What is Conversion Disorder?
Conversion disorder is also called functional neurological symptom disorder. It is a disorder of the function of the nervous system. In this disorder, the brain and nerves are unable to send and receive signals properly. Hence, patients with conversion disorder may have difficulty moving their limbs. Thus, they may complain that an arm or leg is paralyzed. In addition, they can also have problems with their sense of touch, sight, or hearing. But, doctors can’t find any injury or other physical condition to explain them.
The symptoms are real, and the patient is not making them up or faking them. They are commonly triggered by mental factors such as conflicts and stressful physical or emotional event. That is, mental factors are expressed as physical symptoms.
Conversion disorder tends to develop during adolescence to early adulthood. It is more common in women. About two-thirds of patients have evidence of depression and trauma. Personality disorders are also not uncommon.
Treatment includes psychotherapy, stress management training, and hypnotherapy. In addition, it necessary to treat any underlying psychological disorder. Also, physical or occupational therapy may be needed.
Symptoms of Conversion Disorder
People may have only one episode in their lifetime or episodes can recur. Usually, the episodes are brief. Symptoms of conversion disorder can cause substantial distress and affect one’s functioning. And, the symptoms vary in intensity and duration from person to person.
Symptoms affecting body movement and function include:
- Limb weakness or paralysis
- Abnormal movements, such as tremors or spasms
- Difficulty walking
- Loss of balance
- Trouble coordinating movements, such as difficulty swallowing
- Seizures, blackout, fainting
- Overactive bladder
Symptoms affecting the senses include:
- Blindness, double vision, sensitivity to light
- Speech problems, such as inability to speak or slurred or stuttered speech
- Anosmia – loss of sense of smell
- Loss of sense of touch
- Hearing problems or deafness
- Numbness and tingling extremities or face
Causes and Risk Factors
The exact cause of conversion disorder is not well understood. Symptoms appear suddenly after physical or psychological stress. Other triggers could include changes in brain structure, cells or metabolism. Often, you cannot identify the trigger for symptoms.
Factors that increase the risk of conversion disorder are:
- A neurological disease or disorder – e.g., epilepsy, movement disorder or migraines
- Recent significant stress or emotional or physical trauma
- Physical injury or infection
- Mental illness, such as an anxiety or mood disorder, certain personality disorders, panic attack, or dissociative disorder
- A family member with conversion disorder
- History of childhood sexual abuse or neglect
As per DSM-5, the diagnostic criteria for conversion disorder are:
- Symptoms of affected voluntary motor or sensory function.
- There must be clinical findings that show clear evidence of incompatibility with neurological disease. To demonstrate incompatibility, check for internal inconsistency at examination (i.e., demonstrating that physical signs elicited through one examination method are no longer positive when tested a different way).
- The symptom(s) is not better explained by another medical or mental disorder.
- The symptom(s) causes clinically significant distress or impairment in important areas of functioning, such as social and occupational, or calls for medical evaluation.
However, the diagnosis of conversion disorder should be based on the overall clinical picture and not on a single clinical finding. Associated features that can support the diagnosis of conversion disorder are:
- A history of multiple similar somatic symptoms
- Onset is often associated with recent stress or trauma, either psychological or physical
- Presence of dissociative symptoms, such as depersonalization, derealization, and dissociative amnesia.
Treatment of Conversion Disorder
Sometimes, simple reassurance from your doctor that you are not suffering from a serious physical condition can be enough to stop the symptoms. More often, it needs treatment. Since the symptoms vary from patient to patient, tailor the treatments to each individual patient. Therapies and treatments can include:
- Cognitive-behavioral therapy (CBT). It is a type of psychotherapy. CBT helps you respond to situations in a more effective way by making you aware of inaccurate or negative thinking patterns. Moreover, it can also help you to better manage stressful life situations.
- Treatment of associated mental illness. Treat anxiety, depression or other mental health disorders, if present.
- Hypnosis. A trained hypnotist can help people who are receptive to suggestions during hypnosis.
- Physical or occupational therapy. A physical or occupational therapist can help improve movement symptoms and prevent complications. They can help you ward off muscle tightness and weakness if you have paralysis or loss of mobility, with an appropriate movement regimen.
- Speech therapy. A speech therapist can help improve your problems with speech or swallowing.
- Stress reduction. These include progressive muscle relaxation, yoga, breathing exercises, meditation, and music therapy.