Can FND Get Better?

Understanding healing and recovery

One of the questions I am most often asked by people with Functional Neurological Disorder is a very direct one:

Can I get better?

It is an understandable question. By the time many people receive an FND diagnosis, they may already have gone through months or years of symptoms, investigations, appointments and uncertainty. They may have lost trust in their body. They may have lost parts of their independence, their work, their relationships or the life they thought they would be living.

They are not looking for another complicated explanation. They want to know whether there is hope.

My answer is yes. Healing is possible.

But I would like to slow down here, because healing and recovery may not mean exactly the same thing.

Recovery or healing?

The medical model tends to think in terms of recovery. It looks for something that can be measured.

If you have anaemia, we can measure the level of haemoglobin in your blood. If you have diabetes, we can measure your blood sugar. We can repeat the test and see whether the treatment is working.

This approach works well for many conditions. It does not work quite as neatly in FND.

FND is not explained by damage to the structure of the brain or nervous system. The difficulty lies in the way the nervous system is functioning and in the way messages are being communicated. FND can also affect many areas of a person’s life at the same time. It may affect movement, speech, energy, concentration, relationships, confidence, identity and the person’s sense of safety.

So how do we measure getting better?

Is someone only better when every symptom has disappeared?

In my view, healing is a more useful word. Medicine does not always feel comfortable with the word because healing is difficult to measure. It is a deeply personal experience. We can see a broken bone healing on an X-ray, but that does not tell us whether the person has healed from the accident, the fear, the loss or everything that followed.

The same is true in FND.

Can symptoms completely disappear?

Yes, they can.

Over the years, I have seen people recover within days or weeks. I remember a young woman who came to my clinic in a wheelchair and made a full recovery within a few weeks. She was able to walk without support and I never heard from her again.

I have also worked with people whose symptoms continued for many years.

There are many different healing trajectories. Some people experience a complete disappearance of symptoms. Some improve gradually. Some have periods of recovery followed by relapse. For others, FND becomes a long-term condition.

The big question is whether someone can heal in a meaningful way when some or all of the symptoms are still present.

I believe they can.

In fact, it would be difficult to associate healing only with a complete lack of symptoms. The human nervous system does not function in absolutes.

Healing while symptoms are still present

How do you know you are healing?

You may notice that your symptoms are less intense or that they happen less often. You may begin to recognise what brings them on and what helps them settle. You may notice the warning signs earlier. You may recover more quickly after a functional seizure or a flare-up.

You may understand your symptoms better and feel less frightened by them.

You may begin leaving the house again. You may find a way to return to part of your work, reconnect with somebody important or take part in an activity that gives your life meaning.

None of these changes are small.

It is possible to have symptoms and heal at the same time. Healing without full clinical recovery means reaching a place where meaning is found and understanding is gained. It means learning how to be well in the presence of FND.

Just knowing this is possible can offer hope. It tells you that you are not broken and opens up a much wider view of what can change.

Healing does not follow a straight line

I often explain that healing in FND does not follow a straight line. Life takes us through twists and turns, and the healing journey also has its ups and downs.

There may be periods of stability. There may be episodes of relapse. Sometimes you will feel that you have turned a corner and at other times you may feel that you are back where you started.

You are not necessarily back at the beginning.

The true measure of healing is gained by appreciating the journey over time. Perhaps you understand more. Perhaps you are responding differently. Perhaps the flare-up is still difficult, but you know what to do when the warning signs arrive. Perhaps your recovery from it is a little quicker.

These changes matter.

Recovery and healing cannot be forced. We can only work at the pace our nervous system is able to manage.

Understanding leads to healing

An early and clearly explained diagnosis can help the healing journey begin.

Many people with FND become stuck in long loops of investigations, appointments and uncertainty. They know something is wrong, but they do not have an explanation that makes sense. The longer this continues, the more frightening and confusing the experience can become.

