Functional Neurological Disorder
A glitch in how the brain talks to the body, triggering seizures, tremors, or weakness without visible damage. These symptoms - your symptoms - are real.
Definitions
Functional Neurological Disorder (FND) is one of the most common disorders neurologists encounter. It's a condition where the brain's communication with the body becomes disrupted or rerouted (aka abnormal brain functioning).
You could imagine it as your brain's RAM constantly being overclocked and overworked to the point that it starts to fail. This can happen (without a direct cause) to folx from any age, race, or gender. It doesn't stem from identifiable physical damage (like a tumor or lesion), and often isn't visible on MRIs. It's not a problem with the physical state of the brain, but rather how the brain functions.
FND symptoms can include: seizures, movement disorders, feelings of weakness, and abnormal tremors or tics. One might lose consciousness or even their ability to move. It can be disabling and as costly as any structural neurological condition like Parkinson's or ALS.
Because FND doesn't show up on scans, many professionals may misdiagnose or flat-out ignore your symptoms.
Some may even tell you to "stop faking it." Imagine, in 2025, when no one can afford healthcare, doctors are telling patients who have experienced seizures or who are unable to control their limbs that their symptoms are fake. This happens so often that there are multiple forums full of experiences of patients being gaslit or "pushed around from doctor to doctor" for months without any answers or any relief.
To learn more about why doctors are such assholes about FND symptoms and what the current research for FND looks like, check out my colleague, Z L’Erario's, article.
Symptoms
Imagine for a moment that you have experienced anxiety at some point in your life (I would bet you wouldn't be reading this if you haven't).
Anxiety is a very real feeling, with symptoms like shakiness, nausea, tight muscles, and the inability to think clearly, and it can have a big impact on your life!
Yet, anxiety doesn't show up on MRIs, X-rays, or blood tests. In this hypothetical, where you have experienced anxiety at least once in your life, you aren't making these symptoms up to get attention. They're real. Your brain and body are actually experiencing these symptoms, without your permission, even when you want them to stop. It's the same thing with depression, OCD, or anything else in the DSM. These are real conditions that create real struggles and require real and sympathetic care.
All this is to say that YOUR SYMPTOMS ARE 10,000% REAL. And you are not alone.
We are creating networks of researchers, healthcare providers, and patients to tackle this disorder and offer support to others experiencing this condition. You can find more on FNDHope.
Why Does It Show Up?
So, why do people start experiencing FND symptoms? There is no one simple answer.
FND is thought to come from a misfiring in the brain’s communication pathways - like the software glitching even though the hardware is fine.
Sometimes this glitch kicks in after a physical injury, illness, or stressor, but it doesn’t always need a clear trigger. What research has shown is that certain folks might have a vulnerability in their brain’s "prediction system" - the way the brain expects the body to move and feel—and when life throws in stress, trauma, or illness, those predictions can go haywire.
One big player here is the amygdala—that almond-shaped part of the brain known for processing emotions, especially fear and threats.
The amygdala works with many other parts of the brain. It’s wired into motor regions of the brain (like the supplementary motor area) and linked up with areas that handle body awareness, agency, and movement control (like the insula and the temporoparietal junction). When the amygdala is activated by stress, fear, or emotional overload, it can actually change the way your brain talks to your body, sometimes ramping up signals like “freeze” or “shut down” in the motor system.
Studies using fMRI have shown increased amygdala activation in people with FND when they’re exposed to negative emotional stimuli like fearful faces, alongside increased coupling between the amygdala and motor control circuits.
This suggests that emotion and movement aren’t two separate issues—they’re literally connected in the brain.
Why Now?
This is a question I hear a lot: “If it’s the way my brain is wired, why didn’t this happen five years ago?” And the answer is: because nervous systems adapt until they can’t.
You might have been carrying stress, trauma, or sensory vulnerability for a long time without symptoms showing up. But the brain and body have a tipping point.
FND often shows up when there’s a “perfect storm” of stressors - when the nervous system’s usual coping strategies stop working.
This could be a new stressor (like illness, injury, grief, or even sleep deprivation), or it could be chronic stress finally pushing the system over the edge. Sometimes, the accumulation of stress across time, plus whatever else is happening in your environment, sets the stage.
COVID, Social Media, and the Rise in Tic-like Behaviors
We’ve seen this play out during the COVID pandemic. Between 2020 and 2022, there was a huge spike in young people (especially girls and women) presenting with sudden-onset complex tics and tic-like behaviors. Doctors agreed that these weren’t classic Tourette’s tics (and not classic symptoms of turrets), which usually start around age 6–8 and build gradually. These were explosive, complex movements, often with words or phrases repeated out loud, and they showed up fast—sometimes within days.
