What Is Aphonia?
Aphonia is a speech disorder in which you can still speak, but the sounds you make don't rise above a whisper, or they are not heard at all. It usually comes on suddenly, and people who develop this condition try to talk but can't be heard by others. Aphonia is considered a functional speech disorder, meaning it is rooted in a neurological (brain) or psychological (mental) cause instead of a physical impairment.
This article will explore some causes of aphonia, discuss how it is diagnosed, and discuss what you can do to overcome this condition.
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Types of Aphonia
Types of aphonia include functional aphonia and psychogenic aphonia, though both are thought to derive from the same underlying causes.
Functional aphonia occurs when an individual experiences challenges using their larynx (voice box) and diaphragm (the muscle responsible for breathing) to produce speech without identifiable physical or neurological problems.
Psychogenic aphonia occurs when a person loses their voice in response to a psychologically stressful or traumatic event.
What Causes Aphonia?
Some cases of aphonia have developed after an upper respiratory tract infection or repeated laryngitis, but these infections may be incidental rather than causative. Most of the time, it is a stressful or traumatic life event that triggers aphonia.
This condition is considered rare, affecting 0.4% of people between the ages of 14 and 35. Studies show that people assigned female at birth are about 8 times more likely than people assigned male at birth to develop aphonia.
Some possible causes noted in documented cases of aphonia include:
Fear
Problems in personal relationships
How Is Aphonia Diagnosed?
A healthcare provider will perform a physical examination and review your personal and family medical history as the first step in diagnosing aphonia. They will need to rule out any infections or structural problems that could cause you to lose your voice.
However, a diagnosis of aphonia is notoriously difficult to make, mainly because it is not usually linked to any physical problem, like vocal cord dysfunction. Aphonia is considered a conversion disorder, a condition without an obvious organic, physical, or neurologic cause exists. One study suggested that it can take between nine and 32 weeks to get an accurate diagnosis of aphonia, and several misdiagnoses usually come before it.
Other symptoms that can appear with conversion disorders like aphonia include:
Blindness
Paralysis
Hallucinations
Swallowing problems
The American Psychiatric Association has outlined specific criteria for diagnosing conversion disorders in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
These include:
At least one symptom is of altered motor or sensory function.
There's no link between the symptoms and other neurological or medical conditions.
Another medical or mental disorder is not causing the symptoms.
The symptom causes significant distress or functional impairment.
Treatments for Aphonia
Aphonia is typically treated using a combination of psychotherapy and speech therapy. A healthcare provider will pay special attention to underlying conditions, stressors, or events that may have contributed to the condition and what may be done to treat those issues individually.
Dysphonia and aphonia may be confused since both produce similar symptoms. Both conditions can lead to a loss of voice, but the underlying causes and treatments differ. Dysphonia can be caused by conditions that include the following:
Muscle tone problems
Voice misuse or overuse
As for aphonia, treatment for dysphonia may include speech therapy, but it usually also involves some form of medical treatment for whatever physical or structural problem has contributed to the dysphonia.
Learn More:Vocal Cord Dysfunction
Prognosis for Aphonia
While aphonia can be challenging to diagnose, treatment is usually successful. Once you've identified the problem, speech therapy, and psychotherapy are very effective in helping people with aphonia overcome their condition.
Most people who develop aphonia are completely cured with therapy. In one study, all patients treated with speech therapy alone fully recovered. Another study revealed that people with aphonia could regain the use of their voice on the first day of treatment.
However, delayed or missed diagnoses can lead to a fixation on aphonia, making the condition more difficult to treat.
Summary
You can lose your voice for various reasons, but aphonia is a disorder that usually develops from stressful events. Getting a diagnosis of aphonia can be difficult, since it's rare and has no underlying medical explanation. However, once diagnosed with aphonia, your treatments are usually curative.
