- Hey, everybody, happy Thursday.
Now today's question is
all about psychogenic movement disorders.
What are they, what can cause them,
and can we ever get them to go away?
But before I jump into that,
are you new to my channel, welcome.
I am a licensed therapist
creating educational mental health videos,
and I release them on Mondays and on Thursdays.
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Now let's jump into today's question,
and it was, honestly, really more of a conversation
that I had on one of my Patreon hangouts.
One of our community members
has been going through a really, really stressful
and traumatizing time,
and is now experiencing what her doctors
and other mental health professionals say
is a psychogenic movement disorder.
And in all honesty, I didn't really know much
about this prior to having this conversation.
But I was able to find some books, articles,
and research papers that helped explain
why this can happen,
and I'll link those in the description
if you wanna read more for yourself.
Now the definition of a psychogenic movement disorder
which is, according to the National Institute
of Neurological Disorders and Stroke,
is an unwanted muscle movement such as spasm or tremor
that is caused by an underlying psychological condition.
Most psychogenic movement is involuntary,
done without being consciously initiated
by the individual.
And they believe that psychogenic movement can occur
as a result of a conversion disorder,
which is when we have blindness, paralysis,
or other neurological symptoms
that just can't be explained by a medical issue.
Or a psychogenic movement disorder could develop
as part of somatoform disorders
which is really the umbrella term
that conversion disorder falls under.
Now these are mental illnesses
that cause us a lot of pain and discomfort,
but there's no medical or neurological issue
that can explain why they feel what they feel.
Also know that people who struggle with these
are not making up their symptoms
or causing it themselves.
It's just a mental illness
that shows itself primarily through physical symptoms.
They also say these movements could be developed
through us having fictitious disorder
which is when we act like we have
a mental or physical disorder when we really don't,
when we do this so that we can get attention
and/or sympathy from others.
And finally, they have linked these movements
to malingering, which is not a mental illness,
but instead, it's when people fake being sick or ill
in order to get time off of work, attention,
and get money for benefits, et cetera.
Psychogenic movement disorders are different
from other movement disorders like tremors or Parkinson's
in that they come on quickly and can rapidly increase,
and then stop for periods of time
or either not come back at all.
Or they could come back at really a random time,
just pop back up.
So what I really got out of learning
what these psychogenic movement disorders are
is that they aren't movements we initiate.
They can come and go.
And they can be part of another mental illness,
but they definitely are not due to a medical condition.
And obviously, in order for that to be ruled out,
you need to check with your doctor first.
Now there are many types of psychogenic movement disorders,
and from now on, I'm gonna call them PMDs
just to make it a bit easier on myself.
But the first type is psychogenic tremor
which is just like it sounds.
It's a tremor which is an involuntary quivering movement
that comes on suddenly
and can move from one area of the body to another.
And it can get worse when we are under a lot of stress.
And if we get distracted by someone or something,
it can lessen or go away completely.
And this type of psychogenic movement disorder
is usually co-morbid, meaning happens at the same time,
as a conversion disorder,
which, if you remember from earlier in the video,
it's when we have blindness, paralysis,
or other neurological symptoms
that cannot be explained by a medical issue.
The second type of a PMD is psychogenic dystonia
which is when we have involuntary muscle contractions
that cause us to have slow and repetitive movements.
And these are usually really, really painful.
This can come on quickly,
or be part of a recurring attack.
And finally, these are typically certain poses we hold
rather than quick movements that we make.
The third type of PMD is psychogenic myoclonus,
and I might be sayin' these wrong,
but this is when we have sudden muscle movements
like a tic or a twitch,
and we aren't able to control it.
This can also increase our startle response,
so it can more easily push us into fight, flight, or freeze.
And I could see this one being more closely linked
to trauma or PTSD in some form
because of its close connection
to fight, flight, or freeze.
But now, I'm just hypothesizing.
Now the fourth type of PMD is psychogenic parkinsonism.
And this type of movement is rigid and slow
and can take a lot of energy to keep doing it.
