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This article presents the case history of a patient suffering from a presumed unipolar depressive episode with catatonic symptoms who did not respond to IV lorazepam but responded to oral memantine and sertraline. A few days after the improvement in catatonic symptoms, such as mutism, posturing, and negativism, the patient developed hypomanic symptoms and was diagnosed with bipolar disorder. This article discusses the neurobiological basis of catatonia, the importance of diagnostic tools such as the Bush-Francis Catatonia Rating Scale and treatment options, with an emphasis on the correct diagnosis of underlying diseases.