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Can The Mind Disable you?


Tuesday, May 12th, 2009 Can The Mind Disable you?

An unusual report from the BBC today by Jane Elliot (12 05 09) regarding a woman’s physical and mental plight.

Over the space of a decade, Susan Dakin had convinced herself that she was dying. Moreover the 49 year old had lost both her sight and her mobility. Notwithstanding, she was indeed confined to a wheelchair, she had difficulty swallowing and her bladder had ceased to function.

She was tested for neurological conditions such as multiple sclerosis and the movement disorder dystonia were suspected, but nothing ever identified. Dakin states that, ‘”At one point they only gave me a few months to live,” said Susan, from Coventry. I could not eat and lost lots of weight. I thought I was dying and so did my family.”

However, with that in mind and the seriousness of her condition she was never presented with a formal diagnosis and thus was under various consultants. It was when she started seeing a new GP, Dr Grant Ingrams; several years ago the cause of her problems became more apparent.

Significantly, it was after just a few appointments, Dr Ingrams suspected her difficulties might be linked to her mental health as he knew she was in an abusive relationship and had been subjected to violent attacks.

Dr Ingrams confirms, “She had problems with left leg and arm was blind and had swallowing problems, could not control her bladder and had fits,” he said. “I did a quick scan of the physical symptoms, which were very real and very serious, but they did not seem to add up. One of the advantages of being a GP is that you are able to take an overview of a patient’s entire health and lifestyle, something that you are not always able to do when you come from a specialist viewpoint.”

From that perspective, she was referred to the National Hospital for Neurology and Neurosurgery, in London, where doctors diagnosed conversion syndrome - a psychiatric disorder in which psychological problems manifest themselves as physical symptoms.

More specifically Ms Dakin is now featuring in a new British Medical Association book, ‘Partners In Care’, which celebrates NHS success stories, said she had been terrified by her baffling catalogue of symptoms. She says, “It started when two of the fingers on my left hand started to become clawed I thought I had damaged my nerve and then it began progressing and went into the trunk of my body. Then I couldn’t swallow food and could just sip liquids. It was terrifying my leg started to drag and I could not walk, I was blind for three years and in a wheelchair. I could not make sense of it.”

“Luckily Dr Ingrams knew that I was in a relationship with lots of stress and problems. He had his suspicions before he talked to me about them and pulled them together. And thank goodness for that.”

Nevertheless, the initial suggestion that this may indeed be a psychological disorder had been distressing for her to come to term with. Dakin argues, “I went to the neurological ward and one of the professors said ‘how would you feel about going onto the psychiatric ward?” she said. “I got a bit upset, but he said ‘whatever helps you.’ I was there for nine weeks. My sight came back first I started seeing shadows and then I got my vision back. Once I took on board what it was and I got control back, things started getting better quickly, but sometimes I get trouble still swallowing and I gag and still have problems with my leg.”

Subsequently Susan’s partner has since been jailed and she still can’t believe that the physical symptoms she has displayed are a direct result of a psychological condition. Dakin states, “It is unbelievable isn’t it. I had not heard of the illness. Yet they showed me one woman in the hospital with the condition who was paralysed from the neck down.”

Onwards and upwards now for Susan as she is receiving a year of cognitive behavioural therapy and psychotherapy. She is still taking her anti-depressants, but is very clear that her condition has improved overall.

Dr Christopher Bass, of the department of psychological medicine at the John Radcliffe Hospital, Oxford, said Susan’s case is far from unique. He said as many as one third of neurological out patients have symptoms that are not fully explained by disease.

“The incidence of what we call ‘functional’ paralysis, or what used to be called hysteria or ‘conversion syndrome’, is surprisingly common, and is probably similar to that of multiple sclerosis (around five in 100,000),” he said.

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