FND is Neurological: Why Your Symptoms Should Not Be Associated with Conversion Disorder

Functional Neurological Disorder (FND), as the name implies, is a true neurological condition and not a psychiatric condition. FND has been known by various names over hundreds of years, based on the level of understanding at the time.  The diagnosis of Conversion Disorder was changed to Functional Neurological Disorder OVER A DECADE AGO!  What was once understood about “Conversion Disorder” has rapidly changed over this period of time. 

I reflect on how often I have patients attend  their first visit with me and right off the bat say something to the extent of, “I’ve been told I have Conversion Disorder; I just need for you to know I’m not crazy.”

Some of the more common reasons leading to this kind of statement are related to how the diagnosis was initially explained, a provider’s singular focus on psychiatric components of the medical history (i.e. constantly coming back to your anxiety, panic, PTSD, depression, etc.), placing the diagnosis as one of exclusion–meaning your imaging, labs, and so forth all look normal so it is “Conversion Disorder” and it must be all in your head, being bounced around to one provider after another.  The list can go on…

To make things worse, the common tendency is to go home and google whatever diagnosis the doctor has given you and, unfortunately, a lot of the web content is misleading.  This is how AI explains the diagnosis when searched on the web:

“Conversion disorder, also known as functional neurological symptom disorder (FND), is a mental health condition that causes physical symptoms that can't be explained by a medical or neurological condition.”

Don’t get me wrong, I have no judgment or stigma regarding mental health. Elements of one's psychological wellbeing can act as a risk factor for being more likely to develop FND, but there are many other non-psychiatric-based risk factors, and the majority of people diagnosed with FND don’t have a significant history of trauma or other psychiatric conditions.  I’ll explain risk factors more in a future video or post.  Mental health is a vital part of our wellness and deserves expert attention and support; however, it’s highly problematic when you’re experiencing a NEUROLOGICAL disorder that’s being misidentified as a psychiatric problem.  It results in not receiving the correct treatments, having an incomplete care team, and feeling medically gaslighted.  

The big, overarching change that happened between the label of Conversion Disorder to Functional Neurological Disorder stemmed from brain studies and statistics that support this diagnosis being truly neurological in nature and not psychiatric.  It’s a pathway or software problem of the brain's communication with itself and with the body.  This is why it doesn’t show up on conventional forms of diagnostics. There are parts of a history, nature of the symptoms, and positive clinical signs that are tested for by skilled providers that leads to ruling in Functional Neurological Disorder.  It’s important to have a neurological workup done as FND can stand alone or can be layered over other neurological conditions.

FND can be highly managed and symptoms respond well to the correct treatments provided by a complete care team.  The fun part of my job is seeing people gain big parts of their lives back.  The frustrating part is seeing how long people have floundered in the healthcare system before getting answers and effective treatment.  The healthcare community is gradually coming up to speed and there are some great providers out there.  I’ve been fortunate to collaborate with incredible movement disorders specialists, psychologists, social workers, OTs, speech therapists, and physical therapy assistants. 

I look forward to helping you through your FND journey!  Please contact me to schedule, ask questions, or comment on this post to make suggestions for future educational content you want to know about.