Therefore, the people who struggle with this
really get tired very, very quickly.
And these movements usually happen on both sides
of our body unlike Parkinson's,
which tends to only affect one side.
And fifth and finally,
there is psychogenic gait disturbances.
And these are movements
that affect the way we walk.
They could cause us to stagger, lose our balance,
or even walk on our tiptoes.
And although it can look like we are going to fall down,
people with this disorder rarely do
because if you think about it,
PMDs are more about the movement,
not balance or anything to do with our cerebellum.
If there was something wrong with our cerebellum,
it wouldn't be a PMD
because there would be neurological evidence
that it's something else,
that there's something organic happening
in our brain to cause it.
Does that make sense?
And it's also important to know
that these types of movements rarely happen
to anyone under the age of 10,
and the sooner we catch them, the better.
The thing that makes treatment difficult
is that these movement disorders
are really hard to diagnose.
We usually have to see multiple doctors,
specialists, and get second
or maybe even third opinions.
And we all know how hard it can be
to get in to see a doctor,
so making all these appointments
can take us months and months.
But once we get in, they usually take
a two-pronged diagnostic approach.
First, a medical doctor and a neurologist
will rule out any organic illnesses or abnormalities
in our brain structure
because if it's caused by either of these things,
it's not a psychogenic movement disorder.
Next, they will try to figure out
what psychiatric disorder could have led
to its development.
Remember, these mental illnesses that I mentioned earlier
like factitious disorder, somatoform disorder,
they're gonna try to figure out which one of those
is to blame for it.
Or if it's another mental illness altogether,
like OCD, depression, autism spectrum disorders,
or even anxiety.
The research is very clear
that just because there isn't a medical reason
to explain a movement doesn't make it a PMD.
They must also have actual symptoms
that line up with one of the diagnoses
of the five types of psychogenic movement disorders,
you know, like dystonia, tremor, et cetera.
And they're gonna have to have one of those
or those symptoms
in order to diagnose it as a PMD.
Once properly diagnosed, we can get treatment
because research shows that the sooner we treat our PMDs,
the more likely and easily they can go away.
You know, for treatment, they recommend
that we work with a treatment team.
And I know I talk about that a lot,
but it's like having all your people work together
to help you get better.
And so it's really important
that we work with this team
when trying to manage any psychogenic movements.
And this team should ideally consist of
a neurologist, a psychiatrist, a physiotherapist,
and a regular therapist, like me.
Now, we know that that's a lot of people,
but just, just hear me out, I'll walk you through it.
Now the neurologist won't really have
to be as involved once you've been tested,
and they've decided that it truly is a PMD, okay?
So they're kind of just in the diagnostic portion of this.
And they'll answer any questions that you have,
help you understand your diagnosis,
and then pass you off to other members of the team.
Then we move into the psychiatrist.
And if they don't offer therapy,
they can get you started on an antidepressant
or other medication that could help you
with your symptoms.
Remember, you know, this could be caused
by another mental illness like depression,
OCD, or anxiety.
Then the physiotherapist can help us manage
any pain or stiffness our PMD may have been causing us.
They can recommend some exercises
or maybe even massage,
whatever they can do to help us best cope
with the physical side of our movement disorder.
And finally, a therapist.
We will help you using CBT
or cognitive behavioral therapy techniques
or other talk therapy strategies
in order to process through
whatever may be causing the PMD.
Remember it could be
because we really need care and attention,
or it could be because our anxiety is through the roof.
Because there are so many causes,
the therapeutic techniques will really vary a lot
from person to person.
But just remember that the sooner we get this treated,
the better the outcome.
So please reach out and speak up
and know that with proper care, it can get better,
and your psychogenic movements can go away.
I hope you found this
as interesting and helpful as I did,
and if you hadn't heard
of psychogenic movement disorders before,
what did you find to be
the most interesting thing about them?
And if you have struggled with one of these in the past,
what helped you most to overcome it?
Please share those in the comments down below,
and I will see you next time, bye.
(mellow electronic music)