University Teaching Trust

Understanding non-epileptic
attack disorder

Clinical Sciences Building

Department of Clinical Neuropsychology
0161 206 4694

© G18121301W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2018.
Document for issue as handout. Unique Identifier: NOE 42 (18). Review date: January 2021.
This leaflet has been What is Non-Epileptic Blackout/
Lose control/
designed in collaboration Attack Disorder? Unresponsive
Some people worry that being More
People with NEAD experience a
with people who experience diagnosed with NEAD means
disruptive “Absences”/
temporary loss of control and/or symptoms No memory or
Non-Epileptic Attack awareness that happens when that doctors think they are awareness of
the link between the mind “pretending” or that it is “all
Disorder (NEAD) to help you actions
and the body is not working in their head”. This is NOT true.
understand the diagnosis of normally for a brief period. NEAD symptoms are real.
NEAD. It explains what NEAD is NEAD is not dangerous
(though the symptoms are
and how it can be managed. understandably worrying until What does a NEAD
Weakness/Difficulty
controlling movement
If you have any questions people are given accurate episode look/feel like? Less
information). disruptive
NEAD episodes are not Loss of feeling
about this leaflet, please symptoms
On rare occasions, episodes can always the same. You may in limbs
ask a member of staff, result in minor injuries (e.g. if experience symptoms that Changes to vision/
you fall) but a NEAD episode affect your movement, senses Changes to hearing/
or email the Clinical is not damaging you internally or awareness. Changes to other senses
Neuropsychology Department and is not a medical emergency. Some examples are shown on
at: reftoneuropsych@[Link] NEAD can affect anyone. It the diagram opposite (though
often happens to people who you may experience other Feeling unreal/
are good at “putting up” with symptoms not in this diagram). Signs Far away/
a NEAD “Spaced out”
difficult or stressful events and
episode
“carrying on” under pressure for may be Anxiety/
a long time. There can be many coming on Rushing
reasons why a person develops feeling
NEAD and these are not always
obvious at first. Recovery from a NEAD episode
is usually faster in a calmer
environment.

1 © G18121301W. Design Services, Salford Royal NHS Foundation Trust,

All Rights Reserved 2018. Document for issue as handout.
2
Unique Identifier: NOE 42 (18). Review date: January 2021.
 The Pressure Cooker Model
Pressure release valve “closed” (things preventing release of stress)
Why does NEAD happen? What makes the Mind- e.g. Always “putting other people first”
e.g. No one to talk to about upsetting events
- The Mind-Body Link Body link cause NEAD? e.g. “Bottling up” feelings
Psychological experiences affect One way of understanding e.g. Too busy to rest properly
the body all the time. NEAD is to imagine a pressure
For example: cooker.
l Sudden shock = heart beats When heat is turned up under a Emotional and
Emotional stress released
faster pressure cooker, steam builds up physical stress
through mind-body link
l Embarrassment = face goes
inside. A pressure cooker needs (e.g. NEAD symptoms) building up in body
red a valve to release excess steam,
but sometimes this valve can be
l Upset = eyes produce tears
blocked. Difficult life events and
It is normal for some changes on-going stresses affect people
to happen to the body without Stressful life events or ongoing difficulties
in the same way as heat affects
a medical cause or disease (e.g. a pressure cooker. Past stressful Current stressful Mental health problems Physical illness
tears when we feel sad are not situatons situatons (e.g. low mood, anxiety) (e.g. pain, fatigue, poor health)
Emotional and physical stress
caused by a disease; it is the
builds up inside people, similar Why do some people develop NEAD and not others?
mind-body link).
to the way that steam builds
These examples are real effects up in a pressure cooker. This NEAD can affect anyone, but l Some people can get into
of the Mind-Body link. They are can be sudden (e.g. unexpected it usually happens to people the habit of “bottling up”
not always within our control bereavement) or gradual (e.g. who are good at “carrying on” feelings and emotions or
and can happen automatically. financial difficulties, living with through difficult experiences “carry on going” in situations
NEAD also happens through the physical health conditions) that affect their lives. that other people might find
Mind-Body link. There can be a number of too difficult
Just like a pressure cooker needs
a valve to release steam, we all reasons why a person’s pressure l Some people may believe
need to have ways of releasing cooker fills up and the stress is they shouldn’t burden people
pressure/ stress. not released: by talking about difficult life
If we are not able to do things l Some people may not notice events
that will help us to release the build-up of pressure l Some people may feel they
stress, stress is released through over time and may not feel must always put others first
the mind-body link and NEAD stressed and are unable to take a
episodes can happen. break when they need to.

