What Is the Difference Between Dissociative and Conversion Disorder?

Dissociative disorders and conversion disorder are both mental health conditions. While they are separate diagnoses, these conditions often occur together.

Dissociative disorders cause a person to be disconnected from their thoughts, memories, consciousness, and identity. Conversion disorder, also known as functional neurological disorder or functional neurological symptom disorder, causes neurological symptoms without an underlying neurological condition.

This article discusses the similarities and differences between dissociative disorders and conversion disorder.

Types of Dissociative and Conversion Disorders

There are three types of dissociative disorders. These include:

• Dissociative identity disorder: This condition was formerly known as multiple personality disorder and causes a person to have two or more distinctly different identities.
• Dissociative amnesia: This condition causes people to be unable to recall information about themselves. It usually is related to traumatic events, such as emotional neglect and abuse during childhood.
• Depersonalization/derealization disorder: People with this condition feel detached from themselves or their surroundings.

Conversion disorder is one diagnosis but has several types, based on a person's symptoms, including:

• With weakness or paralysis
• With abnormal movements
• With sensory loss
• With swallowing or speech symptoms
• With seizures (psychogenic nonepileptic seizures, or PNEs)

What Are the Symptoms of Dissociative Disorders?

Each specific dissociative disorder has its own symptoms.

Common symptoms of dissociative identity disorder include:

• At least two distinct identities, with different memories, behaviors, and thought patterns
• Memory loss about past trauma, current events, or personal information
• Difficulty performing daily activities

Dissociative amnesia symptoms are centered around not being able to recall information about oneself. The three main types of memory loss are:

• Localized: Specific to a period of time or event—this type is most common
• Selective: Forgetting parts of an event or period of time
• Generalized: Total loss of memory of life history and identity—this type is rare

Symptoms of depersonalization/derealization disorder include:

• Looking at yourself from the "outside"
• Feeling like you're living in a movie
• "Out-of-body" experiences
• Feeling like you're disconnected from your thoughts

What Are the Symptoms of Conversion Disorder?

Conversion disorder is a mental health condition that is characterized by a variety of neurological symptoms that are seen in neurological disorders (disorders that affect the brain, nerves, and/or spinal cord). The symptoms are genuine and can cause distress and impairment. These may include:

• Blindness or double vision
• Loss of sense of touch
• Numbness or tingling in the face, arms, and/or legs
• Paralysis of muscles in the arms and/or legs
• Loss of speech or difficulty speaking
• Deafness
• Pain
• Tremors/shaking
• Difficulty sleeping
• Memory loss or "foggy" brain
• Loss of smell
• Impaired coordination, dizziness, and/or fainting
• Seizures

Diagnosing Dissociative and Conversion Disorders

Dissociative disorders and conversion disorder are formally diagnosed by a mental health professional, such as a psychiatrist or psychologist, using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This reference lists specific criteria that need to be met for a person to be diagnosed with certain conditions.

Dissociative disorders are diagnosed based on a person's history and symptoms. Additional testing might be performed to make sure the symptoms aren't due to other medical conditions that can affect memory and other mental functions, such as a brain tumor, head injury, side effects of medications, substance use, or sleep issues.

Conversion disorder is also diagnosed based on a review of symptoms. However, because conversion disorder causes a host of physical symptoms, other testing is usually performed to rule out neurological conditions or other medical issues that can cause similar symptoms.

Treating Dissociative and Conversion Disorders

Psychotherapy is a primary treatment for both dissociative and conversion disorders. Goals of psychotherapy include:

• Working through past trauma
• Identifying and replacing negative thought patterns
• Learning new coping strategies
• Teaching stress management and self-care techniques
• Improving self-esteem
• Helping people express emotions
• Improving communication

Additionally, psychotherapy for conversion disorder focuses on identifying the emotional issues that are causing the physical symptoms.

Physical therapy may be part of the treatment for conversion disorder to help maintain muscle strength and reduce stiffness that can develop due to inactivity. Occupational therapy is also used to help a person regain the ability to perform daily tasks.

There are no medications that directly treat dissociative disorders or conversion disorder. However, medications are sometimes used to treat depression and anxiety that can occur with these conditions, such as selective serotonin reuptake inhibitors (SSRIs).

Common SSRIs include:

• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Celexa (citalopram)
• Paxil (paroxetine)
• Zoloft (sertraline)

Prognosis

The prognosis for dissociative and conversion disorders varies based on a person's specific diagnosis, circumstances, and whether they are receiving treatment. Symptoms of dissociative disorders can be recurrent, often increasing under stress.

Appropriate psychotherapy and psychiatric treatment can potentially decrease the frequency and severity of the symptoms and improve functioning.

Many people with conversion disorder fully recover. Physical symptoms can last as short as a few days or weeks. However, these symptoms can also be recurrent or chronic (long lasting).

Summary

Dissociative disorders and conversion disorder are mental health conditions that can occur together. Dissociative disorders cause a person to become disconnected from important aspects of their lives. Conversion disorder causes physical symptoms that mimic neurological conditions.

Both conditions are treated with psychotherapy. Other therapies can help restore function as the underlying psychological issues are addressed. In some cases, medications are used to treat depression and anxiety that often occur with dissociative and conversion disorders.

A Word From Verywell

Dissociative disorders and conversion disorder are complex conditions that require treatment by a qualified professional. If you suspect you might have one of these conditions, talk to your doctor. Treatment can significantly improve your quality of life.

If you are caring for someone with these conditions, consider joining a support group; these groups can help you feel less isolated and provide you with ideas and encouragement.