What Is a Conversion Disorder and How Does It Manifest in Teens?

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The pandemic has led to a rise in what’s known as conversion disorder. What is conversion disorder exactly? In a nutshell, it’s a disorder in which emotional issues such as stress, anxiety, and trauma manifest as physical symptoms. Mental health experts say that more teens are now experiencing these somatic (body-based) symptoms due to the loneliness, grief, and loss resulting from the pandemic.

During a time when three out of every four teens are experiencing increased mental health symptoms, it’s not surprising that, in some adolescents, trauma and anxiety express themselves through the body. Teens aren’t faking these symptoms—the physical effects are very real. In essence, conversion disorder is an example of the mind-body connection in action.

What Is a Conversion Disorder?

Conversion disorder is defined as a psychological condition that causes physical symptoms. With a conversion disorder, the physical effects of stress can be as extreme as paralysis or blindness. The most common conversation disorder causes are traumatic, overwhelmingly stressful experiences or events, such as the isolation and fear associated with COVID-19.

Conversion disorder is categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a somatic symptom disorder, also known as conversion neurosis, dissociative disorder, functional neurological disorder, and functional movement disorder. According to the DSM-5, a conversion disorder includes the following criteria:

  • At least one symptom affecting the senses and/or the ability to control one’s body movements
  • No evident biological, neurological, or psychological cause
  • Symptoms are not caused by substance abuse
  • The physical symptoms of stress are accompanied by significant distress.

Teens with existing mental health conditions, such as anxiety disorders, depression, or other mood or personality disorders, are at higher risk of developing conversion disorder symptoms. In addition, young people who are perfectionist and highly conscientious and compulsive are also more likely to develop conversion disorder.

 

The Link Between COVID and Conversion Disorder in Teens

Since the pandemic began, conversion disorder in teens has become more common. It’s often identified when teens are brought to the emergency room with symptoms that seem to resemble COVID-19. Conversion disorder symptoms include loss of smell, which is also a symptom of the virus. However, teens with conversion disorder test negative for the virus and have no other underlying biological or neurological issues.

Therefore, experts believe that fear and anxiety about being infected—coupled with trauma and depression resulting from pandemic-related stressors—may be triggering or exacerbating these physical effects of stress. Consequently, researchers recommend that healthcare providers, mental health professionals, and parents keep the possibility of conversion disorder in mind when encountering unexplainable physical symptoms in teens, particularly because this unprecedented period in history has disproportionately affected adolescent mental health.

COVID-related stressors are not the only issues catalyzing conversion disorder in teens. Academic pressure, troubled peer relationships, bullying, and demanding extracurricular activities can also contribute to the trauma, depression, and anxiety underlying conversion disorder. For this reason, some teens with diagnosed somatic disorders found relief from symptoms during the pandemic. As a result of remote schooling and stay-at-home guidelines, some of the stressors of their daily life were lifted. Therefore, as the country gradually returns to in-person interaction, these teens may need extra support in coping with these symptoms and healing underlying conversion disorder causes.

 

The Most Common Conversion Disorder Symptoms

Conversion disorder symptoms usually appear suddenly, at the time of a traumatic or stressful experience. They can also disappear just as suddenly. Here are some of the most common physical effects of stress associated with conversion disorder.

  • Muscle tremors, weakness, twitching, tics, or spasms
  • Paralysis, particularly in an arm or leg
  • Temporary blindness or double vision
  • Partial deafness or other problems with hearing
  • Problems with coordination
  • Trouble with balance and walking
  • Losing sense of small
  • Inability to speak or slurred speech
  • Numbness or loss of the sensation of touch
  • Seizures or convulsions
  • Difficulty swallowing or feeling as if there is a lump in your throat
  • Weakness or paralysis
  • Blackouts
  • Hallucinations

Hence, the answer to the question, “What is a conversion disorder?” can comprise many different symptoms as well as a variety of conversion disorder causes.

Treatment for Conversion Disorder in Teens

The first step in treating potential conversion disorders in teens is to rule out any medical conditions that may be causing the physical symptoms. Once it’s clear that no health conditions are at play, treatment can address conversion disorder causes—underlying trauma, anxiety, and depression.

Effective treatment modalities for these disorders include:

  • Trauma-Focused Cognitive Behavioral Therapy, which helps teens reframe situations and develop healthy coping mechanisms
  • Mindfulness techniques, such as yoga and meditation, that support teens to rebalance and regulate the nervous system
  • EMDR, which uses eye movements to process and release traumatic memories
  • Attachment-Based Family Therapy to repair breakdowns in parent-child connection, so teens can turn to their parents for support when they are experiencing distress.

With prompt treatment and family involvement, conversion disorder in teens can pass as quickly as it arrived. However, it’s essential that teens continue to receive therapy, whether in an outpatient or residential setting, to address the associated anxiety and depression that catalyze these physical effects of stress. Contact Newport Academy to find out more about our integrated approach to teen treatment and how we help teens get back on track socially, emotionally, and academically.

 

Sources:

Acta Paediatr. 2021 Apr ; doi: 10.1111/apa.15877.

 Psychol Med. 2021 Jan: 1–9.

 Brain Behav Immun Health. 2020 May; 5: 100073.