10 Minutes

By THE BALANCE
Fact checked

Functional neurological disorder puts up with certain neurological symptoms or nervous system symptoms often intricate to explain by certain medical conditions or neurological diseases, carries the name of  “Conversion Disorder” in a broader perspective. It is a psychological health condition in which emotional issues such as anxiety, stress, and trauma appear as physical symptoms. Psychical health experts say that more adults are now experiencing these somatic symptoms due to grief, stress, and loneliness. 

There is no medical state that describes the symptoms associated with conversion disorder, and that’s something, which makes it an extremely challenging condition, as the exact cause of the disorder is still unknown. For example, imagine a fall off from the bike and then find it difficult to move your arm. But there isn’t any injury in your arm. Your body has converted the psychological and emotional stress of your drop into the physical response of paralysed arm. 

It may seem strange, but your symptoms are real, and you can’t repress them. Conversion disorder mainly occurs among people of 10-35 years of age. Among older people, there are greater chances that a medical state commonly causes unexplained symptoms. Usually, conversion disorder lasts only for a few months or weeks. During this time, patients feel difficulty in carrying out different life activities. Many people who suffer from conversion disorder can deal with other medical problems as well.

Conversion disorder is a mental state in which a person experiences sensory and physical conditions, such as numbness, deafness, seizures, blindness, or paralysis, with no known and apparent causes. It is also called functional movement disorder, in which body parts and the brain become unable to send and receive signals. 

As a result of this condition, patients feel difficulty moving limbs or have problems with one or more senses. In the past, these events were referred to as “hysterical paralysis” or “hysterical blindness.” These problems severely impact a person’s daily functioning, such as family life, social relationships, and academic performances.

Usually, some people can experience an acute version of conversion disorder which lasts for a few days. For some people, symptoms remain for weeks or months. According to DSM-5, people gain more chances of getting conversion disorder after a particular period of stress or a stressful life event. And women have 2-3 times more chances of suffering from functional neurological symptom disorder than men. 

Conversion Disorder Criteria

According to DSM-5, conversion disorder includes the criteria:

  • Symptoms are not caused by substance use
  • No evident neurological, biological, and psychological cause
  • At least one sign affecting the ability to control a person’s body movement or the senses
  • Physical symptoms of stress are not accompanied by major distress.

During conversion disorder, there’s typically an unexpected attack of symptoms that impair voluntary, sensory or motor function, and these symptoms can vanish suddenly, without any physiological cause. It typically affects body movements as well as senses.

The physical symptoms of functional neurological symptom disorder are usually described as one’s body’s way of dealing with unexpressed emotions or unresolved stress that sped up the disease. These vary from person to person, depending upon their type. Some of these symptoms include:

Weakness And Paralysis

  • Panic attacks
  • Dropping things
  • “Dragging” or abrupt buckling of the injured leg
  • Pain in different parts of the body
  • Physical damage to the affected limb
  • It feels that the affected limb is not a part of our body or doesn’t belong to our body

Speech Disturbances

  • Slurred speech
  • Whispering
  • Foreign accent syndrome
  • Hoarseness
  • Stuttering speech
  • Mutism
  • Telegrammatic speech

Movement Disorders

  • Abnormal gait 
  • Parkinsonism
  • Tremors
  • Muscle jerking 
  • Unusual muscle contractions
  • Nonepileptic Seizures
  • sudden unresponsiveness
  • unusual generalised limb shaking
  • Loss of consciousness or apparent impaired consciousness

Visual Symptoms

  • Double vision
  • Complete blindness
  • Blurred vision
  • Visual field defects
  • Nystagmus (involuntary eye movement)

Sensory Complaints

  • Tingling and numbness
  • Feeling one side or another side “doesn’t belong”
  • Weakness
  • Feelings of being cut in half

Cognitive Symptoms

  • Impaired fluency
  • Changeability in response time
  • Difficulty in finding the exact word
  • Disarrangement of words while speaking
  • Poor memory and concentration

The exact causes of conversion disorder are not fully understood yet. Researchers suggest that it is commonly caused by abnormal flow to different parts of your brain. Conversion disorder is also a psychological reaction to a highly traumatic or stressful event. Some of the common causes include:

  • Stressful situations and other mental illnesses trigger conversion disorder.
  • Neurological conditions, such as migraines and epilepsy, or a movement disorder also trigger conversion disorder. Psychological health conditions, such as anxiety or mood disorder, specific personality disorder, or dissociative disorder
  •  A history of sexual or physical assault or neglect during childhood.
  • Having a family history of functional neurological symptom disorder.
  • Some stressors that can cause conversion disorder include post-traumatic stress disorder or physical illness.
  • People in the law or military enforcement are more at risk, as these jobs produce more stressful and violent situations, developing conversion disorder. 
  • Some people can experience conversion disorder with no apparent stressors causing the symptoms. 
  • The stress of belonging to a lower socioeconomic class can also cause conversion disorder. 
  • Being closely related to people with a neurological disorder also causes conversion disorder. 

It is usual for healthy people to experience conversion disorder throughout their lives. Women are most liable to suffer from it than men. Moreover, it also happens more commonly in people who have any hurtful mental history.

There is a broad categorization of different types of functional neurological symptom disorder according to accepted psychological and physical symptoms. Nine types of conversion disorder are:

Dissociative Amnesia

In this type of conversion disorder, people usually suffer from memory loss and forget all the recent events. This loss has no particular cause and is said to be due to fatigue or stressors. This memory loss worsens traumatic events or an unforgettable emotional load. Dissociative amnesia is accompanied by different affective states, such as bewilderment and anxiety. 

