Functional Neurological Disorder (FND), is often diagnosed when an individual has a diverse range of neurological symptoms that do not neatly fit into any specific category.
Individuals with Functional Neurological Disorder have provided me with these interesting comments:
FND does not always have a psychological cause i.e. past trauma – for some people, it is just physical symptoms alone with no previous trauma.
It is not a one size fits all disorder and there are many variations in the presenting symptoms.
Not all individuals with FND catastrophise – many of the group say they do not.
Counselling and therapy doesn’t fix or help FND, or work for everyone – as everyone is an individual.
There may be links to fibromyalgia.
FND is often undiagnosed and it is hard to get the right support. There is a lack of awareness and support. It should be recognised in the same way that MS is recognised.
Symptoms of Functional Neurological Disorder
Symptoms may vary from person to person and the most common symptoms include:
sensory issues such as blurry vision
limb weakness, and more.
Biology of Functional Neurological Disorder
The wiring of the nervous system is fully intact but there is a problem with how the brain is sending and receiving messages. This in turn affects the way the body responds to the messages and the subsequent movements.
Whilst the symptoms may appear similar to those seen in neurological conditions such as Multiple Sclerosis, Parkinson’s, and Epilepsy, and can be just as debilitating, they have a different underlying cause.
How to explain FND
There is a possibility that the underlying cause of Functional Neurological Disorder might be due to past trauma. If the body is taking too much strain and the individual is not addressing the issues and dealing directly with their emotions, their stress can manifest in a physical manner.
Unfortunately, many patients diagnosed with FND feel alienated, stigmatised, and are not believed by others. It is difficult when the symptoms are possibly caused by previous trauma because mental health conditions are less ‘solid’ as explanations.
How counseling can help you cope with Functional Neurological Disorder
Cognitive Behavioral Therapy is an effective treatment that can alleviate some of the anxiety that individuals with Functional Neurological Disorder experience. It is normal to catastrophize when your health is at risk and you are limited in your functioning.
Thoughts such as, ” Will I ever get better?” or ” or I am losing my independence and I can’t cope” will certainly affect an individual’s mental health and confidence in their abilities to function as they used to.
Cognitive Behavioural Therapy teaches patients how to manage their lives at a different pace and to see this altered pace in a positive way rather than in a negative and limited way.
Thoughts affect feelings and feeling affect behaviour
The physical limitations that FND brings about will naturally cause panicky thoughts and worries. Life is all about our appraisals – it’s not exactly about what is happening to you but rather what you are thinking about what is happening to you. If you catastrophise when something bad happens and tell yourself it is awful and that the world is coming to an end, of course, you will feel overwhelmed and want to give up.
When you look at life from a different perspective and shift your thinking, your feelings will be more positive, and your general quality of life will improve. This does not mean that you are ignoring the issues, just that you are choosing to think about them in a different way.
Thankfully you have control over what you wish to think and what do you wish to do.
Some factors create more panic and distress. Avoiding or minimising these factors will contribute to an improved experience and quality of life:
1.Beliefs about illness
If you believe that you are physically weak (and you focus on this), you might cause a self-fulfilling prophecy where you become weaker quicker. Instead of focusing on what you can’t do, focus on what you can do – fill your mind with empowering thoughts. Being too vigilant of every ache and pain won’t be helpful and will create more anxiety.
2.Unhelpful behaviours that maintain illness
Avoidance of being active and living life will lead to a weaker physique and possibly secondary health issues. Avoidance prevents ‘reality testing’ to help disconfirm the beliefs. Thoughts aren’t facts – be careful what you believe to be true.
Googling symptoms – this is never a good idea as you will end up catastrophising. Each individual is different in their experience of ill health.
Asking for constant reassurance or body checking regularly fixes your focus on your fears.
Individuals with chronic pain can develop a ‘defensive’ body posture.
Checking comes in many forms: visual inspection, physical touching, and manipulation of body parts, mirror use, mental scanning of the body and experiments to test bodily function e.g. checking one’s pulse.
Reduce your tendencies to focus constantly on your health and focus on enjoying life within the limits you have. Acceptance is key.
Focusing on illness, loss and what might happen in the future will create anxiety and fear and a feeling of being out of control. In contrast, some avoid thinking and suppress these thoughts producing a paradoxical rebound in worrying thoughts. Focusing too much on what is wrong will lead to confirmation bias.
