Conversion Disorders and Pseudo-Seizures: “The doctor says I am not sick, but why do I feel so bad?”

By Dr. Chris Litton

Your seizures have been out of control lately, so you have been hospitalized for 24-hour monitoring. You have been hooked up to an EEG machine for several days now, waiting for the “big event.” After a day or so off your medication, your muscles have started to twitch, breathing has become irregular, and so on. Finally, you feel the beginning of an aura, push the “event” button, and the room is suddenly buzzing with nurses. After everything settles, you probably feel relief that, finally, this confusing “mess” in your life can be figured out by the neurologists.

The next day, your doctor enters the room and tells you something you were not expecting to hear: She says your “event” was actually not epileptic, but rather, connected to emotional factors. Specifically, she says that you have suffered a pseudo-seizure. She goes on to explain pseudo-seizures, and what causes them. Although you completely understand all that she said, you cannot shake the nagging feeling that you have just been called “crazy.”

What is a psychologist’s word for “crazy?” – that would be “psychotic.” A psychotic person is one whose grip on reality is broken or compromised, and that person is unable to adequately understand what is going on around them. Without a clear perception of reality and lacking other basic tools to carry out a normal and productive life, caregivers often must make arrangements for them to remain in treatment and live under some degree of supervision. Does this sound like you? Here’s another way I can ask: Do you understand everything that you have read so far? Does it make sense to you? If so, it is doubtful that the term “psychotic” belongs in your chart!

Although a pseudo-seizure sounds strange, it is one manifestation of a diagnosis called a “Conversion Disorder.” This diagnosis denotes the unintentional display of physical symptoms which are unrelated to a medical problem, where the symptoms are better explained by emotional stress. It absolutely does not mean that you are “faking it.” Research indicates that the incidence of Conversion Disorder is much higher than expected by the general public. A medical doctor (neurologist) is the only person to make the definitive diagnosis of Conversion Disorder, as they are the only professionals qualified to “rule in” or “rule out” the presence of actual seizure activity in your brain.

It is very important to remember that even though your episodes do not fit the medical definition of an epileptic seizure, they are quite real. You are not doing this on purpose, and you cannot help what is happening to you. You need special skills and tools to help you control your episodes, and no one expects you to be able to figure this out on your own. It is important for your friends and family to understand that if you could simply choose to stop, you would have made that choice long ago. No one would choose to suffer the level of agony you have been through! Just like you cannot simply “snap out of” the flu, you cannot “snap out of” a Conversion Disorder. As with your physical body, issues within your emotional system must be treated and given time to heal.

The good news is, a Conversion Disorder is very treatable! After you choose to enter treatment, you will be given skillsets to help you get your episodes under control. Believe it or not, many clients actually look forward to their meetings, and it easily becomes part of their routine. One individual described treatment like “an hour at the spa.” A Psychologist or Licensed Professional Counselor is an expert in helping people process all the emotional muck that has built up over the years, and with Conversion Disorder, you will not believe how much psychotherapy can help! In the short run, you will be much more equipped in handling your events, when they occur. Down the road, most clients with Conversion Disorder are able to greatly reduce or even eliminate their events.

Many people feel ashamed, embarrassed, or even simple-minded when given a psychiatric (or mental health) diagnosis. Society allows us to have a broken arm, but in some families or areas, it is still taboo to seek mental health treatment. The vast majority of people with whom I meet are normal, everyday people, who are experiencing a level of difficulty or stress which they cannot manage on their own. Pitts & Associates treats people from all walks of life. Likely, nothing about the people in our waiting room will make you feel uncomfortable…it probably will feel like any other medical waiting room.

You have already done the tedious part…now it is time to start down the road to recovery! Your first and probably most difficult step is to get in touch with a mental health professional. Talk with your doctors and epilepsy coordinator—they can tell you who is likely to be a good match for you and your symptoms. Many people ask how long the process of psychotherapy takes. It is extremely difficult to answer this question with precision, but studies have shown that many people resolve their issues in 9-12 sessions. Many are also concerned about the cost. Your insurance company likely covers mental health treatment, however, the co-payments likely are different than those of your medical doctor. You can call the customer service number on the back of your insurance card to verify that you have outpatient mental health benefits and find out what are your co-pay (and in some cases) deductible. A deductible is the amount your insurance company requires you to pay out of pocket, before your insurance starts to reimburse (at whatever amount or percentage of the fee).

Finally, let me leave you with this. Although you cannot choose to stop having pseudo-seizures, you do have the choice to fight them. You do have treatment options available that can, in most cases, STOP the episodes, and ultimately, make you a stronger person. Options are available and waiting for you…your only requirement is to ask and arrive.