What is functional neurological disorder (FND)?
Functional Neurological Disorder, or FND for short, is a neurological disorder in which changes have occurred within the brain network, affecting one’s ability to function. FND differs from other neurological disorders in the sense that there is no change to the structure of the brain itself with FND. Physical symptoms reported by those with FND are genuine, but the brain appears structurally healthy, meaning there is often no clear neurological explanation for why symptoms are occurring. The cause of FND is unknown. However, one is believed to be at an increased risk of developing FND if they have experienced childhood adversity or are exposed to psychological stress. People who have been diagnosed with FND often have depression, PTSD, or anxiety. The Medical Journal of Australia reports that a Functional Neurological Disorder was prevalent in at least 15% of presentations to one Australian neurology clinic, and that roughly 8% of acute stroke admissions could actually be due to FND. FND is more prevalent in women and tends to hit the peak number of presentations in those aged between 35 and 50 years. Seeing an experienced counsellor or psychologist can help you feel supported and understood.
What are the symptoms of FND?
There are no universal symptoms of FND – the disorder can affect people in a variety of ways. However, some common symptoms of FND include the following:
- Movement difficulties, like walking, for example
- Seizure-like episodes
- Dizziness
- Difficulties with speech, like stuttering or being unable to speak
- Challenges with cognitive functioning
- Pain, including migraines
- Extreme levels of fatigue
- Difficulties with vision or hearing
FND can present with multiple symptoms for a person, which often interfere significantly with a person’s functioning and affect their ability to go about their daily life. These symptoms are real and physical, and can affect any part of the body. Symptoms can occur at any time.
Medical imaging tests, such as MRIs and CT scans, show normal, healthy brain function in a person with FND. Studies have found, however, that when functional neuroimaging and neurophysiology tests are conducted, the brains of people with FND have altered connections between different areas of the nervous system, compared to a healthy brain. Simply put, the brain of a person with FND has difficulties sending and receiving information.
Research also indicates people with FND have an increased level of activity in the limbic area of the brain, which manages one’s behaviour and emotions. This increased limbic activity often results in people experiencing difficulties with managing their responses to stress.
Some people suffer from FND for a relatively short time, whilst others can experience symptoms of FND for years. The two most common types of FND are dissociative seizures and functional movement disorder.
What is functional movement disorder?
A functional movement disorder is, as the name suggests, a disorder that causes your body to be unable to move as it usually does. Someone experiencing a functional movement disorder may often suffer from more than one type of abnormal motion, which can include:
- Tics
- Tremors
- Involuntary twitching or jerking
- Difficulties with walking, posture, or balance
- Involuntary contractions of the muscles, leading to delayed movement or abnormal posture
- Spasms or stiffness of the muscles
- Weakness or paralysis of the arms or legs
What are dissociative seizures?
Dissociative seizures, also known as functional seizures, are more accurately described as ‘seizure-like’ episodes, as they are not due to a change in electrical signalling in the brain, as is the case with epilepsy. People who have dissociative seizures can experience changes in their movement, sensation, or behaviour that are very similar to a seizure, as well as a temporary loss of memory or attention. The person may feel disoriented, dissociated or confused. Symptoms of dissociative disorders can include:
- Hyperventilation
- Shaking all over the body with awareness of this
- Closing of the eyes during the episode
- Movement of the head from side to side
- Prolonged attacks
How is FND treated?
People with FND often feel misunderstood by medical professionals, as well as family and friends. Healthcare professionals can at times think a person is faking their FND symptoms, leaving the person with FND feeling lonely, isolated, confused and unheard. Obtaining an early diagnosis and treatment can help manage a person’s symptoms, potentially leading to recovery.
For the treatment of FND, it is essential to have a supportive and caring team of health professionals trained in FND. Honest and open communication between the person with FND and their healthcare professionals is crucial for effective outcomes. Effective treatment of FND often involves both physical and psychological therapy. Medication can also be helpful at times, depending on what symptoms the person is experiencing.
Speaking with a trained counsellor or psychologist who recognises and understands FND is crucial to managing the disorder. Speaking with a therapist with experience in treating FND can also help you to gain some clarity about what you’re going through, validating your experiences with FND and helping you to feel less invisible and unrecognised as someone suffering from a genuinely profound disorder.
Typically, psychological approaches used for treating FND include Cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based therapy.
Psychological treatments for FND can also include EMDR therapy. Having FND can be incredibly stressful, and at times, people are unable to work due to the severity of their symptoms. As FND symptoms can strike at any moment and last for varying lengths of time, it can create a real sense of feeling out of control over your life. Your central nervous system can then become hijacked by this cycle, creating a heightened emotional response to the symptoms of FND and the subsequent impacts on the quality of one’s life. EMDR can help decrease your stress response, as well as address any trauma one may have experienced, both in their past and as a result of the FND.
The choice of approach will depend on your individual needs, as assessed and discussed with you by the psychologist or counsellor. FND therapy commonly teaches strategies such as relaxation skills, mindfulness practices, breathing techniques, and tools to challenge irrational thoughts (also known as cognitive restructuring) to help individuals manage their symptoms, build resilience, and develop coping skills. Your counsellor or psychologist at Brisbane Counselling Centre will develop a treatment plan tailored to your individual needs.
Reaching out for help can be a daunting task. At our Centre, the Brisbane psychologists and counsellors are trained and experienced in FND, and they understand and empathise with how challenging this disorder can be.
Help is available
If you can relate to any of these symptoms, or if life is challenging right now, we can help and support you at Brisbane Counselling Centre. Talking to a caring psychologist or counsellor who is trained in FND will help improve the quality of your life. Take the courageous step and reach out for help today.
If you are struggling with FND, it is crucial to seek assistance from a mental health professional to address the challenges you are experiencing. Please call to speak with one of our friendly team members to discuss your needs further. The Brisbane psychologists and counsellors are available to help at Brisbane Counselling Centre.
