NEAD Non Epileptic Attack Disorder, Edinburgh

NEAD is a condition where dissociation is severe and results in apparent loss of consciousness. This looks identical to an epileptic seizure and therefore historically there is common misdiagnosis.

What is NEAD?

NEAD is a condition where recall of suppressed trauma is so painful that the mind of the sufferer chooses to black out rather than consider the scary consequences of the memory. This is unconscious and not deliberate, the sufferer does not “choose” to do this, they are a victim of the trauma. Victims may present with a wide range of seizures and it is not uncommon for diagnosis to only occur when a “fit” happens when on an ECG machine. At this point the difference in brain wave patterns isolates which condition is present.

Non-epileptic attack disorder (NEAD) is a condition characterized by seizures or episodes that resemble epileptic seizures but are not caused by abnormal electrical activity in the brain. Instead, NEAD is believed to be primarily related to psychological factors, such as trauma, stress, or emotional distress. There are cases however where a link to migraine or abnormal white mass areas in the brain are involved, and therefore although most NEAD is trauma related, sometimes there may be some physical cause. This is often downplayed since the stigma around mental health and trauma often encourages patients to pounce on the possibility of a physical cause in the false belief this is somehow better or less “shameful”. 

Key Features:

• Seizure-like episodes: Individuals with NEAD experience episodes that may involve a range of physical symptoms, such as:
  • Loss of awareness
  • Convulsions or jerking movements
  • Stiffening of the body
  • Changes in breathing 
  • Loss of bladder or bowel control
• No abnormal brain activity: Unlike epileptic seizures, NEAD episodes are not associated with the abnormal electrical discharges in the brain that are seen in epilepsy.

  Psychological basis: NEAD is often linked to underlying psychological factors, such as:

• • Trauma or abuse 
  • Stressful life events
  • Mental health conditions like anxiety or depression
  • Dissociation

Causes:

The exact causes of NEAD are not fully understood, but it is thought to be a complex interplay of psychological and neurological factors. Some potential contributing factors include:

• Trauma: Past trauma or abuse can increase the risk of developing NEAD.
• Stress: High levels of stress or emotional distress can trigger NEAD episodes.
• Mental health conditions: NEAD is often associated with other mental health conditions, such as anxiety disorders, depression, and post-traumatic stress disorder (PTSD). 
• Dissociation: Dissociation, a disconnection from oneself or reality, can be a factor in NEAD.
• Physical: Although the majority of NEAD appears to be caused by trauma related factors, sometimes physiological causes can be present. White mass areas on the brain associated with migraines and migraines themselves can be the cause, and this is often overlooked. There also appear to be links with hormone levels including during the menstrual cycle.  Whether this is a cause or a correlation with trauma outcomes is more difficult to know. 

Diagnosis:

Diagnosing NEAD can be challenging because the episodes can look very similar to epileptic seizures. A thorough evaluation typically involves:

• Medical history: Gathering information about the individual’s symptoms, medical history, and any history of trauma or stress.
• Physical examination: To rule out other medical conditions that could be causing the episodes.
• Electroencephalogram (EEG): To monitor brain activity and rule out epilepsy.
• Video-EEG monitoring: Recording the episodes on video while simultaneously monitoring brain activity with an EEG. This is often the most definitive way to diagnose NEAD. 
• Psychological evaluation: To assess for underlying psychological factors that may be contributing to the episodes. 
• MRI scans can be vital in identifying physical cause NEAD since it is often overlooked and psychological causes assumed

Treatment:

Treatment for NEAD typically focuses on addressing the underlying psychological factors that are contributing to the episodes. This may involve:

• Psychotherapy: Cognitive behavioral therapy (CBT), trauma-informed therapy, or other forms of therapy can help individuals process trauma, manage stress, and develop coping skills. 
• Medication: Medications may be used to address co-occurring mental health conditions, such as anxiety or depression.
• Stress management techniques: Relaxation techniques, mindfulness practices, and other stress management strategies can help reduce the frequency and severity of episodes. 
• Lifestyle changes: Getting adequate sleep, eating a healthy diet, and exercising regularly can also be helpful.

Important Considerations:

• NEAD is a real condition: Even though the seizures are not caused by abnormal brain activity, NEAD is a genuine medical condition that can significantly impact an individual’s life.
• Not “faking it”: Individuals with NEAD are not consciously faking their episodes. The episodes are involuntary and often very distressing. 
• Stigma: There can be stigma associated with NEAD, which can make it difficult for individuals to seek help. 
• Positive outcomes: With appropriate treatment and support, many people with NEAD can significantly reduce the frequency and severity of their episodes and improve their quality of life.

If you or someone you know is experiencing seizure-like episodes, it is essential to seek medical attention to determine the cause and receive appropriate treatment

Is NEAD fake?

Absolutely not. The dis-association present in a NEAD seizure is very severe and acute. It is a result of the unconscious basically saying ” I can not do this –  lights off”. It is not voluntary and the subject has no control or choice over the result, at least in the short term. NEAD is often caused by severe trauma, such as sexual abuse, rape and other psychological abuses.

Can NEAD be helped

The NHS suggests CBT, which is pretty much the standard NICE recommended psychological therapy.  It can help, but NEAD is usually caused by severe trauma, often sexual or mental abuse, and therefore a more comprehensive and holistic approach tailored to the needs of the individual may be preferred.

NEAD is a very personal condition, it causes a range of resultant symptomatic conditions including PTSD, Personality Disorders, Anxiety Disorders, Eating Disorders, OCD’s and self harm.

Therapy for NEAD

Moving on from NEAD is very personal, it requires a flexible and comprehensive therapy approach including treating the post traumatic elements, and unlearning the negative formative patterns. Psychoanalysis, CBT and counselling combined would be a sensible approach. No two cases are the same, since the trauma is unique.

Polyvagal theory has provided greater insight into treating disassociative disorders.

NEAD in Edinburgh

Stuart is experienced in treating NEAD in a range of situations, NEAD is an anxiety related disorder and Stuart trained in this speciality from the start of his career. Stuart is a Level I and Level II  Certified Trauma Specialist including Complex and Dissociative Disorders. He is also a Certified Specialist in the use of Hypnosis, Neurology and Mind-Mody work in Trauma Treatment.

Contact via the contact us page HERE