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Non-Epileptic Attack Disorder (NEAD)

Non-Epileptic Attack Disorder (NEAD)

The Non-Epileptic Attack Disorder (NEAD) service is here to help people who have been given this diagnosis.

We provide a range of support to help you understand and manage this condition.

What we offer:

  • NEAD Intervention Course (remote): Learn more about NEAD, including understanding warning signs, lifestyle factors that can affect it, and techniques to help manage your episodes. You will also be supported to create a personal management plan. For more information, please click here. 
     
  • NEAD Intervention Group: Learn all about NEAD and techniques to help manage your episodes, whilst meeting others with similar experiences and learning from each For more information, please click here.
     
  • Individual Therapy: Talk with a therapist in detail about factors in your life which may be connected to your experience of NEAD, and learn new ways of coping to help manage the episodes.
     
  • Working with Healthcare Professionals: Receive training and consultation on NEAD.

Non-Epileptic Attacks (NEAs) are temporary experiences where people lose control of their body, senses or awareness.

NEAs are the body’s natural way of protecting itself from overwhelming pressure. They do not cause any internal damage.

These episodes may happen due to a variety of factors, including physical or emotional stress, trauma, and lifestyle choices.

NEAs may look like epileptic seizures, but the causes are very different.

NEAs are a nervous system response to physical and emotional pressure, rather than abnormal brain activity like in epilepsy.

Common symptoms NEAs:

  • Shaking
     
  • Falling or losing control of limbs
     
  • Numbness
     
  • Losing awareness or experiencing “brain fog”
     
  • Changes to vision or hearing

For more information, please watch the video below: 

Recommend Treatment:

  • It can be helpful to talk to a specialist clinician about the common factors that can lead to NEAD.
     
  • Patients will be encouraged to talk about personal factors that may have led to NEAD developing for them.
     
  • Patients will be encouraged to consider how their routines and relationships can influence.

The body has its own alarm system that helps us respond to signs of threat.

The body spots these signs both inside and outside our body and activates the alarm. This alarm helps us respond to any threats that the body has spotted.

For example, it can give us a burst of energy to help us run away from danger.

Our thoughts and emotions can also activate the alarm and influence how long the alarm sounds for.

We can think of the alarm system in our body as a set of traffic lights with three zones - red, amber and green.

There is nothing wrong with being in any of these zones.

However, we can experience difficulties when we get stuck in a zone or the alarm is sounding when there isn’t a threat.

Additionally, we provide strategies that can help reduce the alarm from sounding and allow you to get into or closer to the green zone with time.
 

Green Zone

In short, when we are in the green zone, we are better able to rest and digest food. When we are in this zone our body and mind is more relaxed.

Our mind is in the moment, and it is not hooked onto thoughts about our past or future.

When our body and mind feel good, we find talking and socialising easier and more enjoyable.
 

Amber Zone

The amber zone is also known as the ‘fight or flight’ response.

Our body has sounded the alarm and changes to our nervous system begin to happen to help keep us safe. For example, our heart rate increases and our breathing gets quicker.

Our muscle tension also increases, and neurochemicals like adrenaline and cortisol are released into our body.

We also become more aware of possible threats in our surroundings.

How our mind takes in and uses information feels different when we are in this zone.

For example, it can be difficult to direct our focus and we may struggle to solve problems.

Overall, we are more likely to feel strong emotions such as stress, anxiety and anger in this zone.
 

Red Zone

The red zone is also known as the ‘freeze or flop’ response.

This zone is thought of as our body’s ultimate survival mechanism, helping us to save energy. We are likely to feel less motivated, lower in mood or numb.

Our body can feel tired, or even as if it is not our body at all. This is the zone where NEAs happen.

For more examples, please click here.

What Can I do?

  • Noticing: This means noticing which zone you are This will take practice. You may find it helpful to keep a diary (click here for an example). You may also find it useful to complete the "What's Affecting My Traffic Lights" questionnaire. You can find a copy of this here.
     
  • Strategies: Once you are able to identify which zone you are in, you can use strategies such as breathing (click here for more guidance) and grounding (click here for more guidance) to get you closer to the green zone. This will take practice too.
     
