Functional Symptoms: Myths and Common Mistakes

Functional (conversion) symptoms are among the most misread presentations in psychiatry. They get mistaken for laziness, pretending, or a simple lack of willpower. Dr. Saulitis identifies several persistent misconceptions that prevent people from getting timely help.

"He just doesn't want to" — the most damaging myth

When a person freezes — unable to start an action, switch tasks, or complete something simple — those around them often interpret it as stubbornness or indifference. In reality, the brain is genuinely unable to organise the required sequence at that moment. Dr. Saulitis describes patients who spent hours moving objects back and forth, powerless to stop — and who were criticised instead of supported.

"People on the outside will say: he's just lazy or something — but he simply cannot."

This is especially critical with negative symptoms: after severe neurodegenerative conditions, psychosis, or brain injury, the brain has physically lost part of its capacity. Blame in these situations is not merely unhelpful — it causes harm.

The "it's all in the head" error — and its mirror opposite

Another extreme is treating functional symptoms as purely psychological, unrelated to biology. Dr. Saulitis is clear: in the majority of cases, a neurotransmitter imbalance lies at the core.

"Usually 80 percent of what we call symptoms is caused by a neurotransmitter imbalance — the brain simply freezes and the person cannot do anything."

Ignoring the biological dimension means people can spend years working on themselves psychologically while the underlying cause goes unaddressed.

The mistake of self-management and delay

People frequently postpone seeing a specialist, trying to cope on their own or waiting for things to resolve. Dr. Saulitis stresses that functional symptoms require an in-person consultation with a psychiatrist the patient trusts — only a specialist can evaluate which specific treatment approach is appropriate.

"Seek out a psychiatrist you trust — and they will competently prescribe the treatment you need."

Delay not only prolongs suffering; it makes subsequent treatment more difficult.