Stress is widely defined as a constraining force or influence. Sooner or later, it affects everyone. Most of the time, it’s temporary, but what happens when it’s not?

Long term emotional stress can frequently occur with past trauma, producing a series of real and sometimes dangerous medical consequences. Often times a patient who is suffering from severe pain and does not receive a medical diagnosis, fears that a doctor may label the situation as “Just stress”. But when “Just stress” manifests physically, it should be handled with just as much care as any physically produced injury or disease.

Conversion disorder (alternatively known as Functional neurological symptom disorder or, in the past: Hysterical neurosis) is a psychiatric condition in which a person develops neurological symptoms that cannot be explained by medical evaluation.  Some of these neurological symptoms can include:

  • Blindness
  • Paralysis
  • Numbness
  • Inability to speak
  • General nervous system malfunctions

The history of conversion disorder stems from the Greek physician Hippocrates when he coined the term “hysteria”. This, he described, was a woman’s problem. In the 1600s, hysteric affliction was linked with witchcraft and demonic possession. Later in 1905, Freud and Breuer’s publication, Studies on Hysteria, detailed the “talking cure”.

Even today, the most recommended treatment for conversion disorder is talk therapy and/or hypnosis.

Someone experiencing conversion disorder often feels symptomatic soon after a stressful experience. People who are more likely to develop conversion disorder are those with:

  • A medical illness
  • Anxiety
  • Difficulties managing multiple feelings at once

According to the Diagnostic and Statistical Manual, conversion disorder is determined by:

The exclusion of neurological disease.

Since the symptoms of conversion disorder are mainly focused around the nervous system, life-threatening diseases and disorders with a strictly physical cause must be ruled out first. Doctors may test for health problems such as: Stroke, epilepsy, hypokalemic periodic paralysis, or multiple sclerosis.  This is not to say that patients with a neurological disease cannot also have conversion disorder. The two are not mutually exclusive.

Some doctors will also check for a “relative lack of concern about the nature or implications of the symptoms” in a patient’s demeanor. This is a controversial assessment seeing as no evidence has been found that patients with functional symptoms are more likely to react differently than patients with a confirmed physical disease.

Psychological mechanism.

If there is a clear and recent trauma that has occurred, the chance of possible psychological stress becomes more apparent in diagnosis. However, just because a trauma may have occurred, there is no known evidence to understand exactly how the trauma is impacting the precise symptom a patient is experiencing.  

Exclusion of feigning.

This is one of the hardest aspects to understand about diagnosis.  Unless the patient confesses or is “caught” feeling healthy and normal over a long range of time, it is almost impossible to tell if someone is ‘faking’ pain. One neuro-imaging study suggested that feigning symptoms vs. suffering physically, can be detected by the activation of frontal lobe patterns. This research is not a clinical technique. Although the percentage of patients feigning pain is unknown, it is widely believed the instances are no higher than that of any other medical condition.

While it is easy to question the intensity of a condition when there is no measurement for distress, people with this disorder are not fabricating symptoms for attention. They have no control over when they are experiencing pain and cannot simply “turn it off and on”. Patients with conversion disorder are in real pain. If you are experiencing what may be considered conversion disorder, prompt treatment is key to recovery.