To celebrate FND Awareness Day (25th March 2021) in this blog I want to look at pain, depression and Functional Neurological Disorder or FND as it is frequently called.
FND is a condition which is caused by problems with the functioning of the nervous system but which is not due to any observable disease. It can include weakness in the limbs, fatigue, blackouts, and pain anywhere in the body.
Because of the wide range of symptoms, it is often difficult to diagnose. On top of this, people affected by the syndrome are often not believedby medical professionals or even their own friends and family. Even when they are believedthere is a frequent view that FND is a mental disease and so their physical experiences and pain are played down. This can cause immensepsychological harm.
What is FND?
We are gaining a much greater knowledge of what happens with FND. We now know that it is a fault in the functioning of the nervous system. In this it is pretty similar to what happens with chronic pain. Put very simply, the nervous system perceives that the person is under attack in some way and so reacts defensively. But in this the nervous system is mistaken and its ‘solution’ is actually causing the problem.
The difficulty in diagnosing the condition can unfortunately mean that people affected often use unhelpful coping mechanisms which can make the pain they are suffering worse. If people believe that the condition is ‘all in the mind’ they can ignore physical symptoms and push themselves much too hard.
Getting help from an expert who understands the condition is very important. If you need a place to start I would suggest Professor Jon Stone’s excellent website. https://www.neurosymptoms.org/welcome/4594357992
Professor Stone is a consultant neurologist and honorary professor of neurology, so he does know what he is talking about and is well worth reading.
In this blog I will assume that you know you have at least some of the symptoms which go with FND and have had investigations to ensure your symptoms do not have an obvious physical cause. For many of you, some relatively simple steps can help you cope much better.
Finding balance for your unique experience with FND.
Most people who have FND have good days and bad days.
If this describes your reality, it is important that you understand how to balance and paceyourself on your good days. It is very tempting to overstretch yourself, both physically and mentally when you are feeling well; to pack in as much as you can while you can. But this can over–tire you and end up making you worse. You may well have had the experience of doing too much one day, then you wake up the next morning with more pain and feeling morefatigued. This can make you feel worse than before your good day.
You can take a different path here.
It is important, in fact it is the most importantthing you can do, that you enjoy your good days. I put the emphasis on ‘enjoy’. Savour that word, you need to enjoy these days, not make them useful, not try to achieve an impossible goal, not try to please others. You need to enjoy your day for you, first and foremost.
Do not put pressure on yourself to catch up on any goals or projects you may have, unless it is absolutely necessary. Try to avoid setting yourself exercise goals, for example. Aim to do things which are gentle and very pleasant. Of course, real life is there, we all live with responsibilities and stuff to do. You may feel under pressure to complete extra household tasks, for example. I know this pressure is real, the washing has to be done after all. But try as far as you can to limit the amount you do to what is absolutely necessary. And spend the rest of your energy doing something you really want to do. It will do your mental health a power of good.
How to use the concept of ‘balance’
I mentioned the word ‘balance’ and I do think this is a very important concept for getting your life as good as possible if you have any of the symptoms of FND.
An example of balanced housework
Here is a case you may feel familiar with. You may feel thoroughly miserable if your house is messy, so when you are feeling a bit stronger you chase around cleaning up, then you feel fatigued and in pain and even more miserable.
A balanced approach to the issue would go something like this. You might say: ‘The messy house is making me feel miserable at 6 on my misery scale (my scale goes one to ten with one being very happy and ten being very unhappy). If I rush around and feel horrible tomorrow I will be miserable at a 9. So, I will do a little bit of tidying and put the washing on. That will make me feel a bit tired, but the house will look nicer and I will have clean clothes. So, I will be 4 on the scale because I will be a bit tired, but that will come down to only 3 on the scale becausemy house looks better. That seems a good outcome to me.’
This is a good approach for things you have to do. Now let’s look at things you don’t have to do,but think you ought to do.
An example of balanced exercise
Exercise falls very firmly into the category of something people feel they ought to do, and people with the symptoms of FND are no exception. As an FND sufferer, you will probably have been told, and it is true to some extent, that regular exercise can help your symptoms. Perhaps you are a person who used to love lotsof exercise and now you feel miserable becauseyou cannot exercise at the same level. Another common story, is that of a bad experience of overdoing it when you were feeling a bit betterand paying for it in pain the next day. This may have left you scared to exercise at all.
Here is a balanced way to look at things.
Firstly, exercise is good for both your physicaland mental wellbeing. Making your body workimproves its functioning, produces feel good hormones which lift your mood and keeps you healthier and more flexible in your tendons and joints. Too much exercise, however, especially at the wrong time for you, can bring on pain and fatigue.
I often advise starting with your mental well-being. When we are looking at the mental side of things hypnotherapy, and self-hypnosis can be a great help. Trained hypnotherapists, suchas myself understand that our conscious being does not distinguish between what is real and what we imagine is real. If you doubt this do a little experiment. Close your eyes and imagine sucking a lemon. Your mouth is watering as if you were really eating a lemon isn’t it? That is the power of a thought.
If you know that heavy physical exercise will hurt you then don’t do it. Instead take yourself on a mental journey which will give you some of the mental benefits of exercise. Imagining you are doing a long swim or running in the countryside can produce just those feel-goodhormones you would get by actually doing these activities. And you will not be risking pain and fatigue.
Of course, you should not avoid exercise altogether. You need to move your body to keep supple and flexible and doing this will actuallylessen your pain. But you can do it in moderation and use your hypnosis as a backup. It will top up those feel-good chemicals in your brain and that will lift your mood, combat depression and make you feel a whole lot better.
Let us look at our scale again and see how it works in this scenario. Say you would be miserable at a 7 if you were feeling good one day, but did not go out for a run. But you knew that the pain and fatigue you would endure the next day would put you on a misery scale of 9.
Instead go for a brisk walk, you can make the most of it by stretching your body and getting fresh air into your lungs.
Then later, when you are back in the warmth and cosiness of your home you can attend to your mental state. Do a hypnosis session to recreate the experience of a long run. The next day you might have slightly increased pain, especially if you have not done any exercise for a while, but if you have been very gentle you might not. Your hypnosis will have made you feel good. So, you may have a bit of pain, say that is making you a 3. But you feel very good mentally as you remember your hypnotic run. That brings you down to a one, which is fantastic.
What you can do on your bad days
I hope that helps with good days. I also want to consider what you can do on bad days. For many people who suffer from FND, there will be days when you feel you cannot do anything at all, it is too much to even get out of bed. Formany people this leads to anxiety, depression and this can quickly lead to a spiral which makes pain seem worse.
I see many clients, at my pain psychology clinics in Milton Keynes and Bedford, (currently being held online) who have got stuck in this spiral. I want to offer hope here. With the right treatment many people can escape this and find a better and less pain–filled life.
Again, psychological techniques such as hypnosis can be a great friend in these circumstances. Targeted hypnotherapy sessions can teach your mind to distract itself from pain and concentrate on more positive thoughts. Practising hypnosis can make you feel in control again and lift your mood. One great thing about this technique is that, after a few sessions of hypnotherapy with a professional such as myself, you can learn the technique. From then on you will be able to use self-hypnosis to help you through the bad days as well as the good.
I hope this has been useful to you. Contact me if you would like more advice and support.