A Case of the Hysterics

Article excerpt

Byline: Casey Schwartz

Is the debilitating medical condition mental, physical--or made up?

Made famous in the 19th century by doctors like Jean-Martin Charcot and Sigmund Freud, hysteria was a fairly common diagnosis in that era. Symptoms included sudden seizures, partial paralysis, and temporary blindness. No one knew the cause--there was no brain lesion to be found, no chemical imbalance to blame. It was unclear whether the condition was neurological or psychological.

Today, the condition remains a mystery. It has a new name--conversion disorder--and it accounts for 1 to 3 percent of all diagnoses in hospitals, making it more common than either multiple sclerosis or schizophrenia. Yet it is still poorly understood, and often misdiagnosed.

Unlike its fictional portrayal--such as in the new film A Dangerous Method, in which Keira Knightley screams and quivers as a Carl Jung patient suffering from hysteria in the early 1900s--the condition can be much more debilitating, involving muscle spasms and twisted limbs.

The symptoms seemingly come from nowhere. That's what happened to Susan Thomas (whose name has been changed to protect her privacy), a mother of two young children in Virginia. She was with a friend one day in 2004 when suddenly, she says, AMy left eye started feeling like it was pulling toward my nose.A Her friend reared back. Thomas's eyeball had rolled completely inward.

They rushed to the emergency room. Thus began a mystifying few years of bizarre symptoms such as involuntary spasms in Thomas's face, some of which would leave the left side of her face pulled upward into a chilling grin, Alike the Joker,A she says. The doctors did endless scans and biopsies. They found nothing. AAfter they didn't see any neurological changes, they started invalidating me--their whole mannerism with me changed,A she says. She began to wonder if she was somehow causing the whole thing herself.

This kind of self-doubt is common for patients with conversion disorder. They are vulnerable to the implied message they often get from doctors: there is nothing physically wrong with you, so you must be faking it.

Fortunately for Thomas, she found her way to a clinical trial at the National Institutes of Health, where, after two weeks of biofeedback--a technique that involves deep breathing and meditation--she began to improve. …