Different phenomena, events and catastrophes occur continuously in the world and can affect our lives to a great extent. From natural phenomena such as earthquakes, floods or hurricanes to human-caused events such as war and the suffering and distress it generates in those who have to live with it or flee their homes, this can generate profound repercussions at both the physical and psychological levels for those who suffer its effects.

In this sense, there are a great number of syndromes, diseases and disorders in the world that are related in some way to altering 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 that we are going to talk about throughout this article.

What is Resignation Syndrome?

The Resignation Syndrome is a strange disorder that has been occurring in Sweden for some years in part of the refugee population . Specifically, this is a condition that has only been observed in children and adolescents between the ages of seven and nineteen.

This syndrome is characterized by the relatively rapid appearance of an extreme level of apathy, immobility and mutism without any apparent biological reason . First, a decrease in habitual behaviour patterns and a reduction in activity and motivation is observed, which may become much worse. Many of these children remain in a catatonic state, and sometimes even become in a coma-like state for months or years, unable to get up or feed themselves.

In some cases, they may require the use of probes to keep themselves nourished. At the 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 , the lack of mobility and response to stimulation being shared by 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 lived through great traumas and complex situations in their countries of origin and/or on their way to the Swedish country and who are facing the possibility of not obtaining a residence permit.

Although this syndrome has only occurred in Sweden (something for which there is no explanation), the truth is that it has similarities with alterations found in concentration camp prisoners during World War II. It is observed that they lose the ability to fight, to face their own defence and search for security or even to respond to external stimulation. It is almost as if the consciousness is disconnected and the body functions automatically.

Hypothesis on its causes

Today, Resignation Syndrome is a little known disorder for which the cause is not yet known. It has been observed that it is closely related to the uncertainty regarding the possibility or notification of having to leave the country (in fact, families that have been able to stay have seen how the child has improved over time), but this does not explain why this only occurs in Sweden or why it does not occur more often, nor does it explain the extreme seriousness that the syndrome can have.

There was also speculation about the possibility of being faced with a feigned or family-provoked illness 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 they have observed some attempts at fraud the majority of the symptoms do not seem to be linked to these factors (their organisms function correctly and the symptoms are not feigned).

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 from their countries of origin they do not manage to be accepted in the country that was taking them in).

On this basis, we can observe, in psychodynamic terms, a splitting of consciousness as a mechanism of protection from reality. In reality, the basic problem seems to be the traumatic experiences that have been lived before and the fear and helplessness before the possibility of living the same conditions again.

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 turn over or express their suffering 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 Swedish territory, what makes some minors trigger this syndrome and others do not and why it only occurs in ages between seven and nineteen and not older remains a question that needs further research .

Treatment

Finding an effective treatment for resignation syndrome is not easy, but most experts believe that recovery involves an increased sense of security and a decreased perception of helplessness and rejection. This could happen by obtaining a residence permit, but it has been observed that the case of families that do not obtain it has been able to provoke a significant improvement and a progressive recovery.

In these cases, the first option is to separate the child from his/her family environment until he/she recovers. Once this has been done, the child is 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 cause a relapse.

This last aspect is something to consider, since recovery does not guarantee that a possible relapse cannot occur. Although the treatment is focused on the child, it could also work with the family on aspects such as psycho-education and psychological counselling.

Bibliographic 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., y Bergquist, J. (2012). Los patrones de esteroides endógenos en niños refugiados apáticos son compatibles con el estrés a largo plazo. BMC Res. Notes 5:186. doi: 10.1186/1756-0500-5-186