Dissociative stupor

In this condition, patients behave like stupors, representing all the symptoms of it. Stupid states are characterised by a lack of response to stimuli and paralysis or decreased voluntary motor skills. At this time, the patient remains still for a very long time. 

Dissociative Disorders Of Voluntary Sensitivity and Motility

In this change, the patient experiences a somatic disease, the roots of which cannot be found. Usually, the symptoms represent that how the patient is taking that disease. 

Trance And Possession Disorder

In this disorder, patients forget their identity, and environmental awareness arises. During this crisis, the patient behaves as if controlled by a higher force, another person, or a spirit. 

Dissociative Crises

In dissociative crises, symptoms can simulate those of a seizure. There is probably no loss of consciousness in this disorder but rather a tiny state of closeness or stupor.

Dissociative Sensory Loss And Anaesthesia

Different conditions can arise in this disorder, like alterations in other senses and skin sensitivity that cannot be explained or justified by an organic or body ailment. Furthermore, this sensory deficit is accompanied by paresthesias having no apparent causes. 

Dissociative Motility Disorders

In these cases, the patient suffers different mobility difficulties, in some cases experiencing a total loss of movement or paralysis of particular parts of the body.

These complications can also appear in the form of coordination difficulties or ataxia: in addition to small tremors or simply tremors, affecting any part of the body.

Mixed Dissociative Disorder

During this disorder, patients suffer from different above conditions, occurring at the same time. 

Other Dissociative Disorders

There are many other conversion disorders:

  • Dissociative escape
  • Ganser’s syndrome
  • Transient conversion disorder in youngsters and children
  • Multiple personality disorder
  • Other specified conversion disorders

People with conversion disorder need support and understanding. You can help your loved ones with functional neurological symptoms by believing that their symptoms are real and treatable. 

Avoid Telling The Patients That Their Symptoms Aren’t Real.

Telling people with conversion disorder that their symptoms aren’t real won’t help. Instead, this will cause more anxiety or will worsen the existing stress. Even if you feel frustrated or annoyed, do not show it off in front of the person and keep calm. Screaming or forcing the patient to understand that their symptoms are mental rather than physical will cause more harm than good.

Emphasise Negative Test Results

Instead of convincing the patients that their symptoms are not real, use proof to make them believe that there is no need to worry about these symptoms. You should first need to force them to perform a lab test. If the test is negative, then celebrate with them, and if it is not, make them ready to seek the treatment. 

Be Hopeful For Recovery

Another way to help your loved ones with conversion disorder is that first, you should be hopeful that their symptoms will disappear. Second, keep telling the person with conversion disorder that he will recover soon. For example, you should say that there is nothing wrong with you; you are healthy and will recover quickly. 

Helping Loved Ones To Seek Treatment

When your loved ones experience any symptoms after a stressful or traumatic event, you should encourage them to see a doctor or seek medical treatment. If they have gone through an accident, then the doctor will find if there will be any physical or psychological injury. 

Conversion disorder is not a lasting disorder. If you or anyone is bearing it or experiencing severe symptoms of conversion disorder, you should seek treatment which varies depending upon the severity of symptoms. Moreover, mild symptoms of conversion disorder recover independently and do not require treatment, but if symptoms are severe, then without delay, see a doctor and tell him about everything you are feeling and experiencing at present. 

Medical Understanding

The first step in dealing with functional neurological symptom disorder is understanding that your symptoms are not just your mind’s thoughts and are genuine. The growing focus of medical science ​on a psychological basis can be helpful in this condition. 

Medications

There are not any particularly recommended medications for conversion disorder. But antidepressants and anti-anxiety medications are often prescribed to help patients with conversion-disorder-related conditions, such as depression and anxiety. 

Psychotherapy

Though functional neurological symptom disorder has a neurological origin, its psychological roots cannot be ignored. A variety of psychical-health treatments have been developed for addressing conversion disorder. Psychotherapy is one of them including:

  • Cognitive-behavioural therapy
  • Hypnosis
  • Biofeedback
  • Relaxation therapy
  • Individual or group therapy

Physical Therapy

Physical therapy is commonly used in people with conversion disorder who have movement difficulties, weak limbs, coordination, walking, or balance problems. It is also necessary to prevent any secondary complications, including stiffness and muscle weakness, which result from inactivity. 

NIBS (Non-Invasive Brain Stimulation) Methods

NIBS methods, such as transcranial magnetic stimulation and electroconvulsive therapy (ECT), are other treatments to recover conversion disorder symptoms, including paralysis or limb weakness. An important note is that these treatments are experimental, and because of this, these treatments should be observed with caution.

Conversion disorder is a pretty rare mental illness, affecting about two-five out of one lac people reporting symptoms of this disorder. According to the (DSM-5) Diagnostic And Statistical Manual of Mental Disorders, functional neurological symptom disorder is categorized as a kind of somatic symptom disorder. 

If it recovers early, it is normal, but if it is not, you are in danger. At that time, your body will start giving you signs that it is not well. If you ignore those mild signs, then those mild symptoms will move towards severe conditions like paralysis of any part of the body, turning to the stiffness of the whole body. 

To avoid these hurtful situations, there are many treatments that can help you cope with the conversion disorder and recover from it completely. But the best way is that you should do some yoga, exercises, or some positive changes to your lifestyle rather than the medications that can leave a harmful impact on your body. 

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