Can You Fake FND? Understanding Functional Neurological Disorder, Misdiagnosis, and Real Healing
Can You Fake Functional Neurological Disorder (FND)?
If you or someone you love has been diagnosed with Functional Neurological Disorder (FND), you may have heard difficult questions like:
“Is this all in their head?”
“Are they doing this on purpose?”
“Can someone fake FND symptoms?”
“Are these seizures real?”
“Could they stop if they wanted to?”
These questions are common—but they are often rooted in misunderstanding.
The short answer is:
No—people with Functional Neurological Disorder are not “faking it.”
Their symptoms are real, distressing, involuntary, and often life-disrupting [1,2].
At Ezer Psychotherapy, we specialize in helping children, adolescents, young adults, and families navigate the emotional, psychological, and nervous-system factors involved in Functional Neurological Disorder, helping clients move toward meaningful recovery.
What Is Functional Neurological Disorder (FND)?
Functional Neurological Disorder (FND) is a condition in which the brain has difficulty sending and receiving signals properly, causing genuine neurological symptoms without structural damage to the nervous system [1,3].
Symptoms can include:
✅ Non-epileptic seizures / dissociative seizures
✅ Tremors or shaking
✅ Difficulty walking
✅ Limb weakness or paralysis
✅ Speech difficulties
✅ Tics or abnormal movements
✅ Dizziness or fainting episodes
✅ Vision disturbances
✅ Brain fog
✅ Chronic fatigue
✅ Numbness or sensory changes
✅ Episodes of dissociation or “shutting down”
These symptoms are not imagined and not consciously produced [1,2].
A helpful analogy:
The brain’s “software” is malfunctioning—not the “hardware.”
Brain scans may look normal, but nervous system functioning is disrupted [3,4].
Can Someone Fake FND?
Technically, a person can intentionally imitate almost any medical symptom, but that is not FND [2,5].
There is an important difference between:
1) Functional Neurological Disorder (Real, Involuntary Symptoms)
With FND:
symptoms happen automatically
the nervous system becomes dysregulated
the body enters survival mode
movement, sensation, speech, or awareness may become disrupted
episodes can feel frightening and uncontrollable
The person is not choosing symptoms [1,2].
2. Malingering: Intentional Faking for External Gain
Malingering means consciously pretending to be sick for a reason such as:
Avoiding work
Financial compensation
Legal benefit
Obtaining medication
Escaping responsibility
This is uncommon in FND-related clinical care, and it is not the same as FND [2,5].
3. Factitious Disorder: Psychological Need to Appear Ill
In factitious disorder, a person intentionally creates or exaggerates symptoms because of a psychological need to be seen as sick or cared for [5].
Again:
This is different from Functional Neurological Disorder [2,5].
Why People Mistakenly Think FND Is Fake
FND can be misunderstood because symptoms often:
1. Come and Go
Someone may be unable to walk one day and function better the next.
This fluctuation is common in FND and reflects changes in nervous system functioning, not pretending [1,3].
2. Worsen Under Stress
Stress, overwhelm, sensory overload, trauma reminders, conflict, illness, fatigue, or pressure can intensify symptoms [3,6].
That does not make symptoms voluntary.
3. Improve With Distraction or Safety
Sometimes symptoms lessen when the nervous system feels safer or when attention shifts away from the symptom.
This can be a positive clinical feature of FND—not evidence of faking [1,7].
4. Look Different Than Traditional Neurological Disease
Because MRIs or EEGs may appear normal, people may incorrectly assume “nothing is wrong.”
But FND is diagnosed by positive neurological signs, not simply by ruling everything else out [1,7].
Is FND Psychological?
This question deserves nuance.
FND is best understood as a brain-body-nervous-system disorder involving interactions between neurology, psychology, stress physiology, learning, attention, and body awareness [3,4].
Factors that may contribute include:
trauma or chronic stress (sometimes—but not always)
dissociation
perfectionism / high achievement pressure
anxiety
burnout
medical trauma
chronic illness burden
sensory overwhelm
nervous system sensitization
For many people—especially high-performing adolescents, athletes, performers, and medically complex clients—the nervous system becomes overloaded.
Eventually:
The body begins expressing distress neurologically.
