Inpatient rehabilitation for Functional Neurological Disorder (FND)

If you suffer from a Functional Neurological Disorder (FND), you may have discovered that treatment can be difficult to come by. Certainly, specialist treatment centres are few and far between and intensive inpatient treatment programmes more so.

What is a Functional Neurological Disorder?

A diagnosis of Functional Neurological Disorder (FND) is given where somebody is suffering functional problems (symptoms) which appear neurological in origin, but where there is no identifiable structural damage to their brain and nervous system. Rather, the problem is with how their brain and body sends, receives and interprets signals. To use a computer analogy, it’s a software problem rather than a hardware problem.

What treatment is typically available?

If you’re very fortunate, your symptoms can sometimes improve or resolve without treatment. However, most commonly a combination of treatments and therapies are recommended. These often include:

• physical therapy such as physiotherapy and occupational therapy;
• psychological therapy such as Cognitive Behavioural Therapy (CBT);
• medication, often including pain and antidepressants medication (although the latter often helps target a number of different symptoms, not just psychological ones);
• lifestyle changes to reduce stress and anxiety such as mindfulness, yoga and meditation.

However, even with input from a number of medical professionals across a range of disciplines, you may still remain very affected by your symptoms, which can be debilitating. If you find yourself in this situation, having tried all other available treatment, you might still benefit from an inpatient rehabilitation programme.

Inpatient versus outpatient programmes

Inpatient programmes for any condition usually have a far better track record of achieving improvement in a person’s symptoms than similar programmes on an outpatient basis. The reason for this is that as a patient you enter a safe, supportive, structured and immersive environment where, for the duration of your stay – typically 3 weeks for FND – you focus entirely on you and improving your symptoms without outside distraction.

Multi-disciplinary input

Inpatient rehabilitation programmes are multi-disciplinary. That means that during your stay you will receive input from professionals across a range of disciplines, but all working together from the same treatment plan. Typically, you will see:

• a psychiatrist;
• nursing staff trained in physical and mental health;
• a psychological therapist;
• a physiotherapist;
• an occupational therapist.

Understanding you

Through one to one sessions with each of these professionals and team meetings in which you are involved, you get to know the treatment team and, crucially, they get to know you and understand your symptoms and how they affect you. After all, no two patients with FND ever present identically. Symptoms are inevitably complex and are affected by different aspects of your history.

You will be taught different techniques and skills and challenged to incorporate them into your day-to-day life to help you to better manage and live with your symptoms in order to improve your quality of life.

Problems

If your FND has so far proved resistant to therapy, a dedicated inpatient programme will likely seem a very attractive option. However, there are two main problems.

First, as highlighted at the beginning of this article, specialist treatment centres are few and far between. More information on the location of specialist centres is available on the FND Hope website.

The second problem is one that we’ve highlighted in a previous article on inpatient rehabilitation – the risk of ‘crash and burn’. In the past, this is a very real phenomenon we have witnessed in clients shortly following their discharge. Accordingly, as FND compensation claim lawyers, we now take care to put arrangements in place to minimise the risk of it occurring. As we explained in that article:

“Suddenly, the helpful and supportive staff are no longer on tap. Family and friends are keen to talk and catch up. A month’s worth of stored-up domestic and other issues have to be dealt with. Even if you can focus on the daily regime of physical and psychological exercises that have been drummed into you, they now seem far less effective. Very quickly that “end of rehab high” upon which you floated home has evaporated and you start to spiral down.

“For this reason it is imperative that before somebody attends an inpatient course of rehabilitation that arrangements are put in place to provide for them local, continued professional support immediately upon the completion of the course. That is the only way to minimise the risk of ‘crash and burn’.”