What is Functional Neurological Disorder (FND) aka Conversion Disorder?

Functional Neurological Disorder (FND) aka Conversion Disorder is the name given to patients who suffer from abnormal cognitive changes that can be so severe it makes it very difficult for the person to function in society.

Conversion Disorder has no known cause, no known treatments, and no way to predict how it will progress or respond to treatment.

What is known about conversion disorder is that there are different levels of severity. Conversion disorder, symptoms can get progressively worse and get in the way of a person’s ability to function in the outside world.

FND is often misdiagnosed as several other mental health disorders, such as Bipolar Disorder, anxiety disorders, and Schizophrenia.

The most notable difference between Conversion Disorder and schizophrenia is the nature of the symptoms.

Schizophrenia is a chronic mental disorder that occurs when the brain is unable to process information normally, causing hallucinations, delusions, and disturbances in thought and behavior.

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Conversion Disorder, on the other hand, is the brain overreacting to mundane or, seemingly, non-existent stimuli and is in “overdrive” to make changes that are causing a wide range of physical symptoms and sometimes cognitive problems.

According to FND Hope, this is a neuropsychological, cognitive, and psychiatric condition that affects both children and adults. It is not an infectious disease or condition and is considered a “real” brain disorder, not a psychological issue.

Nearly 400,000 Americans suffer from Conversion Disorder. The symptoms can impact a person’s ability to function socially, in school, or at work.

Thousands of patients have lost their jobs, their relationships, and significant quality of life disturbances due to Conversion Disorder. These patients and their loved ones have not only been wronged but also betrayed.

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Psychology Today’s definition of Conversion Disorder: “A brain-based condition in which the brain, through a traumatic experience, behaves in such a way that causes a significant disruption of functioning in the individual’s life.”

“This abnormality is often misdiagnosed as schizotypal and other psychosomatic disorders.”

Some of the common symptoms of Conversion Disorder include:

Confusion
Abnormal thinking
Over-activity
Persistence
Temporary Inability to Move (freezing)
Attention-Deficit/Hyperactivity Disorder (ADHD)
Developmental Disabilities
Post-Traumatic Stress Disorder (PTSD)
Personality Disorders
Impulse Control Disorders
Radical Change
Isolation
Tremors
Unsteady Gait (difficulty initiating and coordinating walking)
Limb Motion Changes
Dissociative Identity Disorder (DID)

The DSM-5 classifies Conversion Disorder as a mental illness with No Evidence of Disease. However, new studies from the Mayo Clinic are encouraging doctors to move away from Conversion Disorder to the more formal Functional Neurological Disorder (FND). They cite that the key difference is that the disease is not a “hardware” problem in the brain, but rather a “software” issue. It has nothing to do with tumor or brain disease, but rather a problem with an individual’s adaptive brain, which includes the brain’s ability to switch off neural pathways.

People suffering from Conversion Disorder often find that the symptoms tend to get worse with time.

Voices and Hallucinations

This is one of the factors that regularly lead to misdiagnosis and failed treatment. Under most mental health protocols, if a person reports hearing voices or having hallucinations they are immediately treated as having a schizophrenic disorder.

There is a significant difference in the presentation of these voices, compulsions, or hallucinations. For example, a schizophrenic may hear voices in their head that are threatening to hurt or kill them. A Conversion Disorder sufferer can hear a thought that is a personal insult or command, or they can feel like they are being manipulated into something. This “awareness” creates a reaction in the person and the symptoms listed above will become more exaggerated until the episode subsides. This can last for as little as 30 minutes to many hours or even days.

In addition, two-thirds of patients report episodes of psychokinesis. Many health professionals scoff at this notion mainly because they are not aware of the actual definition of psychokinesis. “The influence of mind on matter, as the use of mental “power” to move or distort an object.” Source: Medical Dictionary for the Health Professions and Nursing © Farlex 2012

The key component is “distort an object”. Because the software of the brain is infected, the distortion of objects, entire rooms, and even large open spaces is quite common. By definition, this is psychokinesis and not a hallucination or delusion.