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Abuse brings on FND functional neurological disorder and worsens symptoms, study finds (pt.1)


The elephant in the room... dare I speak of it? Abuse brings on FND functional neurological disorder and worsens symptoms, study finds. (1) It is also correlated with earlier onset and more severe symptoms.



Does abuse bring on FND functional neurological disorder and/or worsen symptoms?


As an abuse survivor, this is 100% my experience, although my abuse occurred as an adult. And I had a wonderful childhood. ALE in this quote stands for "Adverse Life Experiences", and you can read the study here for more information. Read this quote, and then we will delve more into this divisive topic.


"...Several independent cohort studies reported positive associations between the magnitude of previously experienced ALEs and functional neurological symptom severity (712). For example, in a cohort of 54 patients with mixed FND – childhood physical abuse was associated with a larger number of distinct functional neurological symptoms; furthermore, endorsing multiple childhood traumatic experiences positively correlated with patient-reported symptom severity (9). In individuals with functional seizures (FND-seiz), those reporting childhood sexual abuse had earlier onset and more severe seizures (10). Individuals with FND and concurrent PTSD symptoms also endorsed more somatic symptoms compared to those with FND but without prominent PTSD symptoms (13). Additionally, a large-scale systematic review and meta-analysis identified that childhood abuse was associated with earlier symptom onset across the spectrum of FND (14). There is also some initial data to suggest that patients with FND and childhood maltreatment are associated with worse clinical outcomes (15, 16). Taken together, these findings highlight the clinical relevance of childhood ALEs and PTSD symptoms in FND when present—raising the possibility for a trauma-subtype of FND (17)."

Why is it important to talk about the fact that abuse brings on FND functional neurological disorder and worsens symptoms?


I could probably write a small book on this topic, so I will probably break it up into multiple blogs. I am a huge believer in the saying, "The only thing required for evil to flourish is for good men to do nothing." In this case, good women. lol.



Let's define our terms to avoid triggers.


Now before I delve into my brush with abuse and its affect of my FND, let me add this caveat. My husband is a combat veteran with severe PTSD. For the most part I'm not going to talk about him here, as he values his privacy. But he did raise a good point. We agree that there really should be a rating system of different levels of trauma. Knowing I lived a sheltered life and had a great childhood, he initially found it offensive when I used the word trauma to describe my experiences, and he doesn't love it when I describe things as abuse. In my head abuse is abuse and trauma is trauma, and once you cross the line from normal behavior to abusive you are just in the wrong, period. That said, abuse is on a spectrum. Many people including my husband have endured horrific abuse that I never have. But that does not excuse the actions of my abuser. Get it? Also, remember that trauma is subjective. Two people can experience the same event, and one can come away traumatized while the other one does not. Each person goes into the event with a different set of experiences, memories, and tools with which to interpret the event. For example, if a small child gets bitten by a dog, they could be traumatized and grow up scared of dogs. And they would need to do some trauma therapy to get over the fear. While if an adult gets bitten by a dog, they might have a wealth of positive memories of dogs to draw on, and they could come away from the experience without a fear of all dogs. See? Trauma is subjective. And abuse occurs on a spectrum. Now that we have got our terms defined, lets dive in.



Ok, dish! How did abuse affect your FND functional neurological disorder? (conversion disorder)


Remember that FND functional neurological disorder is greatly related with a disfunction in your fight or flight system (amygdala). So for example, let's say you were walking through the woods and you saw a bear. Your body would pump with adrenaline, and you would freeze, flee, or fight to survive instinctually. But with FND your body could have the same or greater reaction to seeing a bunny in the woods. Get it? With FND, your fight or flight system can be activated when it isn't needed. And it can also be activated way way way more strongly than is needed. It is similar with PTSD.


Leading up to my diagnosis, I had completely overworked myself. That isn't a good start to your immune system. I also have the special circumstance of loving a combat veteran with severe PTSD and co occurring things who isn't always himself. He is my hero, and I am so grateful that he sacrificed his sanity in many ways for us so that we wouldn't have to. He worked very hard to take care of me and keep our businesses going. And out of respect I am not going to mention much about him. But you have to know as a basis of this story that living with a spouse with PTSD can take a toll on your fight or flight system similar to how abuse would. And our conditions made us like two bells next to each other. One of us would have an episode, and that would trigger the other one to have an episode, and so on. For example, one of my symptoms was screaming at the top of my lungs. And that gave him PTSD flashback to battle. And then he might start shouting which then triggers my noise sensitivity... etc. etc.


My doctor explained to me the with FND my brain had created a pathway from the emotion center to the movement center that should not be there.


It stands to reason that in order to heal, you need to reduce the size of neural pathways that shouldn't be there by NOT USING THEM. And simultaneously increase the size of healthy neural pathways.


You can think of neural pathways and how they function like game trails in the woods. The more they are traveled, the more established and larger they become. But if animals suddenly stopped using the trails, they would become overgrown.


So as an example, with FND, I could hear an unexpected noise... and my brain races down the unhealthy path that it has been using a lot lately because its the biggest easiest path it can find. This path sends the information to my amygdala which decides that the noise (my dad putting down the foot of the recliner) signals extreme danger which I will not be able to run away from or fight. It pumps my system full of adrenaline and orders my body to drop to the ground. And this happens in a second, without my willful consent.


So in order to recover from FND, you need a period of avoiding triggers and intentionally activating healthy pathways. I will probably write more about this later.


Anyway, amidst this struggle, we unexpectedly had to move. Housing options with a lot of giant breed dogs were limited. And we weren't financially prepared to buy. My inlaws said we could live with them temporarily while saving for a house. Remember raising dogs was a large source of income we could put toward a house. My parents came and did almost all of the work to move us. We used up all of our money including my Modest Skorts business reorder fund, which put a damper on that income. Plus we had to shut down to move. Plus my parents pitched in money they couldn't afford to spare from my dad's truck driving maintenance fund. We arrived in NC depleted. There were days I could barely move at all. The whole ordeal had been a huge stressor. And the medications I was given for stopping FND symptoms both slowed down my heart rate and made me sleepy.



The story turns crazy at this point, and I am running out of room on this blog page. Click here to keep reading on PART 2 abuse brings on FND functional neurological disorder and worsens symptoms, study finds




Sources


  1. ORIGINAL RESEARCH article. Frontiers in Psychiatry, 15 November 2022 Sec. Psychological Therapy and Psychosomatics. Volume 13 - 2022 | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1040911/full

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