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All Rights Reserved 2018. Document for issue as handout.
4
Unique Identifier: NOE 42 (18). Review date: January 2021.
Often the exact factors affecting A NEAD diagnosis is made because it is not caused by and is not your fault. With
a person’s pressure cooker are from certain signs and disease or damage to the the right information and
not obvious at first, because symptoms that a Neurologist or body. Working with a specialist support you can learn to
everyone’s lives are different. Neuropsychiatrist can recognise. psychological therapist is the manage symptoms and lead an
People are sometimes concerned It is not made because doctors only recommended way to independent lifestyle with little
that NEAD symptoms are their are “giving up” or “have run out manage symptoms. disruption.
fault, that they have caused of tests”.
Treatment is made up of three
them or that they should be People with NEAD are stages: Useful links, associations &
able to control symptoms. This is sometimes given anti-epileptic 1. Information: Learning about contacts
not true. drugs (AEDs), before a what NEAD is and how it
Neurologist or Neuropsychiatrist [Link]
You did not bring on the happens.
symptoms. BUT, with the right confirms a diagnosis of NEAD. [Link]
2. Stabilising: Strategies to
information and support you
How can I learn to manage reduce and control episodes. Contact Details
can learn to manage symptoms
and lead an independent NEAD? 3. Support making changes: For more information about our
Research and national guidelines Find new ways to manage department please visit our website:
lifestyle with little disruption.
recommend people who stressful situations and [Link]/about-us/depts/
experience NEAD episodes work patterns of coping that
How is NEAD diagnosed? prevent NEAD returning.
neuropsychology
with a psychological therapist If you have any further questions or
NEAD is often thought to specially trained in NEAD. concerns please contact us:
be epilepsy at first, but a
Neurologist or Neuropsychiatrist
Some people believe that What will happen in the Department of Clinical Neuropsychology
working with a psychological long term to my NEAD Clinical Sciences Building
can tell the difference.
therapist is a sign that they are Salford Royal NHS Foundation Trust
Sometimes a diagnosis can be episodes?
thought of as “pretending” or Stott Lane, Salford, M6 8HD
made quickly, though it may be that symptoms are “all in their Many people find that once
necessary to carry out several head”. This is NOT true. they gain an understanding of Telephone: 0161 206 4694
tests that take time. NEAD and how to manage the
A specialist psychological
People can feel uncomfortable symptoms they stop happening Email: reftoneuropsych@[Link]
therapist is trained to help you
or confused with the diagnosis as frequently.
understand how the Mind-Body
of NEAD because they have not REMEMBER: NEAD is not
link works and to manage the
heard of it before or it has taken dangerous. It can affect anyone
causes of NEAD. There is no
a long time to get the diagnosis. medical treatment for NEAD
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All Rights Reserved 2018. Document for issue as handout.
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Unique Identifier: NOE 42 (18). Review date: January 2021.
© G18121301W. Design Services
Salford Royal NHS Foundation Trust
All Rights Reserved 2018
This document MUST NOT be photocopied University Teaching Trust
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Unique Identifier: NOE 42 (18)
Review Date: January 2021

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Please contact the service/clinic you are or Email:
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