Conversion Disorder - Causes, Types, Symptoms, Diagnosis, and Treatment

What Is Conversion Disorder?

Conversion therapy,also known as functional neurological symptom disorder, is a psychological disorder with no obvious or known cause. The person suffering has physical symptoms, neurological symptoms (such as paralysis, speech impairment, tremors, blindness, deafness, or fits), or psychological symptoms (such as depression, anxiety, or panic attacks). The body converts emotional and psychological stress into physical symptoms. The root cause behind the symptoms can be traced back to a psychological trigger. Initially, due to the trigger factors being psychological, the symptoms were referred to as hysterical blindness or hysterical paralysis. Abuse or trauma, pressured life stresses, post-traumatic stress disorder, and other iatrogenic factors, together or individually, are responsible for causing conversion disorder.

What Causes Conversion Disorder?

Even after due course of experiments and research, the specific cause of conversion therapy is yet to be known. However, theories have suggested that the disorder occurs as a way for the brain to manage and dispense emotional stress. Perpetually it is almost triggered by stress or mental illnesses. People who have a history of emotional stress are more likely to suffer from conversion disorder. Different probable causes of conversion therapy are:

• Positive familial history.

• History of mental health disorders.

• Maladaptive personality traits (such as schizophrenia, borderline personality disorder, obsessive-compulsive disorder, or antisocial behavior).

• History of neurological disorders (symptoms might reflect similar to a neurological disorder due to positive history).

• Wrecked childhood (a child coming from a neglected, damaged home or has been physically or sexually abused as a kid).

• History of medical illness.

• History of dissociative disorder.

What Are the Symptoms of Conversion Disorder?

Conversion therapy presents with a wide variety of symptoms in different individuals that are often sudden. Every case of conversion disorder is different. Some of the common symptoms of conversion disorder are:

1. Symptoms of Conversion disorder compromising motor skills are:

• Involuntary movement (usually hard to control).

• Paralysis (or numbness).

• Impaired balance (lack of balance).

• Dysphagia (difficulty swallowing).

• Difficulty micturating (urinary retention).

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• Seizures, fits, or convulsions (non-epileptic).

• Involuntary muscle contractions (dystonia).

• Tremors.

• Repeated loss of consciousness.

• Loss of sensation (touch or pain).

• Abnormal walking.

• Unresponsiveness.

2. Symptoms of conversion disorder compromising sensory skills are:

• Impaired vision (tunnel vision or blindness).

• Anosmia (loss of smell).

• Loss of speech (or impairment of speech).

• Deafness (impaired hearing).

• Loss of sensation (touch or pain).

3. Symptoms of conversion disorder compromising psychological skills are:

• Lack of concern (may present as drastic behavior change).

• Anxiety.

What Are the Types of Conversion Disorder?

Conversion disorder has been categorized into four subtypes:

• With motor deficits (symptoms).

• With sensory deficits (symptoms).

• With pseudoseizures.

• With mixed symptoms.

How to Diagnose Someone With Conversion Disorder?

The diagnostic and statistical manual of mental disorders (DSM-5) presented criteria to diagnose conversion disorder, which are:

• The patient must present with a bare minimum of one symptom (motor or sensory).

• Clinical findings should be present (showing no relation between the said symptoms and a neurological or a medical condition).

• The signs and symptoms are not explained by other medical or mental disorders.

• The symptom causes a significant amount of distress in the personal and professional life, needing a medical evaluation.

There is no proven test to diagnose conversion disorder. The doctor starts by ruling out physical, mental, or neurological causes of the symptoms. It is important to note any history of a recent stressful event. The American Psychiatric Association (APA) has set standards to diagnose conversion disorder; they are:

• Symptoms affect the movement, and the movements are involuntary and hard to control.

• The patient is not faking the symptoms.

• Symptoms cannot be linked to any medical condition, medication, or mental disorder (causing behavior change).

• It affects the personal and professional life of the sufferer.

What Is the Treatment of Conversion Disorder?

Treatment protocol to treat and manage conversion disorder involves psychotherapy, medication therapy, and physical therapy.

1. Psychotherapy for Conversion Disorder Includes:

• Cognitive-behavioral therapy.

• Counseling.

• Hypnosis.

• Stress management.

• Treatment for depression and anxiety disorders.

• Psychodynamic psychotherapy.

• Psychoanalytic treatment.

• Biofeedback.

• Relaxation therapy.

2. Medication Therapy Includes:

• Antidepressants.

• Anti-anxiety.

3. Physical Therapy Includes:

• Non-invasive brain stimulation (NIBS) method.

• Occupational therapy.

• Electroconvulsive therapy (ECT).

• Transcranial magnetic stimulation (TMS).

In addition, to the above-mentioned treatment protocols, coping mechanisms have proven to be efficient in the management of conversion disorder.

4. The Coping Mechanism Includes:

• Eating a balanced diet.

• Positive thinking.

• Balanced healthy relationships.

• Maintaining sleep schedule.

• Relaxation techniques (yoga and exercise).

Conclusion:

Conversion disorder is a relatively rare mental illness. It is characterized as a somatic symptom disorder, according to DSM-5. Symptoms of conversion disorder can last from a few days to several weeks. The onset of symptoms is sudden and acute. Most often, the symptoms are non-fatal, whereas complications of the symptoms may be fatal or life-threatening. However, they tend to disrupt one’s personal and professional life. There is no set course of cause for conversion disorder to occur. However, stress has proven to be a strong trigger point. While the symptoms are triggered due to stress, stress management plays a crucial role in the prevention of conversion disorder. Calming activities such as reading, yoga, relaxation, and meditation are the prevention methods as well as the treatment plan for conversion disorder.

Since the symptoms are often termed hysterical, the treatment differs from the treatment of hysteria. Conversion disorder is an acute disorder that causes a drift in the life of the person suffering, though it is a treatable condition. A person suffering from conversion disorder generally recovers completely, making a full recovery. Since symptoms are acute and sudden, they may resolve on their own. However, symptoms managed without a treatment plan often tend to recur.