One reason? Social media exposure.
During lockdown, a lot of young people were watching creators on TikTok and YouTube who were openly sharing their experiences with Tourette’s. This visibility can be a good thing - reducing shame, creating connection. But for folks whose nervous systems were already under high stress, watching these repeated movements over and over seemed to prime the brain’s prediction system, nudging some people into experiencing tic-like behaviors themselves. This wasn’t conscious or intentional - it was the brain doing what it does best: learning patterns, mirroring, and adapting. It’s called social contagion, and it’s been well-documented in other contexts like fainting spells and psychogenic illness clusters.
But it’s not just TikTok. The isolation, uncertainty, and grief of the pandemic created fertile ground for nervous system overload.
Lack of structure, disconnection from support systems, and a steady drip of anxiety about health and safety—all of that put stress on the brain-body system, increasing the likelihood that symptoms like FND would emerge.
In other words: you weren’t imagining it. You were adapting. Your brain was doing its best to survive in a world that felt dangerous and out of control.
Why COVID Made Things Worse (and Why This Might Be Just the Beginning)
It’s not just that the COVID pandemic was stressful (which, obviously, it was). It’s that the pandemic hit right where many nervous systems were already vulnerable: uncertainty, isolation, financial insecurity, disconnection from care, and chronic overstimulation with no outlet.
FND is more likely to show up when the body’s stress systems are running hot for too long, and COVID was basically a global experiment in that exact scenario.
Lockdowns, disrupted routines, loss of social supports, fear of illness, death of loved ones—all of these acted like gasoline on the fire for people whose nervous systems were already working overtime to hold it together.
It was also largely the system we were already living in before the virus showed up.
We know that long-term stress, especially when it feels uncontrollable, can directly affect the brain regions involved in FND, like the amygdala, the insula, and motor planning areas. Chronic stress ramps up the hypothalamic-pituitary-adrenal (HPA) axis, keeps cortisol high, and reshapes brain connectivity, particularly between emotion and motor networks. Studies have shown that adverse life experiences and chronic stress increase the likelihood of developing functional neurological symptoms.
This is structural trauma.
Capitalism asks your body to perform like a machine. It rewards productivity, not health. It pushes people into precarity—gig work, no paid sick leave, impossible housing costs—and then calls it a personal failure when the nervous system can’t keep up. Scholars in public health have long argued that social determinants like poverty, unstable work, racism, and lack of access to care are not just background noise—they’re active ingredients in mental and physical illness.
Paul Farmer and others have called this structural violence: the way social, political, and economic systems harm people’s bodies by design. When survival means hustling through pain and suppressing distress signals, it makes sense that the body eventually finds its own way to say “enough.”
In this kind of environment, it makes sense that we’re seeing more functional symptoms like seizures, paralysis, tremors, or tics. These are not weaknesses or choices. They’re the body saying, “I can’t keep pushing like this.” They’re the nervous system’s form of protest.
And honestly? If things keep going the way they are - with climate disasters, rising inequality, unsafe working conditions, and a healthcare system built on profit over care—we may see even more FND in the years ahead. Not because people are weaker, but because the systems we’re living under are hostile to human nervous systems.
FND isn’t just about the individual. It’s about the social and political conditions we’re all swimming in. It’s about bodies breaking under the weight of chronic uncertainty, lack of safety nets, and forced hyper-independence.
If we want to really address FND, not just symptom management, but actually get at the roots, we have to talk about this.
We have to name the ways capitalism and structural violence shape health. And we have to dream bigger than “resilience.” We have to dream about systems where bodies don’t have to break in order to be heard.
How Therapy Can Help
FND is not something that changes through willpower or intellectual insight alone. If the nervous system could be talked out of a shutdown or a seizure, you wouldn’t be here in the first place.
Healing happens through relationship - through connection, through safety, through pacing.
Together, we build that relationship slowly and intentionally, because your body needs time to learn that it’s safe enough to feel, safe enough to notice, safe enough to soften.
There’s no one formula for how this goes.
Each person’s nervous system is different, and so is their history. Your symptoms have their own shape, their own timing, their own reasons, which is why we don’t use a strict protocol. Instead, we stay in conversation with your body and your experience as we choose the tools that fit. Some days that means somatic practice. Some days, that means parts work. Some days that means sitting in silence together while we notice what arises.
Acceptance and Commitment Therapy (ACT): Making Room for the Hard Stuff and Moving Toward What Matters
ACT helps us shift from “How do I make these symptoms stop?” to “How can I live alongside them in a way that feels meaningful?”
In session, we might name the ways your mind gets hooked - thoughts like “This will never get better” or “I can’t handle this.” Instead of arguing with these thoughts, we practice defusion: noticing the thought, labeling it (“I’m having the thought that…”), and loosening its grip.
