A 57-year-old male with a history of depressive symptoms was admitted to the emergency department with a major depressive episode characterized by catatonic features. The patient presented with neuropsychiatric symptoms including ideational poverty, mutism, akinesia, rigidity of the extremities, fine distal tremor, and decreased blinking. He also refused to eat and remained in a fixed sitting position. The patient was diagnosed with a major depressive episode with catatonic features and responded to midazolam and Lorazepam. After five weeks of hospitalization, he was discharged with antidepressants and standard doses of benzodiazepines, which were withdrawn on an outpatient basis. No recurrence of symptoms was observed during a year of follow-up. The case highlights the importance of recognizing catatonic features in depression, which can be secondary to affective disorders. Catatonia secondary to affective disorders is rare and often overlooked, leading to delayed diagnosis and inappropriate management. The case also emphasizes the role of cyanocobalamin in the evaluation of patients with catatonic symptoms. The use of the Bush-Francis Catatonia Rating Scale (BFCRS) is crucial for diagnosing and monitoring catatonia. Benzodiazepines, particularly Lorazepam, are the first-line treatment for catatonia, while electroconvulsive therapy (ECT) is an effective option for refractory cases. The case underscores the importance of a comprehensive evaluation, including clinical history, physical examination, and laboratory tests, to ensure accurate diagnosis and appropriate management. Early recognition and treatment of catatonic features in depression are essential to reduce morbidity and mortality and improve the quality of life for patients.A 57-year-old male with a history of depressive symptoms was admitted to the emergency department with a major depressive episode characterized by catatonic features. The patient presented with neuropsychiatric symptoms including ideational poverty, mutism, akinesia, rigidity of the extremities, fine distal tremor, and decreased blinking. He also refused to eat and remained in a fixed sitting position. The patient was diagnosed with a major depressive episode with catatonic features and responded to midazolam and Lorazepam. After five weeks of hospitalization, he was discharged with antidepressants and standard doses of benzodiazepines, which were withdrawn on an outpatient basis. No recurrence of symptoms was observed during a year of follow-up. The case highlights the importance of recognizing catatonic features in depression, which can be secondary to affective disorders. Catatonia secondary to affective disorders is rare and often overlooked, leading to delayed diagnosis and inappropriate management. The case also emphasizes the role of cyanocobalamin in the evaluation of patients with catatonic symptoms. The use of the Bush-Francis Catatonia Rating Scale (BFCRS) is crucial for diagnosing and monitoring catatonia. Benzodiazepines, particularly Lorazepam, are the first-line treatment for catatonia, while electroconvulsive therapy (ECT) is an effective option for refractory cases. The case underscores the importance of a comprehensive evaluation, including clinical history, physical examination, and laboratory tests, to ensure accurate diagnosis and appropriate management. Early recognition and treatment of catatonic features in depression are essential to reduce morbidity and mortality and improve the quality of life for patients.