Information about non epileptic seizures and Non Epileptic Attack Disorder.

Stress in NEAD: What is it and why do we feel it?

By on 20 May 2015 in General

Stress is one of those words that get thrown around very casually. We talk about being ‘stressed’ when faced with a choice of which dress to buy for an important event or when we can’t find the charger for our mobile phone. So when a diagnosis of NEAD is given and the person is told it’s caused by stress, most people are very angry and refuse to accept it.

So, what exactly is stress? Professor Stephen Palmer, an expert in stress and stress management, defines it thus: “Stress occurs when perceived pressure exceeds your perceived ability to cope” (Palmer, S. 2007). We all need a certain amount of pressure in our lives to make it enjoyable; that thrill when you go on a first date, the nerves as you walk into an exam room, the fun of trying something new. When you are choosing a dress or hunting for the charger, what you are feeling is pressure. However, if you feel that the pressure has become too much, perhaps your boss is giving you more work than you feel you can cope with or a relationship is going through a bad patch and you are worried your partner will leave you, then your stress responses kick in.

To understand the stress response, we have to wander gently into the world of neuroscience to get a feel for how the brain works. At any given time, your brain is being bombarded with hundreds of pieces of information through your five senses. Your brain processes that information faster than any super computer and it does this by comparing the new information with things that have happened before. If you pick up an apple, your brain will process the information that your eyes, nose and fingers send to it, compare it with what it’s learnt before and come back with ‘apple’. This happens so fast you are not even aware of it. If you pick up a strange fruit that you have never seen before, the brain takes longer to process it and you will find yourself turning it over in your hands, perhaps smelling it and looking for a sign to tell you what it is. This information processing starts from the moment you are born.

What about if you see a tiger loose in the street? Our brains process this slightly differently. The human brain has been in development for thousands of years. The first part to develop was the bit right at the back of your head just above your spine called the amygdala. This is the most basic brain form and it’s here that the things you do to stay alive, such as breathing, are controlled. It’s also where the ‘fight or flight’ response is triggered. This response was essential in the days when if you hesitated for a moment, you could end up being eaten!

Back to the tiger. As soon as you see it, the brain starts running through its processes. A signal is sent along the neural pathways to the areas that control your sight, hearing etc and to the part of your brain that makes decisions about risk. However, part of that signal is sent directly to the amygdala. As soon as the amygdala receives the signal, it sends out a flood of hormones into your system. Your heart starts beating faster, your blood vessels constrict except for those supplying your arms, legs and heart, your pupils dilate, your mouth becomes dry and you get that feeling of butterflies in your stomach as your digestive system slows right down. This all happens incredibly quickly, before the rest of your brain has even had time to process that it’s a tiger on the loose. The technical term for the system that does all this is the sympathetic system and as well as the brain, the adrenal glands and pituitary glands are involved. The adrenal gland secretes the hormones noradrenaline and adrenaline and the pituitary gland sends out hormones to the adrenal cortex to produce cortisol. Now that this is all in place, you can run away from the tiger as fast as you can – the flight response.

The ‘fight’ response works in exactly the same way. When you are in a traffic jam and someone cuts in front of you all those hormones start rushing around your body and your body gets itself ready for a fight. When the danger is past, your parasympathetic system then sends out a different hormone so that your heart rate returns to normal, your blood starts flowing again and your stomach gets back to the business of digesting your food. If you are sitting comfortably relaxed in a chair reading this, it’s your parasympathetic system that’s in charge.

Now you are probably thinking this is all very interesting but the only tigers I have seen have been safely behind bars in a zoo. What does this have to do with NEAD? In this modern age, we are bombarded with more information than at any other time in human existence. Remember that this information is being gathered from the moment you are born. The human brain takes longer to develop to full maturity than any other animal. In fact, all the connections aren’t complete until you are in your early twenties. The amygdala doesn’t know the difference between a tiger and a maths exam you haven’t studied for. It just processes that it’s scary, so let’s get those hormones flowing. In some people, the flight or fight response is activated way more often than usual, especially if as a child they felt very insecure in their environment. This can mean that even simple things like loud noises, or strong smells can be perceived as a threat, setting off the sympathetic system.

Eventually, your body becomes overloaded with cortisol and things start to go wrong. Some people have heart attacks or strokes but in our case, our bodies react by shutting down and going into a seizure. The overload is also what affects our memory. Anybody who has been in a bad car accident or similar will be aware of that feeling of time slowing down and also of not being able to remember what happened. This is because cortisol has flooded through the system. What is interesting is that more often than not, seizures don’t happen at the moment of high stress but appear to happen when the parasympathetic system is getting back in charge. Perhaps that’s an area of research for the scientists?

Hopefully you understand better how your stress responses work and why stress is causing your seizures. Finding ways to deal with stress, thus reducing the amount of times the fight or flight response is activated, is crucial in getting the seizures under control.

Sources:

Palmer, S and Cooper, G: How to deal with Stress (2007) (Kogan Page)

Hood, B : The Domesticated Brain (2014) (Pelican Books)

Harris, T.A. I’m Ok-You’re Ok (1969) (Arrow Books: Kindle edition)

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