By: Erica Rodrigues, MA
Every year on April 13th, International FND Awareness Day serves to educate individuals about Functional Neurological Disorder (FND). This is a complex condition that is often misunderstood and warrants attention to support affected individuals, help debunk myths, and propel research to better understand, prevent, and treat FND.
What is FND?
FND is a malfunction in nervous system functioning, with problems in the transmission and reception of signals between the brain and the body. FND symptoms cannot be explained by a recognizable disease. A useful analogy to understand FND is to envision the brain as a computer: in FND, there’s no structural damage (akin to hardware damage in a computer), but rather the software is not working properly.
The Complexity of Symptoms
FND manifests in a myriad of symptoms, making each individual’s experience unique. Some may exhibit few symptoms, while others may endure a multitude, which can fluctuate in severity. These symptoms may include functional weakness or numbness in limbs, tremors, gait abnormalities, seizures, or speech or vision impairments. Individuals with FND also often contend with fatigue, pain, anxiety, and low mood.
Understanding the Causes
The precise cause of FND remains unknown, often stemming from a combination of physical and psychological factors. Triggers can range from physical illnesses or injuries to emotional stressors like bereavement or divorce. While psychological stressors were once perceived as a necessary trigger for FND, recent research indicates a more nuanced understanding, wherein identifiable stressors are not always present before the onset of functional symptoms.
Debunking Misconceptions
It’s crucial to dispel misconceptions surrounding FND, particularly the notion that symptoms are faked or consciously produced. FND symptoms are real and involuntary and impose significant disability and distress on individuals and their families, warranting compassionate support and effective treatment strategies.
Treatment Approaches
Physical rehabilitation, facilitated by health care professionals like physiotherapists, can be an important part of treatment for re-establishing movement patterns and function. Additionally, psychotherapy plays a pivotal role in treating FND, and is considered the main treatment for those with functional seizures.
Firstly, psychotherapy may help individuals better understand FND. Given that FND is a complex disease with stigma and myths surrounding it, psychotherapy can provide space and structured support for individuals to better understand the nature of their condition.
Cognitive Behavioral Therapy (CBT)
Psychotherapy can also help to address FND symptoms directly. Cognitive behavioural therapy or CBT is a type of psychotherapy that has been shown to be effective in reducing FND symptoms across several studies. CBT aims to identify triggers of symptoms and modify thought patterns or behaviors that are hindering recovery. CBT also teaches individuals coping skills, such as relaxation techniques and problem-solving strategies, to help them manage symptoms effectively.
Mindfulness-Based Therapies
Mindfulness, a core component of therapies like Dialectical Behavior Therapy (DBT), fosters present-moment awareness without judgment. Research has also found that mindfulness-based therapies improve FND symptoms, offering individuals tools to navigate their condition with resilience and acceptance.
Addressing Mental Health
Psychotherapy not only helps individuals improve their functional symptoms but can also addresses the accompanying anxiety and low mood. By fostering a therapeutic alliance, individuals can cultivate resilience, enhance coping mechanisms, and reclaim agency over their well-being.
On International FND Awareness Day, it is particularly important for health care professionals and loved ones of those affected by FND to take the time to learn more about this condition to better support those living with it. By understanding it better, offering compassion, and embracing interdisciplinary approaches, we can make a difference in the lives of those with FND.
References and Resources
Gutkin, M., McLean, L., Brown, R., & Kanaan, R. A. (2021). Systematic review of psychotherapy for adults with functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry, 92(1), 36-44.
Myers, L., Sarudiansky, M., Korman, G., & Baslet, G. (2021). Using evidence-based psychotherapy to tailor treatment for patients with functional neurological disorders. Epilepsy & Behavior Reports, 16, 100478.