Conversion Disorder

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KEY POINTS

• Conversion disorder is a term used when you have physical symptoms that seem to be caused by problems in your nervous system, but which are not caused by a physical disease or disorder of your brain, spine, or nerves. Often the symptoms start after a stressful experience.
• Conversion disorder may be treated with therapy, medicine, or both.
• Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others. Seek immediate help if you have severe chest pain or trouble breathing.

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What is conversion disorder?

Conversion disorder is a term used when you have physical symptoms that seem to be caused by problems in your nervous system, but which are not caused by a physical disease or damage to your brain, spine, or nerves. Your symptoms may keep you from working or doing everyday activities.

It may also be called functional neurological disorder.

What is the cause?

The exact cause of this disorder is not known. Often the symptoms start suddenly after a physically or emotionally stressful experience. For example, sudden blindness after seeing a terrible accident, even though there is nothing wrong with your eyes or the part of your brain that controls vision. It is thought that the brain may process emotions in a different way, so that instead of expressing extreme fear or anger, you have symptoms in your body. The symptoms are real, and not something that you do on purpose.

Conversion disorder is most common among people 10 to 35 years old. The risk is greater if you:

• See or are involved in a stressful event, such as a natural or man-made disaster
• Have a family member with the disorder
• Were physically or sexually abused or neglected
• Have money, housing, or work problems
• Are a woman
• Have a personality disorder that changes the way you relate to others and the way you think about everyday activities.
• Are around people who have physical symptoms

What are the symptoms?

The symptoms start suddenly. Symptoms may include:

• Not able to move an arm or leg because of numbness or paralysis
• Vision changes, such as double vision or blindness
• Hearing problems or deafness
• Not being able to speak or having slurred speech
• Seizures or falling down
• Severe trembling
• Trouble swallowing

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms, medical and family history, and any medicines you are taking. Your provider will check for a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests or scans to check for other possible causes of the symptoms.

How is it treated?

Sometimes conversion disorder gets better without treatment. If symptoms are serious or last longer than a few days, treatment may include therapy, medicine, or both.

Therapy

• Cognitive behavioral therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.
• Group therapy can help you deal with work and relationships. It takes place in a group of 6 to 10 people, under the guidance of a therapist.
• Family therapy is often very helpful. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family to make changes.
• Physical therapy may be helpful if you have weakness, paralysis, or trouble moving your body.

Medicine

• There are no medicines known to treat conversion disorder. Medicine may be prescribed if you also have problems with anxiety or depression. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.

Other treatments

• Learning ways to relax may help. Yoga and meditation may be helpful. You may want to talk with your healthcare provider about using these methods along with medicines and therapy. Physical therapy may be needed until symptoms go away. PT may help keep a paralyzed arm or leg strong.
• Hypnosis may be helpful in treating this disorder.

How can I help take care of myself?

Maintaining a healthy lifestyle is important.

• Get support. Talk with your family and friends. Consider joining a support group.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It’s very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicine doesn't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others. Seek immediate help if you have severe chest pain or trouble breathing.

You can get more information from:

• National Institute of Mental Health
  866-615-6464
  http://www.nimh.nih.gov/
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/