Conversion disorder, also known as functional neurological symptom disorder or hysterical neurosis is a mental condition in which a person has blindness, paralysis, or neurological symptoms that cannot be explained by medical evaluation. Conversion disorder is thought to be caused by the body’s reaction to a stressful physical or emotional event. Some research has identified potential neurological changes that may be related to symptoms of the disorder.
Diagnosis of conversion disorder is based on identifying particular signs that are common among people with the disorder, as well as performing tests to rule out other causes of the symptoms. Treatment may include psychotherapy, hypnosis and stress management training to help reduce symptoms. Treatment of any underlying psychological disorder is also recommended. The affected body part may require physical or occupational therapy until symptoms resolve.
CAUSES OF CONVERSION DISORDER
Conversion disorder symptoms may occur because of a psychological conflict. Symptoms usually begin suddenly after a stressful experience. People are at risk of conversion disorder if they also have medical illness, a dissociative disorder which is escape from reality that is not on purpose and personality disorder which is inability to manage feelings and behaviors that are expected in certain social situations. People who have conversion disorder are not making up their symptoms in order to obtain pity. They are also not intentionally injuring themselves or lying about their symptoms just to become a patient as with factitious disorder.
Some health care providers falsely believe that conversion disorder is not a real condition and may tell people that the problem is all in their head. But this condition is real. It causes distress and cannot be turned on and off at will. The physical symptoms are thought to be an attempt to resolve the conflict the person feels inside. Research into the cause of conversion disorder has found that the brain imaging of some individuals with the disorder shows increased or reduced blood flow to certain areas of the brain.
If areas of the brain that are responsible for communication with other body parts have reduced blood flow, this may cause neurological symptoms associated with conversion disorder. It is possible that these changes in blood flow may be caused by the brain receiving information about physical or emotional stressors regardless of the cause of the disorder, it is important to remember that the symptoms are very real; affected individuals are not faking symptoms of the disorder.
SYMPTOMS OF CONVERSION DISORDER
Common signs of conversion disorder include a debilitating symptom that begins suddenly, history of a psychological problem that gets better after the symptom appears and lack of concern that usually occurs with a severe symptom. Symptoms of conversion disorder can include a variety of neurological symptoms. Common symptoms of the disorder include sudden blindness, paralysis, loss of the voice, trouble coordinating movements (ataxia), loss of the sense of smell (anosmia), loss of sense of touch, or tingling in the extremities. Some people with conversion disorder may experience seizures or hallucinations.
WHO SUFFERS FROM CONVERSION DISORDER?
People are more at risk for a conversion disorder if they also have a mental illness, dissociative disorder or personality disorder. Conversion disorder is more common in women, people of lower socioeconomic status, and people in the military. Most affected individuals first develop symptoms of conversion disorder during adolescence or adulthood. The diagnosis of conversion disorder is based on a healthcare provider observing symptoms consistent with the disorder.
Other causes of similar symptoms should be ruled out to avoid a misdiagnosis. It is best for a neurologist and a psychiatrist to work together on making the diagnosis of the disorder. Current diagnostic criteria for conversion disorder include one or more symptoms of neurological dysfunction, no physical findings that may explain the symptoms and no other disease is known that better explains the symptoms. The symptom causes significant distress or impairment so that medical evaluation is desired.
EXAMS AND TESTS
Your doctor will do a physical exam and may order diagnostic tests. These are to make sure there are no physical causes for the symptom.
For some people, the symptoms of conversion disorder may improve with time, even without treatment. This can occur after they receive a diagnosis of the disorder, reassurance that the symptoms aren’t caused by an underlying problem and validation that the symptoms are real. Individuals with severe symptoms, symptoms that linger or keep coming back, or other mental or physical health problems may require treatment. The specific type of treatment depends on the particular signs and symptoms of the disorder and may include counseling and psychotherapy, hypnosis, physical therapy, occupational therapy and treatment of related physical or psychological stressors. Talk therapy and stress management training may help reduce symptoms. The affected body part or physical function may need physical or occupational therapy until the symptoms go away.
Symptoms of conversion disorder usually last for days to weeks and may suddenly go away. Usually, the symptom itself is not life-threatening, but complications of the symptoms or unnecessary medical tests can be debilitating. For most people, symptoms of conversion disorder get better with reassurance and time. However, up to one in four people may show a recurrence or new symptoms later.
Individuals may be more likely to have long-lasting symptoms or develop a new conversion disorder if they delay seeking treatment, if the symptoms come on slowly or don’t improve quickly, if they have serious psychiatric disorders and if they have tremors or seizures not caused by epilepsy. If it is later discovered that a separate underlying disorder is causing a person’s signs or symptoms, the long-term outlook and treatment recommendations for this person is dependent upon the underlying disorder.
WHEN TO SEEK MEDICAL HELP
See a doctor or mental health professional if you or someone you know has SYMPTOMS of a conversion disorder.