This is where you look for things that confirm what you think rather than keeping a balanced view and considering evidence that doesn’t match reality or fit your picture of what is actually happening. Keep an open mind.
When you misinterpret physical symptoms, anxiety and depression might arise. Try not to overthink or imagine worst-case scenarios. Remind yourself that some symptoms may disappear and tried to take life one day at a time. Make an effort to focus on what is good in your life and perhaps keep a gratitude journal.
You could write in your journal every day about the little things that bring you joy. It could be something as simple as hearing the birds singing or the fact that the sun is shining. Take pleasure in the simple things in life and avoid ruminating and overthinking.
At times, significant others may unwittingly collude with your significant focus on your illness and your beliefs. At times, emotional distress can be hard to deal with and as a result, others may tend to focus on the physical symptoms as there is less stigma around physical problems than emotional issues.
Doctors may also lack the training necessary to convey a psychological understating of symptoms and are often perceived as suggesting that the problems are ‘all in the mind’ leading to a deterioration of the relations and a further loss of faith in the health care system.
If you are affected by Functional Neurological Disorder, it will naturally take time to adjust. Flexible thinkers do well when it comes to adjusting to their ‘new normal’ because they focus more on what is still good and focus on what they can influence. Individuals who fare less well focus excessively on loss and struggle to accept their changes.
If you are struggling, a Cognitive Behavioural Therapist will be able to help you shift your perspective and reduce any avoidance that is unhelpful. It’s important to stay hopeful and to nurture an optimistic mindset and this is completely within your reach.
A personal account of Functional Neurological Disorder:
Thomas Reid’s Story – I will get my life back, to the old me and the way I used to be, but right now I am me!
I never thought I would openly speak or even post about this, but I get questions from people on a weekly basis if I make a rare appearance outside my home. Most people are shocked to see the deconditioning of my mobility, being unable to walk unaided 95% of the time at the age of 23, and make a variety of assumptions that are incorrect!
I spent a long time trying to fight against my neurological issues and chronic pain, and pretending I could just push on out of fear of how people would perceive me. To struggle continuously with countless trips and falls, often collapsing due to weakness, and lose sensation in the right side of my body affecting mainly my leg and like it doesn’t belong to me due to loss of sensation, is terrifying and leaves you very vulnerable. You become fearful that you going to fall in public and what people will think. I also have memory loss issues which is very embarrassing and has made me very isolated. I can’t enjoy the things I used to and this is all because I have a condition called Functional Neurological Disorder (FND).
The brain of a patient with FND is structurally normal, but the nervous system doesn’t function correctly and can occur anywhere in the central nervous system. Following a car accident two and a half years ago, and multiple work injuries to my spine, I have been left needing to use a stick to walk. I have been battling this debilitating condition for too long that it has taken a lot from me, my work and my friends, but I am on the road to recovery! I have a fantastic Neurologist who is extremely knowledgeable on this condition and others in the same field, and understands the severity and complexity it can require to treat. It’s not just a matter of giving a person with FND six sessions of physiotherapy or psychology services and then sending them on their way! This is why so many FND suffers can be in remission and then relapse once they go back home, or deteriorate further. I myself have been in remission twice and both times relapsed and my symptoms got more serious, leaving me unable to do the simplest of tasks for myself without being in extreme pain, and causing a fall or injury.
It’s not all doom and gloom now that I have my diagnosis confirmed and I have a Neurologist who is willing to help. I’m determined to get me back on track, get my life back to the old me and the way I used to be!! But for right now I Am Me! I am working on music and writing songs as I’m a keen musician, and want to provide a platform for awareness. Singing is my biggest freedom and escape from my pain and condition, and l that have big dreams. I will not let FND stop me. I’m coping the best I can and I don’t expect everyone to understand, and that’s perfectly fine. I am aware of the medical facts about my disability and I am not afraid of the stigma anymore! I just hope that anyone else out there that’s going through a condition like FND knows that they are not alone and truly believe we Stand Together Stand Strong!! #FND #Hope #Survivor #IAmMe
Mandy is a qualified therapist who treats depression, anxiety, OCD, PTSD, trauma, and many other types of mental health issues. She provides online therapy around the world for those needing support and also provides relationship counselling.