A 50-year-old man was admitted for a 3-month history of progressive cognitive decline, somnolence, atypical extremity movements, non-sensical speech and subsequently mutism - leading to a bed bound state with feeding tube dependence. Past medical history was significant for depression, post traumatic stress disorder (PTSD), generalized anxiety disorder, bipolar disorder and schizophrenia. Patient’s pre-admission medications included Buspirone 15 mg twice daily, Aripiprazole 5 mg daily, Sertraline 50 mg daily, Hydroxyzine 25 mg thrice daily, Bupropion 300 mg daily, Gabapentin 300 mg thrice daily, all of which were abruptly discontinued 1 month prior to symptom onset. On exam, patient was stuporous, mute except for occasional grunting and echolalia, resisted passive attempts at movements and had stimulus-induced but suppressible asynchronous shaking in both arms (no myoclonus). MRI Brain, electroencephalogram and extensive serum and CSF infectious, autoimmune and paraneoplastic testing was unremarkable except for a positive CSF protein 14-3-3. Patient was empirically treated with broad spectrum antibiotics, high dose steroids, intravenous immunoglobulin and plasma exchange with no improvement. CJD was presumed as the initial diagnosis however specific testing with CSF RT-QuIC was later reported as negative. Psychiatry was consulted and a Lorazepam challenge test was performed for presumed catatonia. Patient's testing was positive based on improvement in his Bush-Francis Catatonia Rating Scale. Patient was placed on scheduled Lorazepam and underwent electroconvulsive therapy with dramatic improvement in mental status and resolution of catatonic signs - regaining his ability to speak, walk and lead an independent life.