What is FND?
Or rather, what does my FND look like?
Honestly, it can look like I am well until you work with me closely over time. Then the cracks show.
Functional Neurological Disorder is not a personality flaw. It is a neurological condition in which the brain’s signalling does not work reliably. The symptoms are real. The impairment is real. The fallout is real. It is often invisible, and it is often misunderstood.
Let me be specific about what it is and what it is not. My cognition is intact. The disruption is signalling, not intelligence or judgment.
In my case, it often looks like misjudged capacity.
Two weeks ago, I went to the office. I stayed too long. Fourteen days later, I am still paying physiological interest on that debt. I was hanging on by my fingernails for a while there.
It looks like the crash that follows joy. I feel good, so I ride my bike with my child. Yay. Present parenting. It is not a long ride, because fitness as I once knew it is gone. I get home, I get into bed, and I stay there for a week. The price of one bike ride is a week of working from bed. I move as little as possible to keep functioning.
It looks like the invisible tax of professional presence. I go to a conference because I love my work. Then, in the quiet of the hotel room, the tax is collected: spasms, neurological episodes, and sometimes seizure-like activity. On difficult nights, I experience visual distortions that take time to recognise for what they are.
Let me clarify something before anyone reaches for the lazy solution. I want to go. I want to do the work. Conferences, work retreats, and strategy sessions are not a play at martyrdom. They are part of my role and part of what I enjoy. The issue is not willingness. The issue is the nervous system bill that arrives afterwards.
I understand the cost. I choose it anyway. Do not take the work away and call it care. Removing someone with a disability from meaningful work is not support. It is control dressed up as concern.
Support looks like planning, pacing, and respecting stated limits without turning them into a debate.
Planning, pacing, and forward planning should not be treated as accommodations. It should be the default operating practice. They protect people and improve delivery.
The anatomy of the invisible
For me, FND is a collection of symptoms that can vary widely but stay consistent in their pressure.
- The Saturday crash: a mandatory day of total collapse.
- Phantom pain: pain with no visible cause, nerves jangling, limbs going numb.
- The long migraine: a near-constant migraine cycle that has not properly broken in months.
- The medical carousel: recurring visits to the physician, neurologist, endocrinologist, psychiatrist, and psychologist.
- The blue screen of death: silent migraines where my brain enters recovery mode. The brain-to-mouth connection severs. The signal drops. I am physically available, but the system is offline.
The social friction
The hardest part of FND is not fatigue or brain glitches. It is doubt.
I can see the doubt on people’s faces when I describe my reality. FND looks different from person to person. This leads people to reach for the easiest story: that I am not telling the truth. The irony is that I am usually explaining it between flares. In that moment, I look fine. That does not mean the rest of the story is untrue.
Sometimes the doubt is shallow. They see my colourful braids and manicured nails and assume an ill person would not have the time or energy for any of it. Illness does not have “a look”.
But you make time for what keeps you psychologically steady. My nails were manicured long before FND. Colourful hair is not a contradiction. It is a choice, a reminder when I look in the mirror that there is still room for fun.
Presentation is not proof of wellness. It is sometimes proof of strategy.
Let me be clear: I am not inconsistent. My nervous system is.
And then there is pity. Pity is not support. I do not need it, and I do not want it.
What I need is to be believed and to be planned with. One hundred per cent effort today can become twenty-five per cent capacity tomorrow. This is not a motivation issue. It is neurobiology.
I can surge for delivery. I can carry intensity during peak moments. The requirement is recovery space afterwards because I can’t go at 100% all the time. Protecting those days is not indulgence. It is what keeps delivery predictable.
If you want to support me, ask what success looks like for the next 48 hours. Don’t ask whether I’m sure I should be here.
The bottom line
This is not only about me. It is about how people treat invisible disabilities when they do not behave the way they expect.
Some people suggest I change my work. They misunderstand the problem.
I like my work. I like working. What I will not do is perform Superwoman to make other people comfortable.
Do not measure my capacity by my appearance. Do not call it exaggeration because you do not understand the mechanism. And do not confuse variability with dishonesty.
If you want to work well with people with invisible disabilities, start by believing them the first time. Build work designed for reality, not assumptions.
I will keep naming this until “invisible” stops being treated as “impossible”.
FND: The Facts Behind the Invisible
What is Functional Neurological Disorder (FND)?
Functional Neurological Disorder (FND) is a neurological condition in which there is a problem with how brain networks function and communicate, rather than structural damage such as a tumour or stroke
It can present with various physical symptoms. These include seizures or seizure-like episodes, tremors, weakness, and paralysis. Other symptoms are speech disruption, sensory changes, and cognitive shutdowns. These symptoms are real and involuntary.
A useful analogy is software, not hardware: the “computer” is intact, but the system is misfiring.
FND is the modern, clinically preferred term. You may still see “conversion disorder” in older systems or paperwork. However, that label is increasingly avoided. It pulls the focus toward stigma rather than mechanisms and care.
FND is best understood through a brain-network and biopsychosocial lens. That means biology, nervous system functioning, stress, trauma, and environment can all contribute. The mix varies from person to person.
Is it a mental health condition?
No!
FND is not a mental illness. It is a neurological disorder of functioning.
Mental health can influence symptoms and recovery in specific ways for some people. It affects recovery just as it can in many other neurological and chronic conditions. That does not make FND imaginary or voluntary.
Mental wellness is often important in managing FND. It can reduce triggers and improve coping. It does not mean the condition is caused by weakness of character or lack of resilience.
You can’t think your way out of a misfire in your nervous system.
Why does it show up physically?
This is due to the brain’s control over movement, sensation, speech, and awareness.
The body reflects the disruption in signalling between networks. That can look like paralysis, seizures, tremors, speech loss, or sensory change, even when structural tests are normal.
Functional does not mean fake. It means the problem is with how the system is operating, not whether it exists.
Why is it so often misunderstood?
Structural scans, such as MRI and CT, look for structural disease. In FND, those tests are usually normal. The problem is in functional signalling and network activity rather than a visible lesion.
Misunderstanding is also fueled by stigma. People are still told, “It’s all in your head.” They are treated as if they are exaggerating or faking. That response is inaccurate and delays appropriate care.
Why does capacity change day-to-day?
Variability is part of the condition. Signals can move smoothly one hour and misfire the next. That is neither moodiness nor dishonesty. It is the nature of a signalling system that does not regulate reliably.
The rule: In a conflict between intent and the nervous system, physiology wins.
What does “believing the patient” actually look like?
It means accepting that someone can look fine while their internal systems are not functioning normally. It means understanding that “normal” tests do not automatically mean “nothing is wrong.” This is especially true when the condition is about function rather than structure.
Believing also means listening to the lived pattern: triggers, crashes, variability, and the real-world cost.
What does support look like at work?
Support does not mean removing people with disabilities from meaningful work. It means planning, pacing, reducing avoidable overload, and respecting stated limits without turning them into a debate.
What should you not say to someone with FND?
Treat normal tests as inconclusive, not definitive.
Do not prescribe attitude as treatment.
And do not mistake invisibility for choice.
Where Words Take Root 
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