Psychogenic Non-Epileptic Seizures (PNES) are seizure-like episodes that look very similar to epileptic seizures but are not caused by abnormal electrical activity in the brain. Instead, they are triggered by psychological factors, especially stress, trauma, emotional conflict, or overwhelming internal pressure.

What Causes Psychogenic Non-Epileptic Seizures (PNES)?

PNES is categorized under Functional Neurological Symptom Disorder (Conversion Disorder) in psychology. The person does not fake symptoms — the episodes are real, involuntary, and deeply distressing.

This article provides a clear, professional breakdown of what causes PNES, how the mind-body connection works, and why these episodes occur.

Table of Contents

What Exactly Are PNES?

PNES episodes often resemble epileptic seizures, including:

shaking or convulsing
unresponsiveness
collapsing
stiffening or jerking movements
crying, trembling, or hyperventilation afterward

However, EEG scans show no epileptic activity, which means the cause is psychological rather than neurological.

What Causes Psychogenic Non-Epileptic Seizures?

PNES develops when emotional or psychological distress overwhelms the brain, causing it to “shut down” or express distress through physical symptoms.

Here are the main causes:

1. Past Trauma (Most Common Cause)

Trauma is the strongest predictor of PNES.

Types of trauma linked to PNES:

childhood emotional, physical, or sexual abuse
domestic violence
traumatic grief
witnessing violence
medical trauma (e.g., ICU stays, surgeries)
accidents or sudden loss

PNES acts as the brain’s emergency coping mechanism when emotional pain is too overwhelming to process consciously.

Why trauma causes seizures:
The nervous system becomes hyper-activated. When overwhelmed, it disconnects or “freezes,” leading to seizure-like responses.

2. Emotional Suppression

Many individuals with PNES have learned — consciously or subconsciously — to suppress emotions.

For example:

“I can’t get angry.”
“I shouldn’t show sadness.”
“I must stay strong for others.”

When emotions have no safe outlet, they often manifest physically. PNES becomes the body’s way to release internal tension that the person cannot express verbally.

3. Chronic Stress and Emotional Overload

PNES can develop after prolonged stress that overwhelms the nervous system.

Stress triggers include:

relationship conflict
job stress or burnout
financial pressure
academic pressure
immigration stress
caregiving responsibilities
health worries

When the brain reaches its limit, it may trigger a PNES episode to “shut down” emotional overload.

4. Anxiety Disorders

PNES often co-occurs with:

Generalized Anxiety Disorder (GAD)
Panic Disorder
PTSD
Social Anxiety
Phobias

Panic can trigger the fight-flight-freeze response, and in some cases, the body enters a freeze or collapse pattern that resembles a seizure.

During severe panic, the body may:

dissociate
hyperventilate
lose control of muscles
faint or shake

PNES is the extreme form of this response.

5. Depression

People with depression may develop:

emotional numbness
difficulty coping
fatigue and exhaustion
guilt or hopelessness

When emotions build up without release, the body may respond through physical shutdown, leading to PNES episodes.

6. Dissociation

Dissociation is when a person mentally “disconnects” during stress. PNES can occur during deep dissociation when the brain momentarily disconnects from physical control.

Signs of dissociation include:

feeling detached
zoning out
memory gaps
feeling unreal or disconnected
emotional blunting

PNES may appear when this dissociation becomes overwhelming.

7. Unresolved Inner Conflict

Psychodynamic and trauma-based theories suggest PNES can result from internal emotional conflict, such as:

wanting to avoid a stressful situation
feeling trapped in responsibilities
unresolved guilt
fear of expressing needs
deep emotional pain

The seizure becomes the brain’s way of escaping impossible emotional pressure.

8. Learned Physical Response

In some individuals, exposure to seizures in family members or past medical experiences can “teach” the brain a physical response to stress.

For example:

Growing up with a family member who has epilepsy
Having fainting episodes in childhood
Witnessing others have seizures

The brain may reproduce similar symptoms during emotional distress.

9. Personality Factors (Not Personality Disorders)

Certain psychological traits increase vulnerability to PNES, such as:

high emotional sensitivity
difficulty expressing emotions
perfectionism
fear of conflict
people-pleasing behavior
strong need for approval
internalizing stress

None of these traits cause PNES alone — but they intensify emotional pressure.

10. Recent Major Life Event

PNES often begins shortly after:

a breakup
divorce
job loss
relocation
death of a loved one
medical diagnosis
severe argument
major life transitions

These events push the nervous system into overwhelm.

11. Medical Stress or Misdiagnosed Neurological Symptoms

Medical situations can trigger PNES — especially when:

the person fears a severe diagnosis
symptoms are confusing
tests are inconclusive
there is uncertainty about health

This fear-stress cycle can activate the functional neurological response.

12. Difficulty Communicating Emotional Needs

Some people struggle to verbalize emotional pain, conflict, or needs.

Instead of expressing:

anger
fear
sadness
frustration
helplessness

…their body expresses it through PNES episodes.

How PNES Works in the Brain: The Mind–Body Link

PNES episodes occur because the brain’s emotional center (amygdala) becomes overactive, while the reasoning center (prefrontal cortex) shuts down temporarily.

During overwhelm:

The brain enters survival mode.
Conscious control over the body decreases.
The nervous system “resets” through an involuntary physical reaction.

This produces:

shaking
unresponsiveness
collapse
convulsions

It is a neurobiological response, not intentional.

What Does NOT Cause PNES

It is important to understand:

PNES is not epilepsy
PNES is not faking
PNES is not attention-seeking
PNES is not manipulation
PNES is not “in the person’s head”

The symptoms are genuine and often terrifying.

Common Triggers for PNES Episodes

Episodes may occur during:

stress or emotional conflict
arguments
overwhelming responsibilities
traumatic reminders
intense anxiety
feeling trapped
sensory overload
physical exhaustion
sleep deprivation

Sometimes, episodes occur shortly after stress — not during it — because the nervous system crashes once the stressor passes.

Treatment: Can PNES Be Cured?

PNES is highly treatable, especially when the psychological root is addressed.
Most effective treatments include:

1. Cognitive Behavioral Therapy (CBT)

Helps the patient:

understand triggers
manage stress
reduce physical symptoms
break the cycle of episodes

2. Trauma-Focused Therapy (EMDR, somatic therapy, trauma-informed CBT)

Essential for individuals with trauma histories.

3. Dialectical Behavior Therapy (DBT)

For emotional regulation, distress tolerance, and management of intense feelings.

4. Psychiatric Treatment (when needed)

To treat co-occurring:

depression
anxiety
PTSD

5. Physical Therapy

For movement-based symptoms.

6. Psychoeducation

Learning how the brain-body interaction works reduces fear and stigma.

7. Stress Reduction Skills

Breathing, grounding, mindfulness, and nervous system regulation.

Recovery Outlook

With proper treatment, 60–80% of people improve significantly.

Early diagnosis greatly increases success.

Final Thoughts

Psychogenic Non-Epileptic Seizures are real, involuntary, and deeply rooted in emotional or psychological distress. They are caused by the brain’s response to trauma, stress, emotional overload, internal conflict, or unresolved psychological pain.