What is it?
Is it epilepsy or conversion disorder?
The term “conversion” comes from the idea that psychological distress is being converted into a physical symptom.
The cause is not known.
A long-standing theory has been that a person with conversion disorder must block out the source of the distress — be it a conflict or stress — because it is too unacceptable for the person to remain aware of it.
There is, however, little formal evidence to support this theory.
An estimated 5% to 10% of outpatients receiving treatment for epilepsy and about 20% to 40% of patients hospitalized for intractable epilepsy may be suffering from psychogenic nonepileptic seizures (PNES).
Conversion disorders affect up to 400,000 people in the U.S.
Both neurologists and psychiatrists — emphasize that it is, indeed, a real and debilitating condition but that it is a psychological disorder, not epilepsy. It absolutely does not mean that you are “faking it.”
These symptoms might or might not show up as seizure activity when tested, but the source is different than with epilepsy, so it can’t be treated as such.
Different causes require different treatments, after all.
The good thing about these being non-epileptic seizures is that they don’t cause as much damage to the brain and nervous system as epileptic seizures can.
The bad thing is that we’re awake during them, feeling every bit of pain and/or the stares of people around us as we cause a scene.
It can be different for many people, but imagine if your mind is managing stress by keeping this shield up around you. Bad days can chip away at it, some more than others, but it’s rebuilt as you rest.
What if your mind never gets that rest, whether it’s from psychological trauma (even subconscious) that you’re unable to let go of, or something around you at all times?
That shield will wear thin until every little stressful thing that hits you, like a loud noise or swift change in emotion, can cause such a shock to your mind that it subconsciously short circuits.
It doesn’t know what to do with this overload of anxiety, so it converts it into something physical.
This can resemble the entire body shutting down, though you’re wide awake, or a full body charley horse of twists and spasms.
It could be gradual through the day as twitches or vocal noises. Your knees could wobble and drop right out from under you. You could feel like you’re on a ship at sea. You could go temporarily deaf or blind. The list goes on and on!
It’s up to your mind and how it chooses to deal with it. And you have no conscious control over this.
One thing people with conversion disorder are not: crazy.
While this is considered a mental disorder, we are still completely functional, psychologically.
This is a subconscious issue and we can’t help it.
Many sufferers may have other psychological problems in addition to this, but simply being diagnosed with conversion disorder does not mean you’ve lost any faculties of the mind.
You’re still normal in that sense.
Sometimes additional tests can clarify the diagnosis.
These tests may include an electroencephalogram, which measures electrical activity in the brain, or an electromyogram, which measures how well nerve impulses are being conducted through muscle tissue.
In some cases, particularly if not treated soon enough, conversion disorder symptoms can result in substantial disability, similar to that caused by physical medical conditions.
More severe symptoms, such as paralysis or blindness, also may not last a long time because it is harder to sustain symptoms that interfere significantly with daily activities.
A less severe symptom (such as tremor) or a symptom that is repeated and limited (such as seizure) can continue or come and go, depending on the person’s circumstances.
The symptoms of conversion disorder usually do not last long.
Generally, the more quickly the symptoms start, the more rapidly they go away.
If the symptoms came about in response to a clearly defined stress, the symptoms are likely to last only a short time.
If symptoms do not improve relatively quickly, more vigorous rehabilitation may be required.
Physical or occupational therapy can be helpful.
A led by a Rhode Island Hospital researcher has found that a cognitive behavior therapy-informed psychotherapy significantly reduces the seizures in patients with psychogenic nonepileptic seizures.
The study led by W. Curt LaFrance Jr., M.D., M.P.H., director of neuropsychiatry and behavioral neurology at Rhode Island Hospital and assistant professor of psychiatry and neurology at Brown University is published in JAMA Psychiatry.
The outlook for conversion disorder varies. It depends on the nature of the stress and on the symptoms.
The person may either learn to deal with the conflict or retreat from the source of distress. In either case, the physical symptoms may stop. Functioning remains a higher priority than insight.
There is no single medication that is best for this disorder. But medication may be helpful for treating an underlying problem with anxiety or depression.
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