Importantly, psychological stress or trauma is not required for an FND diagnosis [1,3].
Treatment for FND: Recovery Is Possible
The brain can change.
With proper treatment, many people improve significantly, especially when diagnosis is clear, treatment begins early, and care is coordinated [8,9].
Evidence-based treatment often includes:
Nervous System Regulation
Learning how to move from survival mode into safety.
Trauma-Informed Therapy
Addressing unresolved trauma, grief, medical trauma, or chronic stress when these factors are part of the person’s story.
Somatic Work
Helping reconnect mind and body safely.
Cognitive and Behavioral Skills
Reducing fear loops around symptoms and rebuilding a sense of control.
Family Education
Helping loved ones respond in ways that support healing.
Identity Restoration
Helping clients reconnect with school, sports, relationships, purpose, and joy.
Recovery is not about proving symptoms are “real.” They already are. Recovery is about helping the brain and body relearn safety, movement, regulation, and confidence [8,9].
Specialized Therapy for Functional Neurological Disorder at Ezer Psychotherapy
At Ezer Psychotherapy, we understand that FND is real, complex, and deeply disruptive—not just for the person experiencing symptoms, but for the whole family.
We provide virtual outpatient psychotherapy for clients in Minnesota, Wisconsin, North Dakota, and Florida, specializing in:
✔ Functional Neurological Disorder (Conversion Disorder)
✔ Anxiety disorders
✔ Trauma & nervous system dysregulation
✔ Eating disorders
✔ Chronic and acute medical conditions
✔ Performing artists & athletes
✔ Parenting support for complex mental health needs
✔ Christian counseling upon request
Our approach is:
Compassionate. Evidence-based. Collaborative. Nervous-system informed.
We help clients understand why symptoms are happening—and build the tools needed for healing.
You Are Not Making It Up—And Help Is Available
If you are struggling with Functional Neurological Disorder, or if your child has symptoms that others do not understand:
You deserve answers, support, and specialized care.
Healing begins when symptoms are understood—not dismissed.
Ezer Psychotherapy is here to help.
Schedule a consultation today and begin moving toward recovery.
References
Stone J, Burton C, Carson A. Recognising and explaining functional neurological disorder. BMJ. 2020;371.
Edwards MJ, et al. Why functional neurological disorder is not feigning or malingering. Nature Reviews Neurology. 2023.
Hallett M, Aybek S, Dworetzky BA, McWhirter L, Staab JP, Stone J. Functional neurological disorder: new subtypes and shared mechanisms. The Lancet Neurology. 2022;21(6):537-550.
Espay AJ, Aybek S, Carson A, et al. Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurology. 2018;75(9):1132-1141.
Mason X. Challenges to the diagnosis of Functional Neurological Disorder: feigning, intentionality, and responsibility. Neuroethics. 2022.
Paredes-Echeverri S, et al. Autonomic, endocrine, and inflammation profiles in Functional Neurological Disorder: a systematic review and meta-analysis. Journal of Neuropsychiatry and Clinical Neurosciences. 2021.
Patwal R, et al. Diagnostic accuracy of clinical signs and investigations for functional weakness, sensory and movement disorders: a systematic review. Journal of Psychosomatic Research. 2023.
Kozlowska K, Chudleigh C, Savage B, Hawkes C, Scher S, Nunn KP. Evidence-based mind-body interventions for children and adolescents with Functional Neurological Disorder. Harvard Review of Psychiatry. 2023;31(2):60-82.
Kim YN, Gray N, Jones A, Scher S, Kozlowska K. The role of physiotherapy in the management of Functional Neurological Disorder in children and adolescents. Seminars in Pediatric Neurology. 2022;41:100947.
Gaskell CJ, et al. A meta-analytic review of the effectiveness of psychological treatment of functional/dissociative seizures on non-seizure outcomes in adults. Epilepsia. 2023.
Laptook R. The importance of language and messaging in psychological treatment for Functional Neurological Disorder in children and adolescents. Rhode Island Medical Journal. 2024.
Watson C, et al. Telehealth provision of Retraining and Control Therapy on cognitive and biopsychosocial functioning in pediatric Functional Neurological Disorder. Journal of Psychosomatic Research. 2025.