We explore what actually matters to you - what you want your life to be about beyond symptom management - and take small steps toward those values, even when symptoms show up.
ACT is about choice, not control. It helps widen the space between “This is happening” and “What do I want to do with it?”
Exposure and Response Prevention (ERP): Teaching the Body That It Can Handle the Things It’s Avoiding
For many people with FND, certain movements, sensations, or situations have become so tightly linked with fear that the nervous system reacts before you can think your way through it.
ERP allows us to gently face these triggers with care and consent. Together, we build exposures that meet you exactly where you are.
For someone whose seizures are triggered by crowded spaces, we might start with imagining being in that space while using grounding tools. Over time, we might practice walking into those spaces with support, slowly teaching the body that it can stay present without needing to shut down.
With functional tremors, we might practice intentionally bringing on the tremor in small, safe ways—learning that the body can feel the sensation without spiraling into fear.
ERP is about growing your capacity, one step at a time, within a frame of safety. It’s never about pushing past your limits.
Gestalt Therapy: Giving Voice to What’s Been Held in the Body
Symptoms often carry something unspoken. A shutdown, a leg that won’t move, a shaking hand - these may be the only ways the body has found to express overwhelm, grief, anger, or unmet needs.
Gestalt work helps us turn toward these experiences with curiosity, not judgment. We might use experiential techniques like the empty chair dialogue:
"Imagine sitting in one chair as yourself, and in the other chair as the part of you that shuts down, trembles, or collapses. What does that part want to say? What has it been holding for you? What does it need from you now?"
This is about direct, embodied experience. It’s about staying with what’s here long enough to hear what’s been unsaid.
Internal Family Systems (IFS): Listening to the Parts of You That Are Protecting You
IFS helps us understand that symptoms aren’t the enemy - they’re protectors. They’ve been working hard, sometimes for years, to keep you safe.
In IFS, we get to know these parts with compassion. The shutdowns, the seizures, the tremors - they’re often parts that believe shutting the body down is the only way to avoid harm.
In practice, we might meet the part of you that collapses when anger rises, or the part that shakes when fear gets too big. We learn about the history of these protectors: "When did they first show up? What were they protecting you from? What happens when we meet them with care instead of resistance?"
IFS doesn’t try to push symptoms away. It asks: "What if we listened to the parts of you that have been asking for help all along?"
Somatics-Focused Work: Working Directly with the Body's Language
FND shows up in the body, so the work has to include the body. This doesn’t mean big, dramatic catharsis. Often, the most powerful shifts come from the smallest movements.
In somatic work, we slow things down. We track breath, tension, and sensation, noticing where the body braces, where it holds, or where it collapses.
We might practice grounding through the feet, orienting to the room, or gentle pendulation between activation and calm.
For someone whose symptoms flare when they feel trapped, we might experiment with gentle movements of the arms to create space, practicing the embodied experience of agency.
We might spend time just noticing: "What happens in your body when you talk about this? Can we stay with the sensation without jumping to fix it?"
This kind of work respects the pace of your nervous system. It’s not about pushing into sensation. It’s about building capacity, slowly and respectfully, for your body to feel without going into shutdown.
Somatic work is also where we practice co-regulation. Your body learns safety from both what and how we practice together.
Our Work Together
There’s no rush here. This work asks a lot from your nervous system. It takes time to build enough trust between us and within your own body to try something different.
Some days, the work looks like building skills and practicing tools. Other days, it looks like grieving what’s been lost. In some sessions, we sit quietly with the part of you that’s terrified to hope. In some sessions, we laugh because you caught yourself doing something hard that felt impossible before.
Healing FND is about building relationships.
Relationships with me, with your body, with the parts of you that have been carrying so much for so long. It’s about listening carefully enough, for long enough, that your body doesn’t have to shout to get your attention.
In therapy, we are tending to the exhaustion of having to fight so hard just to be believed. It’s about making space for the grief, the anger, the loneliness that comes from sitting in doctor’s offices hearing “normal” test results while your body is screaming.
We name it, we honor it, and we build tools together for the very real emotional labor of navigating a system that wasn’t built with your body in mind.
And when you need to push - when you need to advocate for yourself, ask for the referrals, ask for the testing, demand to be heard - I’m here beside you. I'm not telling you to “calm down” or “self-care” your way through injustice, but holding the reality of how hard it is while still believing in your right to keep asking for what you need.
The healing work is twofold: tending to the nervous system and tending to the wounds of dismissal.
Let's help your body feel safe enough to trust again - trust yourself, trust your signals, trust that you deserve care. You shouldn’t have to fight this hard. But until the world catches up, you don’t have to fight it alone.
References
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