  • Managing activity level: Not having enough time to rest and look after ourselves can mean that we stay in the amber. Being inactive can also mean that we stay in the amber zone. It is important to find a balance between doing too much and doing too little.
     
  • Psychological strategies: Working with a psychological therapist to identify and understand the reasons why you spend too much time in the amber or red. You can then learn new ways to manage difficult thoughts, feelings and responses to difficult experiences.

DO maintain a calm and quiet environment DO give the person space

DO speak to them calmly (e.g., remind the person where they are, who you are, that they are safe, and tell them to take their time to come around—there is no rush).

DO tell other people it is not a medical emergency
 

DO NOT call 999 (unless there is a serious injury that needs immediate treatment) DO NOT give the person medication

DO NOT touch them (unless to protect their head) DO NOT crowd or stand over them

DO NOT try to bring them out of it—the episode will pass naturally without any need to intervene
 

Disclaimer: The above guidance is for patients with a sole diagnosis of NEAD. Patients should follow the guidance provided by their neurologist if they have a diagnosis of NEAD and epilepsy.

  1. How common is NEAD? NEAD affects about 20,000 people in the About 1 in 5 people who go to the doctor for seizure-like symptoms are diagnosed with NEAD.
     
  2. Are there other names for NEAD? Yes, NEAD can also be called functional seizures, psychogenic seizures, or dissociative seizures.
     
  3. What’s the difference between NEAD and epilepsy? NEAD and epilepsy can look similar because both affect movement, awareness, and senses. The difference is the cause:
     
    • NEAD happens due to physical and emotional pressure building up
       
    • Epilepsy is caused by unusual electrical activity in the Neurologists and neuropsychiatrists can tell the difference
       
  4. Can someone have both NEAD and epilepsy? Yes, some people with NEAD also have epilepsy.
     
  5. Is there medicine for NEAD? Since NEAD isn’t caused by changes in the brain, medication doesn’t help. Talking therapy is the best way to treat NEAD.
     
  6. I don’t feel stressed—how can this be psychological? NEAD can happen to anyone, especially those who have been through difficult times. You may find it useful to talk to a thera- pist about the factors in your life which may have led to NEAD developing for you.
     
  7. Why do I have episodes when I’m relaxed? It’s common for episodes to happen during relaxing Your body may be releasing pressure it has been holding onto for a long time.
     
  8. What can I do whilst I wait for an appointment? There is a waiting list for our service because of the high number of referrals. We’ll contact you as soon as you reach the top of the In the meantime, we will contact you to offer you a chance to complete our in-person NEAD Intervention Group, or our NEAD Information Online Course. Please see the Leaflets and Resources section for more details.
     
  9. What will happen at my first appointment? Your therapist will ask about your experience of NEAD and the impact it has on you. They may also ask about your health, relationships, work, and what’s important to you.
     
  10. Can someone come with me to appointments? Yes, you are welcome to bring someone along to support you at your assessment.
     
  11. Will I get better? Many people with NEAD live full and happy. Understanding your condition and practicing management strategies can reduce episodes, and some people stop having them entirely. Even if episodes continue, knowing how to manage them helps you to stay in control.
     
  12. Can I drive if I have NEAD? Please visit the Driver and Vehicle Licensing Agency (DVLA) website for driving rules here.
     
  13. Can I keep working with NEAD? Yes, we encourage you to stay active in all parts of your life, including work. You might need extra support or changes to your role to stay safe and comfortable. Telling your coworkers about NEAD and how they can help during an episode can be useful.

To access the NEAD service you must:

  • Have a confirmed NEAD diagnosis made by a neurologist or neuropsychiatrist
     
  • Agree with the diagnosis
     
  • Live in Greater Manchester or be referred by an MCCN Neurologist/Neuropsychiatrist
     
  • Be aged 16 or above

A healthcare professional can make a referral on your behalf if the above criteria are met. If your referral is accepted, you will be added to our waiting list.

For professionals: Please click here for a referral form.

Useful Links:

Watch our short video:

This leaflet is also available in other languages and formats on request.

Resources