Functional Speech Disorders
Speech and swallowing symptoms in FND are characterized by a sudden or fluctuating loss of normal control over the muscles used for communication. Like other FND symptoms, these are "software" issues; the vocal cords and swallowing muscles are structurally healthy.
Functional Aphonia
A complete loss of voice where the patient can only whisper. This often comes on suddenly, sometimes after a period of laryngitis or a stressful event.
Functional Stuttering
A hesitant or block-style speech pattern that differs from childhood stuttering. It often fluctuates significantly and may improve with singing or whispering.
Dysphagia (Swallowing)
The feeling of a "lump" in the throat or difficulty coordinating a swallow. This is often triggered by the conscious effort of trying to swallow perfectly.
The Automatic vs Conscious Paradox
In healthy individuals, speech and swallowing are mostly automatic. In FND, the brain attempts to consciously control these automatic programs, which paradoxically causes them to fail. This is similar to how "over-thinking" your golf swing can make you miss the ball.
Speech Therapy Focus
The 'Globus' Sensation
A very common symptom is the 'Globus' sensation—feeling like there is something stuck in your throat when there isn't. This is often caused by tension in the throat muscles related to the brain's "alert" state in FND.