Functional Neurological Disorder (FND) Explained: What It Is and How It Overlaps With Dizziness

Functional Neurological Disorder (FND) is often misunderstood... but it’s real, common, AND treatable. In this episode of Talk Dizzy To Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Carly Lochala, PT, NCS sit down with Dr. Julie Hershberg, PT, NCS to explain what FND is, why it’s been minimized in healthcare, and how it overlaps with dizziness, migraine, dysautonomia/POTS, hypermobility/EDS, and vestibular disorders.They break down brain networks like the default mode network and salience network, discuss common clinical clues (variability, attention-related shifts), and explain how treatment often starts with nervous system regulation, trust-building, and whole-person care—not just exercises.If you’ve been told your symptoms are “all in your head,” this episode is for you.Guest: Dr. Julie Hershberg / Reactive PT Instagram: @reactiveptResources: FND resources hub, reactivept.com/FNDresourcesHosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Carly Lochala, PT, NCS For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Connect with Us:→ ⁠⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠Get free resources straight to your inbox⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠Join The Dizzy Reset™ for FREE⁠→ ⁠⁠⁠⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠Follow us on Instagram⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠Follow us on TikTok⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠Follow us on Facebook⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠Disclaimer⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠Enjoying the podcast? Leave us a review!⁠⁠This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. The views expressed by guests are their own and do not necessarily reflect those of the host(s).Timestamps 00:00 Welcome to Talk Dizzy To Me (intro)01:42 What is Functional Neurological Disorder (FND)? How to explain it to patients02:08 FND as a brain network dysfunction (function vs structure)03:32 Why education improves outcomes in vestibular care + FND04:02 Why FND has been misunderstood/minimized in healthcare04:12 From “hysteria” and “conversion disorder” to modern neuroscience06:05 Harmful stigma: being told symptoms are “fake” + medical trauma08:19 What to look for when you suspect FND (clinical clues)09:13 Variability, attention-related shifts, symptoms “moving”10:35 Screening for other diagnoses + doing a thorough neuro screen11:04 Common comorbidities missed: migraine, EDS/hypermobility, POTS/dysautonomia, vestibular disorders12:53 What you’ll hear in the subjective history that suggests FND15:13 Why “one test” (like Hoover) isn’t enough + signs vary by symptom type16:54 Diagnostic criteria: what exists, what’s lacking, what needs improvement19:12 Risk factors & triggers: sex differences, pain, sleep, physical injury/illness21:01 Dizziness in FND: how common is it + vestibular system connection21:59 Autonomic + sensory overlap (vestibular sympathetic reflex, otolith sensitivity)24:44 Treatment approach: why there’s no one-size-fits-all protocol25:38 Whole-person assessment + “pie chart” contributors + education foundation29:00 Building trust, validation, and safety (especially after medical trauma)31:18 Why play, fun, and salience matter for nervous system regulation + motor learning32:45 Default mode network vs salience network explained simply37:48 Social media + FND: what we think vs what research shows41:26 Adapting vestibular rehab when FND is part of the picture44:26 Safety + motor symptoms: when you prioritize regulation over exercise48:18 Sensory inventory & building a regulation toolkit (OT-informed strategies)51:00 Not everyone needs “calm”—some people need safe movement to regulate52:18 “Mic drop” messages for people who feel stuck55:21 Where to find Dr. Julie Hirschberg’s FND resources