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

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Conversion disorder is a mental condition in which a person has blindness, paralysis, and neurologic symptoms that are not explained by any medical evaluation.

Written byDr. Kirti Maan

Medically reviewed byDr. Abhishek Juneja

Published At September 19, 2022
Reviewed AtJune 26, 2024

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 the 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 Is the Difference Between Conversion Disorder and Somatic Symptom Disorder?

Both these disorders fall under the same group of conditions. Experts usually group the two as they can overlap, and there is a chance of a person having both conditions at the same time. In the case of a somatic condition, there will be at least one severe symptom that disrupts the person's life, whereas in the case of a conversion condition, it is a brain-related condition, but the symptoms do not interfere with the normal life of the person.

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).

  • 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, and a medical evaluation is needed.

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 a sleep schedule.

  • Relaxation techniques (yoga and exercise).

What Are the Risk Factors of Conversion Disorder?

  • Presence of neurological conditions like epilepsy, migraine, etc.

  • Stress, emotional or physical trauma.

  • Mental health conditions like anxiety disorder.

  • Family members with neurological conditions.

  • History of physical or sexual abuse.

Some common complications are:

  • Pain.

  • Anxiety disorders.

  • Depression.

  • Fatigue.

  • Insomnia.

What Is the Outlook of Conversion Disorder?

Conversion disorders can have severe effects on the person’s life depending on the symptoms. Many people experience severe symptoms that keep them away from doing their normal activities. It is not a dangerous condition but can affect the overall mental health. People affected by this condition are less likely to get good outcomes if they:

  • Delay the treatment process.

  • If the person refuses to believe that they are affected by this condition.

  • The person does not communicate well with the doctor.

  • The person does not follow the treatment plan properly.

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 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.

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Frequently Asked Questions

Conversion disorder is treated with various treatment options, such as psychotherapies, physical methods, medications, and coping mechanisms. Psychotherapy includes stress management, cognitive behavioral therapy, and counseling, and physical methods include occupational therapy and non-invasive brain stimulation methods. Medication therapy includes anti-anxiety and antidepressants, and coping mechanisms include positive thinking, maintaining sleep schedules, etc.
Anxiety is a psychiatric condition that presents as a symptom in conversion disorder patients. Extreme stress and trauma can cause anxiety in conversion disorder; therefore, mental illness becomes a physical symptom. Conversion disorder gets triggered by stressful events such as anxiety and depression.
Conversion disorder is considered a mental illness as it presents various neurological symptoms such as convulsions, seizures, fits, paralysis, and blindness. Also, patients show psychiatric disorders such as personality disorders, depression, and anxiety. Conversion disorder is considered a rare disease and is known to produce mental illness symptoms.
A person usually recovers entirely from conversion disorder. The symptoms are sudden, acute and may resolve in some time. However, these symptoms may recur over time if treatment is not given.
 
Conversion disorders are treated with several antidepressant and anti-anxiety drugs for depression, insomnia, and mood swings. However, medications are less effective in treating conversion disorders than physical therapy and psychotherapy. In addition, the medicines can treat underlying medical conditions related to various psychiatric issues.
Conversion disorder is a rare mental illness that occurs in two or five out of every one lakh people yearly. The disease is also rare because it presents neurological symptoms in a person without any associated medical conditions. Also, conversion disorder can convert the mental stress of a person into physical symptoms; hence, it is called a rare mental illness.
Conversion disorder, also called hysteria, is a mental health condition characterized by sensory and motor disturbances in the brain. Hysterical conversion disorder causes unexplained and functional neurological effects such as somatosensory loss, paralysis, and emotional stress. This condition is borderline between psychiatric and neurological conditions and is often known to produce hysterical symptoms.
There is no particular diagnostic test for conversion disorder. However, the condition can be diagnosed by neurological and physical examinations based on a person's symptoms. Therefore, the doctor can interpret conversion disorder by examining the behavioral changes and neurological symptoms and ruling out the causes.
Conversion disorder is considered a disability if a person’s physical abilities are compromised and produce severe symptoms. A person with conversion disorder is given social security by considering various factors involving claims. Therefore, conversion disorders are referred to as disabilities if they cause impaired quality of life and permanent disabilities.
Conversion disorder causes physical problems in a person due to psychological issues. For example, the condition causes blindness, paralysis, seizures, and involuntary movements in a person. For this reason, conversion disorders are often treated with psychotherapies to resolve mental disorders that turn into physical symptoms.
Children's conversion disorder can be due to psychological or emotional trauma, physical abuse, sexual assault, neglect, etc. The disease is most common in adolescents, especially girls and older children. Conversion disorder is less common in boys and pre-pubertal kids.
Conversion and dissociative disorders are both mental health conditions that can be present in a person. In dissociative disorders, people get disconnected from their consciousness, thoughts, memories, and identity. Neurological disorders are present in people. A person may escape from reality unintentionally through mental disorders.
Difficulty walking and loss of balance are hallmarks of conversion disorder. In addition, seizures or tremors are also seen in patients with this disorder. A person also has blindness and other vision problems, hearing difficulties, and difficulty speaking.
Conversion disorder is a neurological condition that can cause seizures in a person. Seizures are, therefore, the symptom caused by conversion disorder due to the disruption of brain functioning. Conversion disorder can cause a person to have frequent tremors or seizures and eventually lose consciousness.
Conversion disorder is now known as a functional neurological disorder. The new name for conversion disorder features neurological signs and symptoms, which are typically associated with conversion disorder. These symptoms cannot be explained well by any other mental health condition.
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Dr. Abhishek Juneja from iCliniq
Dr. Abhishek Juneja

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