The behavioral variant of frontotemporal dementia (FTD) begins with psychiatric symptoms, including changes in personal conduct and/or interpersonal behavior. Prior to developing cognitive impairment, differentiating FTD from primary psychiatric disorders, like schizophrenia, can be challenging. This paper presents a case of traumatic brain injury with subsequent depression and catatonia. Initial response to electroconvulsive therapy and lorazepam suggested primarily psychiatric pathology. Subsequent symptom progression, reduced treatment response, and detailed family history evaluation led to the diagnosis of familial FTD with C9ORF72 mutation. This case highlights that familial FTD can present with depression with suicidal tendencies and catatonia, and that the responsiveness of these behavioral manifestations to standard therapies can change over time.