Conversion Disorder

Conversion disorder is a condition in which people experience symptoms affecting the nervous system that have no physical explanation. This may include symptoms such as: 1

• Weakness
• Movement problems, such as tremors or twitching
• Sensory issues, such as loss of sense of smell or touch
• Blackouts

Conversion episodes are nearly always triggered by an overwhelmingly stressful event, an emotional issue or a mental health disorder, such as depression. Although there may be no medical or physical cause found to explain the symptoms, they are real to the person who is experiencing them.

Conversion disorder is relatively common, with women more likely to experience the condition than men. It can affect people of any age, but tends to be more common between the ages of 20 and 50.

Symptoms of conversion disorder may be worrying to experience but they do not pose any long-term threat to health. Although symptoms will generally get better without treatment, they may recur if the underlying cause is not addressed. Treatment of the underlying cause makes recurrence less likely.

People with conversion disorder may experience symptoms such as: 2 3 4

• Blindness
• Double vision
• Weakness or paralysis
• Muscular spasms
• Seizures
• Loss of balance
• Trouble coordinating movements (ataxia)
• Numb skin or tingling limbs
• Loss of sensation in limbs
• Memory loss
• Unresponsiveness
• Deafness
• Difficulty swallowing
• Inability to speak (aphonia)
• Loss of sense of smell (anosmia)
• Motor tics
• Hallucinations
• False pregnancy

Symptoms may begin without warning and can be debilitating. Episodes are typically short in duration, usually lasting days or weeks, though this can vary from person to person.

Up to 25 percent of people with conversion disorder may experience a recurrence of symptoms or develop new symptoms in the future. 5

People experiencing possible symptoms of conversion disorder should consult a doctor. In addition, the free Ada app can be used to carry out a symptom assessment.

Conversion disorder is believed to be an expression of psychologically stressful experiences. While many people experience physical changes related to their mindset, such as a racing heart when feeling nervous, people with conversion disorder tend to experience more dramatic symptoms when faced with psychological and emotional stress.

Examples of such emotions causing physical symptoms in people experiencing conversion disorder include:

• A person suppressing anger and the desire to hit someone may experience numbness, tingling or paralysis of the arm
• A person with a past history of traumatic experiences may experience seizures and loss of consciousness, due to suppressing memories of their experience(s)

Conversion disorder is classified in the DSM-5 as a somatic symptom disorder, the symptoms of which were formerly known collectively as somatoform disorders. 6

Somatization is a process in which psychological distress is converted into physical symptoms. Although there may be no medical or physical cause found to explain them, the symptoms are real, and affected people are encouraged to seek medical attention. In addition, the free Ada app can be used to carry out a symptom assessment.

Diagnosis is made by a doctor or psychiatrist based on the history of the affected person’s symptoms, as well as a discussion about their life and feelings. It can be difficult to diagnose conversion disorder, and multiple tests are often performed to exclude other causes of the symptoms. A diagnosis is usually reached by process of elimination.

Tests are likely to concentrate on possible other causes for the neurological symptoms. One sign that a person has conversion disorder may be that symptoms differ from those of neurologic conditions. Key indicators that a person may be affected by conversion disorder, rather than a neurologic condition include: 3

• The presence of physical symptoms that would need to involve multiple parts of the nervous system
• Assessment revealing that a person’s responses differ from those typically associated with neurologic conditions

When no physical cause can be found for the symptoms, and there is a known cause of stress, a diagnosis of conversion disorder may be reached. Physical symptoms must also cause significant distress and impact the person’s daily life in order for a diagnosis of conversion disorder to be made. 7

Diagnosing conversion disorder and subsequently developing trusted relationships between health practitioners and the affected person is an important first step in treatment. That relationship can be used to begin education about the condition and counseling to address the cause of the stress. 8

Reassurance that symptoms are not caused by a serious underlying condition may also go some way to easing them. If the person with conversion disorder is also suffering from anxiety or depression, this can be addressed as part of the treatment and often helps to improve the symptoms.

Treatments that can be recommended for conversion disorder include: 2 3

• Psychotherapy, such as cognitive behavior therapy (CBT) or counselling
• Hypnosis
• Physical therapy
• Occupational therapy

Practicing stress-relieving techniques, such as regular light exercise and enjoyable activities, such as gardening, can be helpful in preventing the symptoms of conversion disorder. It is also helpful to have a reliable source of emotional support during times of stress.

People affected by conversion disorder generally make a full recovery. Even without treatment, symptoms are generally short-term, usually lasting a few days to a few weeks, and often resolve themselves. However, without treatment, recurrences are common. Treatment can provide reassurance and support during times when symptoms occur, and may help to identify and address the underlying psychological cause for the condition.

• Conversion neurosis
• Dissociative disorder
• Functional neurological disorder (FND)
• Functional movement disorder

Q: Is conversion disorder a disability?
A: The United States Social Security Administration recognizes somatic symptoms and related disorders as a disability. However, the qualifying criteria are quite stringent and are based on detailed evidence of the disorder in a person’s medical profile, as well as its functional impact on their ability to go about their daily routine.

Q: Can conversion disorder be cured?
A: While it may not be appropriate to talk of “curing” conversion disorder, symptoms can be managed effectively through proper treatment and, in time, the underlying psychological cause of the condition can come to be understood. This may involve a combination of counseling, psychotherapy, hypnosis, physical therapy and occupational therapy.

Q: Can conversion disorder be fatal?
A: It is not typical for the symptoms of conversion disorder to be fatal. They can, however, be debilitating and cause significant distress. People experiencing possible symptoms of conversion disorder should speak to a doctor. In addition, the free Ada app can be used to carry out a symptom assessment.

Q: Can conversion disorder cause seizures?
A: Yes, seizures can be a symptom of conversion disorder. Classed as psychogenic nonepileptic seizures (PNES), they tend to resemble those experienced as a result of epilepsy, but are not caused by a disturbance in the electrical activity of the brain. Instead, PNES are caused by emotional or psychological distress. 9 10 Seizures may never be witnessed or, alternatively, only occur while the affected person is around other people.

Q: Can conversion disorder come and go?
A: Yes, it is typical for the symptoms of conversion disorder to last for between a number of days and a few weeks and suddenly disappear. 1 Without effective treatment, symptoms may then reoccur at a later date.

Q: Can conversion disorder cause hallucinations?
A: Yes, hallucinations can be a symptom of conversion disorder. 2 A hallucination is defined as seeing, smelling or hearing something that seems real, but is not. People experiencing hallucinations should seek medical attention urgently. 12