Page last updated at 10:44 GMT, Monday, 11 May 2009 11:44 UK

'I was disabled by my mind'

By Jane Elliott
Health reporter, BBC News

Susan Dakin
It took years for Susan to get a formal diagnosis

Susan Dakin was convinced she was dying.

Over the space of a decade, the 49-year-old had lost her sight and mobility.

She was confined to a wheelchair, her bladder had packed in and she had difficulty swallowing.

Neurological problems such as multiple sclerosis and the movement disorder dystonia were suspected, but nothing ever pinpointed.

"At one point they only gave me a few months to live," said Susan, from Coventry.

Seeing the whole picture

"I could not eat and lost lots of weight. I thought I was dying and so did my family."

Yet despite the seriousness of her condition she had never had a formal diagnosis and was seeing different specialists for her separate problems.

They showed me one woman in the hospital with the condition who was paralysed from the neck down
Susan Dakin

It was not until she started seeing a new GP, Dr Grant Ingrams, several years ago the cause of her problems was identified.

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.

"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."

Getting help

She was then 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.

Susan, who features 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.

"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," she said.

CONVERSION SYNDROME

Conversion syndrome, also known as conversion hysteria, was first documented by the ancient Greeks and Egyptians

Conversion symptoms are presumed to result from an unconscious process

Various parts of the body can be affected. In Susan's case, she lost the use of her bladder, sight and the ability to swallow or walk properly

"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."

But she said initially the suggestion of a psychological cause had upset her.

"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."

Recovering well

But Susan, whose abusive partner has been jailed, said she still can not quite believe that her physical symptoms were caused by her psychological condition.

Art work showing the puzzle of the brain: Pic caption:Pic credit: Pasieka/SPL
Susan's symptoms were thought to be neurological

"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."

Susan had a year of psychotherapy and cognitive behavioural therapy and still takes antidepressants, but feels her condition is much better.

Although she does still have problems when she is anxious.

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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