What Is FND Disorder? The Brain And Mental Wellness
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Functional neurological disorder (FND) is a rare neurological condition causing changes in brain networks that may lead to a vast array of neurological symptoms. Because FND is rare and can have different presentations in each person who is diagnosed, there can be various mental health challenges associated with living with the condition. Understanding FND, how to find support, and how to cope with its mental health impacts may be helpful for people experiencing this condition. If your mental health has been negatively affected by a physical ailment, speaking to a licensed therapist may be helpful.
What is functional neurological disorder?
According to the National Institute of Neurological Disorders and Stroke (NINDS), functional neurologic disorder is a condition that causes differences in how the brain processes neurological signals.
The functional neurological symptoms caused by FND are real, physical symptoms, but they generally cannot be explained by any changes in brain structure, such as a traumatic brain injury. In addition, there is no known cause of the condition, and each person’s symptoms can differ, so treatment is often individualized.
Symptoms of FND
- Seizures and seizure-like episodes
- Persistent postural perceptual dizziness and fatigue
- Numbness in the limbs
- Slow movement
- Speech difficulties, such as stuttering
- Vision issues
- Nervous system challenges like anxiety
- Hearing issues
- Chronic nerve pain
- Movement difficulties
- Cognitive difficulties and memory challenges
- Dissociation
Not everyone with FND has the same symptoms. Some people may experience functional movement disorder (FMD), multiple sclerosis (MS), or functional and dissociative seizures alongside FND.
Functional seizures typically refer to seizure-like episodes that can involve dissociation, shaking, head movement, and hyperventilation. Functional movement disorders can cause tremors, difficulty walking, spasms, tics, and paralysis in specific body parts.
How does functional neurological disorder (FND) impact mental health?
The symptoms of FND can cause significant difficulty in daily life, often leading to social embarrassment, stress, anxiety, and functional challenges. Below are a few of these impacts.
Difficulty finding treatment and diagnosis for functional neurological disorder (FND)
In most cases, FND cannot be seen on a brain scan, which may make the condition difficult to diagnose. A person with FND may attend several appointments before they receive a diagnosis, and they could face medical discrimination or unkind comments from others in their lives. Some people with FND may be misdiagnosed with factitious disorder if their symptoms are not accurately identified.
Misunderstandings, misdiagnosis, and discrimination can lead people with this condition to experience stress, depression, emotional or physical trauma, and mistrust of medical providers.
The difference between FND and factitious disorder is that FND is caused by neurological changes in the brain, although these changes are not structural. Factitious disorder usually involves feigned symptoms in an attempt to receive treatment for an illness that one is not actually experiencing.
Anxiety and depression
Low mood can be a common symptom of dissociative or functional neurological disorders. In some cases, this symptom can develop into depression, which can involve the following symptoms:
- Prolonged low mood lasting for more than two weeks
- A lack of interest in previously enjoyed activities
- A lack of motivation
- A sense of apathy or emotionlessness
- Social withdrawal
- Difficulty practicing self-care due to mood
- Suicidal thoughts and self-harm
People with depression tend to have a higher risk of also developing anxiety disorders, such as generalized anxiety disorder (GAD). Unexplained neurological symptoms can also contribute to anxiety, and anxiety may sometimes be a direct effect of a physical symptom.
Functional challenges and social stress symptoms
For some people, FND can be physically disabling, leading to difficulty functioning in various environments, such as home and work. Some people may struggle to leave the house and may become isolated, which can lead to social stress, depression, and worsened anxiety. Social isolation can worsen physical and mental health, which may put people with FND at risk of developing cardiovascular issues, high blood pressure, and chronic stress.
How to cope with mental health challenges due to FND
If you’re living with FND and experiencing mental health challenges, you might find the following options helpful.
Find a support system
Although updated evidence may be needed, a 2013 study found that people with physical disabilities often benefited significantly from having a social support system. The study’s authors reported that social support generally allows people to know they are loved, cared for, and valued, and it can improve psychological health.
If you have FND or another neurological disability, consider the following options for finding support:
- Support groups
- Community mental health centers
- Clubs and hobby groups
- Family and friends
- A spiritual or religious community
- A pet
- Community events
- Disability or mental health advocacy groups
- A therapist
Practice self-care
Self-care may positively impact FND symptoms. Research suggests that relaxation and mindfulness exercises could reduce both stress and FND symptoms. Hypnosis was also recommended to induce relaxation.
Daily meditation, mindfulness, and relaxation may improve challenges like anxiety, depression, insomnia, and migraines. You could also try modified exercise by working with a physical therapist who has experience helping individuals with FND.
Accommodate yourself in daily life
Accommodations may relieve some of the stress associated with daily life and responsibilities. Find ways to make life at home more accessible, such as having a snack cart by your bed, a cane to help you walk, a wheelchair if you frequently faint, and other mobility aids.
Talk to your doctor to learn how your symptoms might be accommodated more effectively. You can also put in an accommodation request at work to help you perform your job more easily. For example, if you usually must stand while using a cash register at work, you might put in a request to have a chair so you can sit during your shift. Accommodations can reduce pain, which may reduce stress.
How to support a loved one with FND
The Functional Neurological Disorder Hope organization (FND Hope) recommends a few steps for caregivers to support their loved ones:
- Encourage independence
- Laugh with them
- Stay calm and emotionally regulated
- Avoid social isolation
- Advocate for their needs in medical environments and consider accompanying them to appointments
- Expect challenges and be prepared to support your loved one
- Care for your own mental and physical health
- Accept help from others
- Don’t give up hope
How is FND treated?
Functional neurological disorder, sometimes called conversion disorder, currently has no cure. However, physical therapy and psychotherapy are often recommended to reduce symptom severity, as stress and mental health challenges can worsen physical symptoms. Some people may be prescribed medications for nerve pain on a case-by-case basis.
A significant aspect of treatment for FND tends to be stabilizing the patient and helping them achieve a pain-free or low-pain lifestyle. A medical provider might offer education on symptoms and recommendations for mobility aids or other supportive devices.
The types of psychotherapy recommended for a client can depend on their unique experiences but often involve cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT).
Mental health support options
Mental health support can be a significant part of managing life with functional neurological disorder. However, some may struggle to work with a provider in their area due to symptom severity. In these cases, online therapy through a platform like BetterHelp may be more accessible.
Through an online platform, clients can access therapy from home or any location with an internet connection, allowing them to receive support even on days when symptoms present challenges. In addition, they can choose between phone, video, or live chat sessions, giving them control over how they receive support.
Studies suggest internet-based CBT can be effective for people with chronic somatic conditions and functional neurological conditions that cause fatigue and chronic pain. Online interventions usually reduced fatigue and improved pain acceptance in clients, according to a 2022 study.
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