How is the diagnosis of conversion syndrome made?

There are certain criteria that one must meet to be diagnosed with a conversion syndrome.

-Your symptoms are out of your control and may mimic another medical disorder.

-The  symptoms must be recent and follow a stressful event

-You did not deliberately cause the symptoms.

-Your symptoms cannot be explained by drug use, any organic lesion or cultural behaviour.

-Symptoms must induce intense impairment in your social life, work or other environments.

-Symptoms are not related to pain or sexual problems and cannot be accounted by any other mental disorder.

 Because the symptoms of conversion disorder may mimic a real physical disorder, many individuals go through extensive investigations before a diagnosis of conversion disorder is made. Conversion disorders can mimic syphilis, Parkinson’s disease, stroke, lupus, spinal cord trauma, or a muscle movement disorder like myasthenia gravis.

What is the outlook for people with conversion disorder?

In most patients, simple reassurance will help improve the disorder but at least 25% of individuals develop recurrent symptoms. Individuals who develop recurrence because of failure to seek treatment, have an underlying serious mental health disorder or have tremors/seizures not related to seizures. There are reports that some patients who have a neurological disorder can also develop a conversion disorder.

What are risk factors for conversion disorder?

Female gender especially 20-30 years of age

Recent emotional trauma or stress

Already having a diagnosis of generalized anxiety, major depression or having a certain personality (hysterical)

Having a close family member with conversion disorder

History of physical or sexual trauma

Financial hardship

What causes conversion disorder?

The exact cause of conversion disorder is unknown but it is believed that the area of brain responsible for muscle control somehow is now controlled by emotions. It is believed that this is one way in which the brain reacts to an apparent menace.

What is a Conversion Disorder?

Conversion disorder is a situation where psychological stress (e.g. depression) is manifested in a physical way. Conversion disorder frequently develops after an intensely stressful event. The physical features of Conversion disorder may have no underlying cause and one has not control over the symptoms. In most cases, conversion disorder will present with an inability walk or use the arms, have difficulty hearing or seeing or one may not be able to speak. In rare cases, one can even have seizures, hallucinations, inability to feel pain and inability to urinate. The symptoms may be very dramatic but in the majority there is rapid improvement in several days or weeks.

Besides drugs, how else can I treat my anxiety attacks?

Life style and home remedies may help diminish anxiety. Try to exercise regularly, eat healthy, avoid alcohol and prescription medications, use some type of relaxing technique like yoga or meditation and get adequate sleep. Exercise is one of the most powerful reducers of stress and can help improve your mood and keep you healthy. Perform exercises that you like and gradually increase the intensity. 

Other alternative remedies that can be used to relieve anxiety include the use of Kava, valerian and vitamin B. Remember, except for the vitamins there is no solid evidence that any herb can relieve anxiety. Moreover, these plant products are also expensive and can have side effects. To help you manage anxiety, join an anxiety support group and address what is bothering you. Try not to dwell on the past and break the cycle when you feel anxious by going for a long walk.  Socialize with friends and family as these interactions can help reduce stress and develop loving relationships.  

Why Do I Keep on Physically Hurting My Body? A Look at Self Injury

There are, unfortunately, some people who deliberately harm their own bodies. Self injury is not intended to be a suicide attempt but rather a detrimental means to cope with emotional pain, anger, frustration or hopelessness. Self injury brings a transient sense of calm and a release of stress but this is soon followed by guilt, humiliation and going back to the same agonizing emotions. Self injury usually starts as minor injuries but can lead to severe disfigurement.Self injury is felt to be an impulsive behavior problem but may be associated with depression, an eating disorder (bulimia) and borderline personality. Individuals who self injure may have a variety of symptoms including physical scars, scratches, broken bones, being lonely, having difficulty with interpersonal relationship, wearing long sleeved garments even in hot weather or blaming the injury on others. Self injury is not only cutting oneself but may involve piercing the skin, breaking bones, head banging, biting, pulling out hair and making the wounds worse by probing.

Self injury is rarely a one-time episode and for some people it is a repetitive behavior that is often impulsive. Like most things in psychiatry, the cause of self injury is a mystery. Some people simply are not able to cope with their emotions and find self injury one way to relieve the psychological pain. It is believed that the physical injury distracts the individual from the painful emotions. Some people self injure their bodies to chastise themselves for alleged faults, and in others self injury may be a way of manipulation or getting attention.

Besides the direct physical injury to the body, this behavior also has other complications including accidental suicide, permanent scars, disfigurement or worsening of shame and guilt. The number of people who self injure themselves remains unknown but the disorder appears to be slightly more common in women. The disorder tends to peak in the second or third decade of life.

Self injury is a very difficult disorder to treat. There is no one treatment for everyone.The treatment is usually long-term psychotherapy, which can help one learn skills to manage stress control emotions, enhance a better body image, and develop a healthy lifestyle.There are no drugs to treat self injury but sometimes anti depressants may be prescribed to improve depression, reduce anxiety or control the impulse behavior. 

Depending on the degree of injury, one may even need hospitalization. Because of the seriousness of the problem, there are national hotlines where one can call for immediate help. The national suicide prevention lifeline (800- 273-8255) is available 24 hours a day. For people who have this problem, it is recommended that they try to reach out to their family and friends for support. Try to enroll in a support group and do not underestimate your ability to change. Avoid abuse of drugs and alcohol and get to know more about your medical illness. Unfortunately there is no way to prevent this behavior. For people who have no mental health disorder and injure themselves, the prognosis is good but for those who have other mental health problems, the prognosis is poor.