It seems like there are doctors out there who call symptoms "psychogenic" with no other evidence than that they can't find any other diagnosis. That's bad medicine for all sorts of reasons. There are some objective diagnostic criteria for psychogenic movement disorders. One reason I was able to listen to my doctor when he suggested my shaking was psychogenic was that he explained some of these criteria to me and they made sense.

Part of the stigma attached to the "psychogenic" diagnosis comes from the idea that psychogenic disorders are always a response to emotional trauma (conversion disorder). So if you have psychogenic symptoms, you must be really "messed up" emotionally--you're a wreck. Well, I don't feel like an emotional wreck. Emotionally, my life is in decent order. I'm not a hysterical person. But my theory (speculation) is that scary and unpredictable neurological symptoms can also trigger additional psychogenic symptoms. My shaking (I'm guessing) wasn't a reaction to an emotional trauma; it was a reaction to my experience of MG symptoms.

This phenomenon is called "psychogenic overlay": the patient has a mixture of symptoms. Some are directly caused by the neurological disorder, and some are a physiological response to the patient's perception of the first symptoms. That's my best guess about what happened to me. Thanks to a friend I met on this forum who helped me figure all this out.

Abby