Why do non-epileptic attacks start?

The reasons why NEAs start are sometimes called ‘precipitating factors’. The reasons for attacks starting can be different for different people.

Many patients report that attacks start ‘out of the blue’ without any significant cause. However, the following list contains examples of things, which can set off NEA.

Negative life events

NEAD can develop after a range of bad experiences. Most people with NEAD have had traumatic life events in the 12 months before their attacks started. These events include experiences like injuries, accidents, being a victim of a crime, rape, meeting a previous abuser, surgical procedures, giving birth and undergoing anaesthetics, death of or separation from family members or friends, job loss, earthquakes, relationship difficulties and legal action.

Stress and dilemmas

NEAD may also develop when people face difficult choices. People sometimes talk of ‘unspeakable dilemmas’ because the hard choices, which can contribute to NEAD, may be difficult to discuss with others. For instance, someone may feel duty-bound to look after a sick and elderly parent although they cannot cope with the many challenges involved in providing this care. Some choices may be so difficult to think about (or admit to) that not even the person facing the choice is fully aware of their dilemma.

Coping strategies

Everybody uses a range of coping strategies to deal with the difficulties life throws at them. Different strategies are most effective for different situations. Some research suggests that a tendency to ‘avoidant coping’ (side-stepping or ignoring problems) or pretending that problems don't exist can increase stress and cause problems to get bigger over time. An issue which may have been resolved at an early point by talking about it or by asking someone to help may get so big that it causes the kind of stress which can start NEAs.

Psychiatric conditions

Sometimes NEAD develops as a symptom of conditions such as depression, anxiety, PTSD or bipolar disorder.

Physical factors

NEAD can develop when people are having to deal with medical conditions such as epilepsy, surgical procedures, asthma, fainting (syncope) or heart disease. Up to two thirds of people with NEAD have previously experienced a head injury.