Breaking Down FND: Understanding the Hidden Link Between Stress, Brain Injury, and Recovery

By: Kiley Como with Shane Smith Law

At Shane Smith Law, we see the unseen impacts of head injuries every day—especially the kind that don’t show up on a scan. On this episode of Mind Matters, our host and Legal Nurse Consultant Kiley Como is joined once again by Dr. Mackenzie Lerario, a board-certified neurologist, psychotherapist, published author, and passionate advocate for patients dealing with Functional Neurological Disorder (FND).

Together, they dive deep into how trauma, stress, and even societal stigma can contribute to neurological symptoms—and how treatment and recovery are not only possible but often dramatic.

What Is Functional Neurological Disorder (FND)?

FND is a condition where patients experience neurological symptoms (such as seizures, weakness, or movement problems) without structural damage to the brain. It’s a “misfiring” between the brain and body—and it’s more common than most people realize.

Dr. Lerario shared, “Even in a short amount of treatment—several months—we could see very drastic recoveries. Someone who couldn’t walk can walk again. Someone who had seizures could become seizure-free for years.”

The Hidden Role of Stress, Emotion, and Trauma

According to Dr. Lerario, many patients with FND have experienced significant stress or trauma—whether physical, emotional, or psychological. These stressors may not always be obvious, but they deeply impact the brain’s wiring and the body’s function.

Kiley highlighted how this overlaps with what we see in many mild traumatic brain injury (TBI) cases:

“When it’s a so-called mild TBI, there are no clear procedural interventions. And medications often lead to polypharmacy and side effects. That’s where therapies like CBT come in—but stigma often stops people from getting help.”

Effective Treatments: Therapy and More

Dr. Lerario emphasized that psychotherapy, especially Cognitive Behavioral Therapy (CBT), is one of the most evidence-based treatments for FND. It helps patients understand the connection between their thoughts, emotions, and symptoms—giving them tools to interrupt the cycle of fear and physical reactions.

But mental health care isn’t the only path. Physical therapy is another critical part of FND recovery. Through techniques like distraction-based movement retraining, patients can begin to “rewire” how the brain and body communicate.

Breaking Barriers with Telehealth

Access to care is a major barrier—especially for individuals who can’t drive due to seizures or anxiety. Fortunately, telemedicine is helping break that wall down. Dr. Lerario, who is licensed in multiple states, uses virtual visits to meet patients where they are—literally and emotionally.

“There’s a real convenience and comfort in seeing patients in their homes,” she explained, noting that telehealth is a powerful way to reach people who may otherwise avoid or delay care.

Why We Need More Trained Providers

One of the biggest challenges? Lack of awareness and understanding.

FND is underrepresented in medical education, and many neurologists stop at the diagnosis without offering treatment support. But patients need long-term partners—not just a diagnosis.

“There’s still a lot of stigma. People are afraid others will think they’re ‘crazy’ or making up their symptoms,” Dr. Lerario said. “We need more providers who truly understand FND and will advocate for this community.”

Hope Is Real—and Recovery Is Possible

With the right treatment team and tools, FND is treatable. Two-thirds of patients respond positively to therapy, and many go into full remission. While relapses can happen during stressful life events, continued care and understanding make a difference.

Dr. Lerario’s message is one of hope, not helplessness.

Final Thoughts from Kiley

“As a Legal Nurse Consultant, I hear stories every day from clients who feel lost in the system after a brain injury. Episodes like this remind us: there is help, there is treatment, and there is a path forward.”

If you or someone you love is dealing with the effects of a concussion, mild TBI, or a suspected Functional Neurological Disorder, don’t wait. Explore options, ask questions, and seek out qualified professionals who understand.

And as always:
In pain, call Shane! 980-999-9999
Let Shane Smith Law help you navigate the legal and medical maze after a head injury. You don’t have to do it alone.