Treatment of Functional Neurological Disorders (FND)

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Treatment generally starts with the recognition of the diagnosis and the nature of the disorder. If you are referred to Neurology for assessment, you will usually be seen by a Neurologist who may or may not need to carry out tests to confirm the diagnosis.

The Neurologist may refer you psychotherapy but will also consider other therapy options such as physiotherapy or occupational therapy, which may or may not happen alongside psychotherapy. Occasionally medications may be considered, especially when there are additional symptoms of depression or anxiety.

If you come to the Neurology Psychotherapy Service for treatment of your FND’s we will meet you for an assessment session and then agree what kind of therapy might work best for you. There are a number of different approaches we might suggest such as:

Stabilisation

There are a number of fairly simple techniques that we can show to people to help them to prevent functional seizures, anxiety and panic attacks and other symptoms such as flashbacks and nightmares. Some of these techniques are described in our leaflets that you can find here.

We may also give you a relaxation CD and suggest that you practice relaxation techniques on a regular basis. You can download relaxation audio tracks from our resources section or use other relaxation CD’s if you prefer. People who are more relaxed are less likely to get FND’s or panic attacks.

Psycho-education

These are sessions that can take place in small groups or on a one-to-one basis, in which we help you and other important people in your life to find out more about FNDs and how to cope with them, or about how emotions affect our brains and physical symptoms.
Usually the first thing is to help you understand your diagnosis and why it is that you might have developed your symptoms at this particular time. This is important because many of the people referred to our service are still very confused about the diagnosis when they first come to see us, and wonder why they have been referred to a psychotherapy service when they have very physical symptoms. Understanding the symptoms, how and why they arise, is generally a significant contributor to improvements in your health. You can begin to learn what sorts of things can ‘trigger’ your symptoms (they are not always obvious).

1-1 Psychotherapy

We may offer a course of one-to-one psychotherapy if this is appropriate. This involves fortnightly or weekly meetings with one of our psychotherapists.

There, you will be offered:

  • Kindness
  • Warmth
  • Respect
  • Acceptance

The therapy will take into account the most appropriate approach for you. You may work with the therapist on rebuilding your confidence to start to do some of the things that you may have been avoiding. This way you can start to do more, life feels more interesting and worthwhile and your confidence and self-esteem can improve.

You may work on starting to notice, accept and talk about your feelings more in therapy, and also how to communicate better with the people close to you.

Working on painful and frightening experiences from the past can be a very important aspect of therapy. However, we will only do this by agreement, if we think it is safe and you feel ready to do so. If we do this we will take it at your pace and you will not be pressured to discuss anything you are unwilling to talk about. If we decide to go down this route, psychotherapy will proceed a little like physiotherapy – we aim to make progress in very small steps – starting with easier mental “exercises” before progressing to more challenging tasks.

Multi-disciplinary team working

With some symptoms it is helpful to work together with other healthcare professionals such as physiotherapists or occupational therapists to get the best outcome. This might involve having a meeting all together to make a plan of how we can best support you.

What improvement can I expect?

Many people find that with specialist treatment their symptoms resolve completely.

Others find that their symptoms gradually improve but they continue to have a tendency to develop physical symptoms when they are under particular stress.

Often people feel less troubled by their symptoms when they understand what causes them, and can live better with them and get on with their lives.

Some people remain disabled by functional neurological symptoms for many years, but with the right approach gradual improvement can be expected.

Even after treatment, many people will continue to have a tendency to express stress as physical symptoms and from time to time when new symptoms occur they will need to be checked out by a doctor

 

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