Resignation Syndrome: symptoms, causes and treatment

This disorder appears only in Sweden, especially in young refugees who present traumas.

In the world different phenomena, events and catastrophes occur continuously that can greatly affect our lives. From natural phenomena such as earthquakes, floods or hurricanes to human-induced events such as war and the suffering and helplessness it generates in those who have to live with it or flee their homes, it can have profound repercussions both physically and psychologically for those who suffer its effects.

In this sense, there are a large number of syndromes, diseases and disorders in the world that are related in some way to alter the lives of a large number of people. One of them is the Resignation Syndrome, a strange phenomenon that has only been detected in Sweden. and which we are going to talk about throughout this article.

What is the Resignation Syndrome?

It is denominated Syndrome of Resignation to a strange alteration that takes taking place in Sweden for some years now in part of the refugee population. Specifically, it is a condition that has only been observed in children and adolescents between seven and nineteen years of age.

This syndrome is characterized by the relatively rapid onset of an extreme level of apathy, immobility and mutism for no apparent Biological reason.. A decrease in habitual behavioral patterns and a reduction in activity and motivation are first observed, which may worsen to a great extent. Many of these children remain in a catatonic state, and sometimes even remain in a coma-like state for months or years, unable to get up or nourish themselves.

In some cases they even require the use of probes in order to stay nourished. On a biological level, the organism of these minors functions correctly, but in spite of this they remain completely immobile and inert. In fact, it has been speculated that we are facing a case of catatonia. a case of catatoniaThe lack of mobility and response to stimulation is a common feature of both conditions. It has also been associated with dissociative disorders.

Refugee children in an absent or comatose state.

These minors are commonly called "apathetic children", and have in common the fact that they are children of refugees from different countries, generally from the Balkans or from the territories that were part of the former Soviet Union, Yugoslavia or Syria, who have experienced great traumas and complex situations in their countries of origin. who have experienced great traumas and complex situations in their countries of origin and/or on their way to Sweden and who face the possibility of not obtaining a residence permit.

Although this syndrome has only occurred in Sweden (for which there is no explanation), it is certain that it has similarities with alterations found in concentration camp prisoners in World War II. It is observed that they lose the ability to fight, to cope with self-defense and search for security or even to respond to external stimulation. It is practically as if consciousness is disconnected and the body functions automatically.

Hypotheses about its causes

To this day the Resignation Syndrome is a little known alteration and with respect to which the causes are still not known. It has been observed that it is closely related to the uncertainty regarding the possibility or the notification of having to leave the country (in fact, families who have been able to stay have seen how the child has improved over time), but this does not explain why it occurs only in the case of the child who has not been able to leave the country (in fact, families who have been able to stay have seen how the child has improved over time). does not explain why this only happens in Sweden or why it does not happen more or why it does not occur on more occasions, nor does it explain the extreme severity of the syndrome.

There was also speculation about the possibility of a feigned illness or one provoked by the family as an attempt to remain in the country in the face of a child's illness (something similar to Munchausen by proxy), but despite the fact that some attempts at fraud have been observed in the past, it is possible that the family has been able to prevent the child's illness. some attempts at fraud have been observed the symptomatology does not seem to be linked to these factors for the most part (their bodies are functioning properly and the symptomatology is not faked).

One of the main hypotheses indicates that the causes of this syndrome are predominantly psychological, being similar to other dissociative disorders generated by the experience of traumatic events, and that there may be a link with the phenomenon known as learned helplessness. The child has observed that their actions and the actions of their parents have not been able to protect them and have not had a real effect (for example, despite fleeing their country of origin, they have not managed to be accepted in the country that was taking them in).

On this basis, we observe, in psychodynamic terms, a splitting of the consciousness as a mechanism of protection against reality. In reality, the basic problem seems to be the traumatic experiences they have lived previously and the fear and helplessness in the face of the possibility of reliving them. the possibility of reliving the same conditions.

Linked to the above, it is considered that cultural elements such as the repression of negative emotions typical of some cultures can facilitate this Resignation Syndrome by not being able to express their suffering externally. externally. Also the absence of contact or the fact of being constantly aware of their legal situation are elements of risk.

Why this problem has only been detected in Sweden, what causes some children to trigger this syndrome and not others, and why it only occurs in children between the ages of seven and nineteen and not older remains to this day an unknown that requires further research..

Treatment

Finding an effective treatment for the syndrome of resignation is not easy, but most experts consider that recovery requires an increased sense of security and a decrease in the perception of helplessness. and a decrease in the perception of helplessness and rejection. This could involve obtaining a residence permit, but it has been observed that in the case of families who do not obtain one, a significant improvement and a progressive recovery have been achieved.

In these cases, the first option is to separate the child from his or her family environment until recovery is achieved. Once this has been done, the child is then subjected to a cognitive stimulation program in which the child is gradually revived through exposure to situations and stimuli: games, smells, physical exercise (even if they are not able to walk or move they are guided by physical guidance), music or expression through drawing. It is important during this process that the migration process or expulsion from the country cannot be discussed, as this could reintroduce insecurity and provoke a relapse.

This last aspect is something to keep in mind, since recovery does not guarantee that a possible relapse will not occur. Although treatment focuses on the minor, the fact is that work could also be done with the family in aspects such as psychoeducation and psychological counseling.

Bibliographical references:

• Sallin, K.; Lagercrantz, H.; Evers, K.; Engström, I.; Hjern, A. & Petrovic, P. (2016). Resignation Syndrome: Catatonia? Culture-Bound?. Front. Behav. Neurosci., 10 (7).
• Söndergaard, H. P., Kushnir, M. M., Aronsson, B., Sandstedt, P., and Bergquist, J. (2012). Patterns of endogenous steroids in apathetic refugee children are compatible with long-term stress. BMC Res. Notes 5:186. doi: 10.1186/1756-0500-5-186