What is 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:
- Movement disorders, such as tremors or twitching
- Sensory issues, such as loss of sense of smell or touch
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 symptoms, they are real to the person who is experiencing them.
Conversion disorder is relatively common, with women more likely than men to suffer from the condition. Conversion disorder 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.
Symptoms of conversion disorder
- Double vision
- Weakness or paralysis
- Muscular spasms
- Loss of balance
- Trouble coordinating movements (ataxia)
- Numb skin or tingling limbs
- Loss of sensation in limbs
- Memory loss
- Difficulty swallowing
- Inability to speak (aphonia)
- Loss of sense of smell (anosmia)
- Motor tics
- False pregnancy
Symptoms may begin without warning and can be debilitating. Episodes are typically short in duration, usually lasting days or weeks, though the experience varies 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.
Causes of conversion disorder
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. 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.
Diagnosis of conversion disorder
Diagnosis is made by an experienced doctor or psychiatrist, based on based on discussions with the affected person about their life, feelings, and the history of their symptoms. It can be difficult to diagnose conversion disorder, and multiple tests are often performed to exclude other causes for 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:
- 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.
Treatment of conversion disorder
Diagnosing conversion disorder, and developing a trusted relationship between health practitioner and the person with the condition, 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.
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 for conversion disorder and often helps to improve the symptoms.
- Psychotherapy, such as cognitive behavior therapy (CBT) or counselling
- 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.
Prognosis of conversion disorder
People affected by conversion disorder generally make a full recovery.. Even without treatment, symptoms are generally of short duration, 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.
FAQs for conversion disorder
Q: Is conversion disorder a disability?
A: The United States Social Security Administration does recognize somatic symptom 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.
Other names for conversion disorder
- Conversion neurosis
- Dissociative disorder
- Functional neurological disorder (FND)
- Functional movement disorder
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Edited by American Psychiatric Association. ↩
US National Library of Medicine. “Conversion disorders: psychiatric and psychotherapeutic aspects.” October 2014. Accessed May 11, 2018. ↩