Why have the attacks not stopped?
There is a number of reasons why attacks may continue (or get worse) once they have started. These reasons are sometimes called “perpetuating factors”.
Ongoing stress or worry often explains why attacks still happen. Examples are relationship problems, bereavement and money worries. However, there are often other factors that explain why attacks can continue, even if people don't feel particularly stressed. Identifying and addressing these factors can help to stop attacks.
Over time attacks can start to happen without any obvious trigger. They can happen randomly and with no warning.
You may be feeling calm and relaxed before an attack. This can make it difficult to work out what triggers your attacks.
Factors which may cause NEAD to continue include:
- Healthcare contacts: Many people with NEAD end up seeing a range of different health professionals for their attacks and other health problems. Going to see a doctor can be a stressful experience. Many people with NEAD have had attacks in front of the doctor. Doctors may arrange many tests and you may receive different explanations for the symptoms. Many people end up feeling confused and receiving the wrong treatment. Three quarters of people with NEAD are initially diagnosed as having epilepsy and are given antiepileptic drugs. It often takes several years before the correct diagnosis of NEAD is made.
- Avoiding activities: Most people with NEAD feel that their health is determined by factors beyond their own control. They often become anxious about continuing activities they used to enjoy for fear of having an attack. Avoiding such activities contributes to isolation, undermines self-confidence and increases the risk of depression.
- Isolation: Increased avoidance of potential seizure triggers and social contacts can lead to increased isolation. This increases the risk of depression and can make people feel dependent on a small number of close friends or even a single carer. This is likely to undermine your self-confidence further and can have negative effects on your mood.
- Financial worries: About one in three people with NEAD become disabled by their attacks and other health problems. They end up losing their jobs and living on health-related benefits. Receiving such benefits may mean that they are not allowed to work any more, increasing the feeling of dependence.
- Medication: NEAD can be made worse by medication (including sedatives, painkillers and antiepileptic drugs).
- Illness Perceptions: NEAs often feel like a physical problem. Many people can't understand how their NEA could be caused by emotional factors or by how the brain deals with stress. This means that they may be unwilling to address their emotional problems or to reduce stress in their lives. . Understanding the link between stress or emotions and your attacks is an important start to your recovery.
For examples of how these different factors can act together to cause NEAD, click here to read more about Helen and John.