What are the causes?

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How do dissociative seizures start?

It can be very difficult to pinpoint exactly how dissociative seizures start. The truth is, lots of different factors appear to contribute to the onset and maintenance of dissociative seizures, and these vary significantly from individual to individual. So what’s true for you, may be totally different for somebody else.

A lot of the time, dissociative seizures can be traced back to an event or a difficult period of time. For some people, they may have experienced an emotionally stressful event, for others, a physical health issue and for others still, a combination of the two. Perhaps they have experienced a traumatic event or experienced a sustained period of family or work stress.  They may have had a particularly nasty virus that laid them up for weeks on end, or maybe they sustained an injury.  Other people may have an existing illness, like epilepsy and experienced a nasty flare up, or a particularly bad seizure. Sometimes stress and health problems combine, feeding off each other to produce a ‘perfect storm’ of distress. When this happens we often feel overwhelmed. For some people, this is when they experience their first dissociative seizure.


What is dissociation?

Dissociation is a change in consciousness and awareness.

It is actually very common and tends to occur on a continuum ranging from low level day dreaming to more dramatic losses of consciousness similar to what we see in dissociative seizures.

It happens to everyone but some people are more prone to dissociation than others.

Dissociation can be quite helpful. When we experience difficult circumstances for example, we often experience a sense of detachment and this can help us get through a distressing time. When we need to think carefully about something, the ability to disengage from our surroundings can help us get into flow state.


But as with everything, too much of a good thing can become quickly unhelpful. Perhaps there was a time when your dissociative seizure occurred to give you space from something difficult. But after it has happened once, the brain can get stuck repeating the same process over and over, even though this is no longer helpful at all.

Why is this happening to me?

Everyone is different. We all have things that make us unique. Some people are naturally quite positive, whereas others tend to be more pessimistic. Some people are very tall, others very short. Some people are very fast at running, others will only ever be able to muster a wee trot. It’s what makes everyone interesting, and we have no say in many of the things that make us who we are. It’s what psychologists call our ‘predisposition’ and it’s often in our genes.

Not everyone experiences dissociative seizures when they become highly distressed though. So why is it happening to you? Again, it is impossible to say for everyone, but we know that people who experience dissociative seizures are often more likely to a) experience dissociation more generally and b) experience intense emotion, compared with most other people.

It may be that you have experienced trauma in your life, and dissociation was a way you coped at that time. Or it may just mean that you are simply more prone to drifting into a different state – perhaps others notice that you often go into a daydream or you recall other times in your life when you lost periods of time. This was probably dissociation – it probably means you’re good at it!

There is also increasing evidence that the brain areas involved in emotional processing are more highly activated in people experiencing dissociative seizures.  It appears that the brain’s fight-flight-freeze response – the brain’s way of protecting us from danger - is more sensitive in people with dissociative seizures. You can recognise when you are in the fight-flight-freeze response by a number of bodily changes, which can be dramatic but are perfectly safe and normal:

For people experiencing dissociative seizures this response may be activated more easily or remain switched on.  This means they will potentially be especially sensitive to stimulus in their environment e.g. sudden noise, lights, conflict and so on.  When the brain encounters substantial stress and perceived threat it has two potential responses: it either shuts down and (something psychologists call ‘hypo aroused’) or it goes into panic overdrive (and becomes what psychologists call ‘hyper aroused’).  Each of these states can be linked to the emotional and physical precursors to dissociative seizures.

What keeps dissociative seizures going?

Once somebody has one dissociative seizure, they are likely to have another.

This is because the brain adopts a dissociative seizure programme as an automatic response and will begin to activate this programme, without you even knowing about it! And every time it activates it, it becomes a bit better at it, so it becomes easier and easier and you find that your dissociative seizures can occur without much prompting.

Some people are aware of the process beginning; they maybe feel certain feelings coming on (like anxiety or fear), or they experience certain changes in their body (like their heart rate increasing or their legs turning to jelly). Sometimes they just know that a certain situation will trigger it (like being involved in an argument or being in a room crowded with people).

But for others, they get no warning. Their brain is so adept and activating the programme, that they’ve lost awareness (‘dissociated’) before they can become aware of the programme starting.