Understanding does not mean that every question has been answered. It means that the person has enough of a map to begin finding a way forward.

I often think of the process in this way:

Awareness → Understanding → Healing

Awareness begins when you become curious about what you are experiencing. You notice the symptoms, but you may also begin to notice what is happening around them. You become aware of your energy, your relationships, your physical health, your emotional world and the systems around you.

Understanding develops as the pieces begin to connect.

Healing becomes possible when that understanding creates new choices, new connections and new ways forward.

FND affects more than one part of life

FND is not a purely physical condition or a purely psychological condition. It overlaps both sides of a division that was never as clear as we once imagined.

FND is a whole-person condition. It can be understood across three broad areas: biological, psychological and social.

The biological area includes the functioning of the brain and nervous system, physical health, pain, sleep, fatigue, medication and movement.

The psychological area may include thoughts, emotions, fear, attention, previous experiences and the meaning the person makes of what is happening.

The social area includes relationships, family, work, healthcare, money, community and the wider systems in which the person lives.

These areas do not exist separately. They interact continuously.

This is why healing may need to happen across several parts of life rather than through one treatment alone.

Different people need different forms of help

The person who helps you may be a physiotherapist, occupational therapist, speech and language therapist, neurologist, psychiatrist, psychologist, GP, rehabilitation professional or somebody from another discipline.

The professional title matters less than whether the person understands the nature of FND, listens to your experience and can work with you collaboratively.

Physical therapy may help retrain movement and rebuild confidence in the body. Speech and language therapy may help where speech, voice or swallowing have been affected. Occupational therapy may help with energy, daily activity, work and independence. Psychological therapy may help you understand patterns, manage fear, work with trauma where it is relevant or make sense of the impact FND has had on your life.

Psychological treatment does not mean that the symptoms are imagined. FND is real and involuntary. Psychological and relational experiences are part of being human, just as physical experiences are.

There are different therapy models and different ways of working. If possible, find an approach that resonates with you. Ask questions. Find out what the treatment involves. Speak with people who have experienced it. Give your nervous system enough time to experience the work before deciding whether it is helpful.

Finding your voice is part of recovery

Healing from FND involves finding your voice or strengthening the voice you already have.

Sometimes FND directly affects speech. The person knows what they want to say, but the voice does not come or the words become difficult to produce.

At other times, the physical voice is working but the person does not feel able to use it. They may feel overwhelmed, dismissed or frightened. They may have spent so long trying to explain themselves that their voice has become quieter.

Our voice is connected with our identity. It is how we communicate our needs, ask questions, access help and take part in treatment.

Before an appointment, write down the questions you want to ask. When the thinking has already happened and the words are on the page, it may be easier to make your voice heard.

Use your lived experience. You know your body and your FND in a way that no professional can know it. A good consultation brings your knowledge together with the professional’s knowledge. It should be a collaborative partnership.

Energy can become a barrier to healing

People with FND often tell me that they struggle with energy. This is one of the most familiar patterns I have observed over the years.

Energy is needed to think about options, put solutions into practice and make changes. When energy is low, it is easy to feel stuck in the FND maze.

I think of energy in two forms: physical and emotional.

Low physical energy may be experienced as fatigue, heavy limbs or weakness. Low emotional energy may feel like brain fog, numbness or mental exhaustion. It can become difficult to take in information, remember new strategies or plan what to do next.

It is important not to assume that every experience of low energy is simply part of FND. Poor sleep, anaemia, low vitamin levels, thyroid problems, diabetes, low mood and medication side effects can all contribute and may need medical review.

Another pattern is the “boom and bust” cycle. On a better day, you may try to complete everything that has been waiting. The body then crashes and needs a long time to recover.

Finding a balance between activity and rest is part of healing. Resting all the time can lead to deconditioning and a loss of confidence. Pushing beyond what the nervous system can manage can lead to another crash.

