Conversion Disorder: Information, Symptoms, Treatment and More

Conversion Disorder (also known as Functional Neurological Symptom Disorder) is a mental health condition that involves physical symptoms developing – with the symptoms resembling those of a nervous system disorder.

However, crucially, no nervous system disorder is present. Instead, the pain appears to be as a result of somatisation – where emotional pain is expressed as physical symptoms. As such, Conversion Disorder is a Somatic Disorder.

Symptoms typically include paralysis, blindness, numbness or convulsions. This disorder is difficult to live with, and can cause substantial functional impairment. The condition is typically caused by a psychological trigger.

Treatment is available for Conversion Disorder, with recovery a strong possibility. The disorder was once known as Hysteria.

What are the symptoms of Conversion Disorder?

The symptoms of Conversion Disorder can range from person-to-person. Generally, the disorder begins with some form of psychological distress.

The emotional pain manifests itself as physical symptoms – primarily affecting sense or movement. These symptoms cannot be explained by a general health condition.

As mentioned, symptoms normally affect sense or movement. One or more of these symptoms can then be accompanied by other symptoms. Symptoms include, but are not limited to:

• Blindness
• Deafness
• Paralysis (sometimes partial)
• Numbness
• Convulsions
• Impaired vision
• Inability to speak
• Inability to walk
• Inability to swallow
• Inability to urinate
• Loss of sense of smell
• Tremors

These symptoms will typically appear suddenly. They will typically lead to a change in the behaviour of an individual. The person may struggle with mobility, and spend excessive time in bed. This in turn may lead to low mood to become a significant problem.

As a result, Conversion Disorder can run alongside other mental health conditions – especially Depression.

These symptoms would normally represent a problem with the nervous system. However, this will not be the case with cases of Conversion Disorder, with these symptoms persisting even after physical disorders have been ruled out as being the cause.

What are the causes of Conversion Disorder?

Conversion Disorder is a very complex condition – with its specific cause currently unknown. It is possible that multiple factors contribute to the onset of the condition.

There appears to be differences in the way brain processes certain events in those with a Conversion Disorder [1].

It appears that emotional pain is an important factor in Conversion Disorder. Any emotional distress can feasibly be converted into physical symptoms. This would suggest that the disorder is related to any form of emotional trauma.

In terms of risk factors, women are more likely to develop Conversion Disorder than men [2]. Symptoms commonly appear in adolescence, though can appear at any time. Genetics may also be a risk factor, though this is unclear.

It is very difficult to pinpoint exactly what contributes to the onset of Conversion Disorder. It is a condition which isn’t well understood. As research continues and advances, it is possible that there will be more of an understanding of the condition’s causes.

Diagnosis of Conversion Disorder

It is important for anyone who believes they are suffering from Conversion Disorder, or any other condition, to see a Doctor or mental health professional.

It is normal for someone to seek a Doctor’s help when they believe there is a physical disorder causing their symptoms. The doctor may suspect that Conversion Disorder is present.

At an appointment, a Doctor will attempt to gain a thorough understanding of an individual’s symptoms, and the effect they are having on their life.

A range of medical tests or other laboratory examinations may be carried out in an attempt to find the cause of the symptoms. If there appears to be no physical cause of the symptoms, it is likely that Conversion Disorder is present. This may eventually be realised by process of elimination.

In terms of the actual symptoms, for Conversion Disorder to be diagnosed, a patient will satisfy the following criteria:

• Symptoms are not caused by any neurological disorder
• Symptoms cause significant distress to the individual
• Symptoms cause functional impairment
• Symptoms are not better explained by an alternative mental health condition
• Symptoms may be related to a recent stressful event (not essential)
• Symptoms are not being faked

Once a diagnosis has been made, treatment can proceed.

How is Conversion Disorder treated?

Treatment is available for Conversion Disorder. In many instances, with the right treatment plan, recovery is possible.

An individual will normally be referred to an external service for treatment to be carried out.

Treatment normally involves talking therapy, and if symptoms require – medication. This is dependent of course on individual circumstances.

In select occasions, a Doctor’s assurance that no physical disorder is present can lead to symptoms disappearing. Unfortunately, this isn’t always the case, with actual treatment often required.

Talking Therapy

Talking therapy is generally used to treat Conversion Disorder. Talking therapy can help an individual process their thoughts and emotions in a healthier way – which may lead to an improvement in symptoms. Some common types of therapy that can be used include:

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

Hypnotherapy: Hypnotherapy is a form of therapy that uses hypnosis in an attempt to treat a condition. Hypnotherapy normally involves an individual being in a deeply relaxed state. The therapy also uses focused attention and concentration to induce a heightened state of awareness. This allows the patient to focus on specific thoughts or factors. Hypnotherapy will commonly involve suggestion therapy, which allows a person to be more inclined to changing behaviours (including pain management). It can also be used to explore causes of a condition or symptom. This may include events that have been hidden in an individual’s unconscious memory.

In addition to the above, there are other types of talking therapies that exist. There are many ways that talking therapy can help, so it is definitely recommended. For further information, you can see our Therapy section.

Medication

There are many different medications that can be used to treat Conversion Disorder. The type of medicine that is used will depend on the symptoms present, along with any other relevant circumstances.

For those who are depressed or anxious, antidepressants can help. For those experiencing convulsions (fits), an anticonvulsant should be prescribed. With the pain associated with this condition, a painkiller or opioid may be prescribed.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Anticonvulsants (Mood Stabilisers): For those experiencing convulsions (fits), it may be necessary to take anticonvulsants. From a mental health perspective, these medicines are also mood stabilisers. Anticonvulsants, like Lamotrigine, Valproate and Lamotrigine, appear to work changing the levels of certain chemicals in the brain. In theory, this stops seizures occurring.

Painkillers: For mild to moderate pain, painkillers that can be purchased over the counter can be very effective in subduing the pain. Paracetamol and Ibuprofen are commonly used painkillers.

Opioids: Opioids relieve pain. For moderate to severe pain, a mild opioid, such as Codeine, can help relieve physical pain associated with some mental health disorders. In cases of severe pain, a high strength opioid like Tramadol or Hydrocodone can be prescribed, though this is only under certain circumstances.

Other

In some cases, physiotherapy may be carried out. This will be conducted in an attempt to restore bodily functions to normal.

Summary

Conversion Disorder is a complex condition. But with the right treatment, it is possible for a person to recover.

It is very important that anyone suffering from a mental health condition – whether it is Conversion Disorder – or anything else, seeks treatment. Our website has plenty of information to assist you.

See Also

• Somatic Disorders Section
• What is the Prognosis for Somatic Disorders?
• Therapy Homepage
• Medicine Homepage