Functional Neurological Disorder
Updated: Dec 2, 2021
Functional neurological disorder is a very misunderstood and stigmatized disorder, that some might argue is not a mental illness, however for the purpose of this article, is classified under somatic symptom disorders. Functional neurological disorder, or FND for short, is a disorder where there is a miscommunication between the brain and nervous system. This can cause a variety of neurological symptoms.
“It does show me that no matter who you are, everyone has some struggles of their own, whether or not they show is another story,” says a high school student with FND, after mentioning how challenging the unpredictability of the disorder can be.
One way to explain it is to compare it to a computer. The computer is made up of hardware, such as the screen, the mouse, and the keys. It is also made up of software which helps it to run. In FND, it is not the hardware that has a problem, like in some conditions, it is the hardware. The problem lies in the fact that both the software and hardware need to work together, and this lack of function in the software of the brain causes the presenting symptoms.
Oftentimes, people with FND get MRI’s, CT scans, EEG’s, or other tests because of their debilitating symptoms. However, these are likely to be all normal, and because of this fact, patients dealing with this disorder are often dismissed. When this happens, patients are told that it’s “all in their head”, that they’re exaggerating it, or to “suck it up”. This is very misleading, as functional neurological disorder is a very real condition, and the symptoms are not in the patient's control.
In order to be diagnosed with a functional neurological disorder, symptoms must not be explained by another medical condition. Like many conditions, symptoms vary for everyone, and can fluctuate in severity and presence over time. Symptoms can include:
Limb weakness/paralysis
Tics or tremors
Difficulties with walking
Difficulties with speech including slurred speech
Non-epileptic seizures (also known as dissociative seizures, pseudo-seizures, or psychogenic non-epileptic seizures (PNES) and drop attacks
Vision problems
While it was previously thought that FND was solely caused by stress and anxiety, that is not the case. While symptoms can flare during periods of increased stress, stress does not cause the disorder in itself. The exact cause of functional neurological disorder is unknown. Therefore, treatment often takes a multi-pronged approach.
Psychotherapy is used to treat the accompanying anxiety, or any other challenges a patient might face, while occupational therapy, physical therapy, and speech therapy are used to help a patient with specific symptoms they may be experiencing. Many patients with FND recover and are able to learn how to manage their symptoms through the help of these therapies.
It can be very helpful to connect to other people with the same condition or experiencing similar things as you. There are organizations dedicated to providing support, and support groups, both online and in person that can help connect people together.
Organizations such as FND Hope UK exist to create awareness and support those with functional neurological disorders.
**Other names include functional movement disorder, conversion disorder, functional neurological symptom disorder, and dissociative neurological symptom disorder
Check out this video on people with FND and their perspectives: https://youtu.be/KmuNiNmfDZU
Sources:
https://fndhope.org/fnd-guide/
https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197