Functional Neurological Disorder: Why Can FND Affect Speech and Swallowing?
Have you been told that you have Functional Neurological Disorder (FND) and noticed changes in your speech or swallowing?
Perhaps your speech suddenly sounds different.
You may slur your words or struggle to get them out. Your voice may not sound like it used to.
Eating and drinking may also feel difficult. You might cough, worry about choking or feel that your mouth and swallow are not working properly.
These symptoms can be frightening.
They can be even harder when you feel that other people do not understand or believe what you are experiencing.
If this sounds familiar, it is important to know that your communication and swallowing difficulties deserve to be listened to and properly assessed.
What is Functional Neurological Disorder?
Functional Neurological Disorder affects how the brain and body work together.
FND can affect people in different ways. For some people, this includes changes to speech, voice or swallowing.
The symptoms can have a real effect on everyday life.
You may find yourself worrying about having a conversation, eating with other people or going somewhere where you will need to speak.
You might simply want to understand:
“Why is this happening to me?”
That is an important question.
Getting clear information about your difficulties can be an important part of feeling more confident about what happens next.
What can speech problems with FND feel like?
Speech and voice changes are not the same for everyone.
You may notice that:
Your speech sounds slurred.
Words become difficult to say.
Your voice sounds different.
Speaking feels less automatic than it used to.
You struggle to speak clearly at certain times.
People have difficulty understanding you.
Your speech changes when you are tired or under pressure.
These difficulties can be embarrassing.
You may worry about what other people think when your speech changes.
You might avoid talking in groups or meeting friends because you do not want to explain what is happening.
This can make your world feel smaller.
Can FND affect swallowing too?
Some people with FND can also experience difficulties with eating and drinking.
You may feel that your mouth or swallow does not work as it normally would. You may find certain foods difficult or become worried about coughing or choking.
This can make mealtimes stressful.
You might start avoiding foods you used to enjoy or feel nervous about eating away from home.
For families, this can be worrying too.
If you are experiencing changes in swallowing, it is important to seek professional advice rather than trying to manage the problem by yourself.
A Speech and Language Therapist can assess your swallowing and help you understand what may be happening.
“What if nobody believes me?”
This can be one of the hardest parts of living with FND.
People with FND may worry that their symptoms are not being taken seriously or that someone thinks they are “faking” their difficulties. This fear came through strongly in the clinic's own client research.
That experience can leave you feeling frustrated and alone.
You may have already spent a long time trying to understand why you cannot speak, eat or drink as easily as before.
Being listened to matters.
Speech and language therapy provides an opportunity to look carefully at the difficulties you are having and how they affect your everyday life.
How can speech and language therapy help with FND?
The first step is understanding your individual difficulties.
A Speech and Language Therapist can look at how you are communicating and, where appropriate, assess concerns about swallowing.
Support is personalised because FND does not affect everyone in exactly the same way.
Depending on your difficulties, therapy may focus on:
Understanding what is happening with your speech or voice.
Finding ways to make speaking easier.
Building confidence in everyday conversations.
Finding strategies for situations you find difficult.
Assessing swallowing concerns.
Helping you feel safer and more confident around eating and drinking.
Supporting your family to understand your communication needs.
The aim is to help you find practical ways forward based on what matters to you.
That might mean talking more easily with your family.
It might mean feeling confident enough to meet friends again.
Or it could mean enjoying a meal without spending the whole time worrying about your speech or swallowing.
What can families do to help?
FND can be confusing for family members too.
They may not understand why speech seems easier at one time and more difficult at another.
Try to focus on supporting the person rather than questioning the difficulty.
Give them time to speak. Avoid finishing sentences unless they want help. Reduce distractions and listen to what they are trying to communicate.
Most importantly, ask:
“What makes this easier for you?”
A Speech and Language Therapist can also help family members understand what is happening and find useful ways to support communication.
You do not have to manage these changes alone
If your speech or swallowing has changed, it can affect far more than the physical act of talking or eating.
It can affect your confidence, independence, work, relationships and social life.
You may be worried that things will get worse. You may simply want to understand what is happening and find a way to feel more like yourself again. These are key concerns expressed by people with FND and their families.
Helen McLean has over 15 years of experience working with adults with communication and swallowing difficulties. She provides personalised support based on the individual, their symptoms and the things they want to get back to doing.
If FND is affecting your speech, voice or swallowing, get in touch to discuss your concerns and find out whether speech and language therapy could help.
