Akathisia is diagnosed through clinical observation using the Barnes Akathisia-Rating Scale (BARS), a four-point measure of restlessness.
This condition is often misdiagnosed as persistent anxiety or agitation.
Symptoms of akathisia often mimic or overlap other psychiatric conditions such as psychosis, mania and ADHD.
What’s the treatment of akathisia?
There’s no definitive treatment of akathisia, but healthcare providers may switch the patient to a different antipsychotic medication or lower the dosage.
Some studies have shown that other medications may help akathisia symptoms, like beta-blockers, benzodiazepines, asthma therapies and vitamin B6.
If left untreated, akathisia can impact quality of life and even lead to severe anxiety, dysphoria and possible suicidal ideation.