The aim is not to find a perfect formula. It is to listen, notice and adjust.

Patience is your best travel companion

The brain has millions of connections. These connections are more changeable than we once believed. New patterns can develop, but they need time, repetition and the right conditions.

When progress feels slow, it is easy to conclude that nothing is happening.

Patience creates space. As you learn about your symptoms, your relationships and the barriers around you, exits and solutions may begin to appear. Sometimes they emerge gradually. Sometimes a moment of clarity arrives unexpectedly and something suddenly begins to make sense.

These moments can be brief, but they are important. They tell us that the journey is moving.

Do not pressure yourself to heal quickly. Do not treat recovery as another task at which you can succeed or fail.

Your nervous system has its own pace.

What if I feel stuck?

When healing does not seem to be progressing, the answer is not always to push harder.

Slow down and become curious.

Ask yourself:

• What is my body trying to communicate?

• What has changed recently?

• What happens before a flare-up?

• What helps, even slightly?

• Is there a physical-health problem that needs attention?

• Is my energy being used faster than it can be restored?

• Is there a relationship or environment that keeps my nervous system under strain?

• Am I receiving the right kind of help?

• Have I lost my voice within my treatment?

Listen again. Acknowledge a little more than last time. Try to make deeper sense of what is happening.

Sometimes the solution that helped at first becomes less useful later. This does not mean you have failed. It may mean that something has changed and a different exit is needed.

Acceptance does not mean giving up

Acceptance can be a loaded word in FND.

It does not mean accepting stigma, poor treatment or injustice. It does not mean abandoning the possibility of improvement.

Acceptance means beginning from the reality of where you are. It means acknowledging that FND and its symptoms are part of your present experience without allowing them to define your whole identity.

There is an important balance between striving and resting, and between exploring and accepting.

Too much striving can become another source of pressure. Too much resignation can leave you feeling trapped.

The task is to find the place between them where movement becomes possible.

You are not responsible for having FND

FND is outside conscious control. You did not choose the symptoms, and you are not to blame for them.

Many people carry an unfair sense of responsibility. They have been made to feel that because the condition is functional, they should somehow be able to stop it.

Your nervous system has adapted to whatever has happened. It has tried to communicate with you, and it may have been trying to keep you safe. You are doing your best within the limitations FND has imposed.

You are not responsible for what has already happened. You can, however, take responsibility for what comes next. This is agency. It means deciding which questions to ask, which support to seek, what you need to understand and which next step is available to you now.

Healing seldom happens in isolation

Healing is personal, but it is also relational.

We heal internally and we heal through our relationships with other people and the systems around us.

You may be able to begin this journey by yourself through reflection, learning and making sense of your experience. You may also need another person, a professional, a family member or a community you trust.

Reaching out is not weakness. A supportive relationship can offer validation and help you see exits that were not visible before.

FND-specific services remain limited in many places. Begin with what is available locally. Speak with your GP or primary-care doctor. Explore physiotherapy, occupational therapy, psychology, psychiatry, neurology, pain services or rehabilitation depending on your needs. Online support may also help you connect with people who understand the condition.

Start somewhere and build gradually.

So, can FND get better?

Yes.

For some people, symptoms disappear completely. For others, healing means that symptoms become less frequent, less intense or easier to understand. It may mean recovering more quickly, feeling safer, finding your voice, rebuilding relationships or returning to a life that carries meaning.

Healing is a journey, not a destination.

Optimism should be our default position because the structure of the nervous system is preserved and change remains possible. You may still have difficult days. There may be setbacks and relapses. The path may twist and turn.

Begin with awareness. Allow understanding to develop. Let healing happen at the pace your nervous system can manage.

There is no single pathway. Every pathway is unique, and every journey is special.

Medical note: This article provides general information and does not replace assessment or treatment from your own healthcare professionals. New, severe or substantially changed symptoms should be assessed appropriately rather than automatically attributed to FND.