Returning to School After Your Child Has Been Diagnosed With Psychogenic Non-Epileptic Seizures (PNES)

Returning to school after your child has been diagnosed with psychogenic non-epileptic seizures (PNES) can feel overwhelming. Many parents worry about safety, stigma, academic performance, and how teachers or classmates will respond. At the same time, school is an important part of a child’s recovery, routine, and emotional development.

The good news is that with the right support, planning, and communication, most children with PNES can successfully return to school and thrive academically and socially.

In this guide, we will explain what PNES is, why returning to school is important, and practical steps parents and schools can take to make the transition smoother and safer.

What Are Psychogenic Non-Epileptic Seizures (PNES)?

Psychogenic non-epileptic seizures are episodes that look like epileptic seizures but are not caused by abnormal electrical activity in the brain. PNES are not emergent in nature and therefore do not warrant urgent or emergency medical intervention. However, they are still real, and these episodes are not purposeful or intentional. These episodes are not “all in your head.” The PNES often result from difficulty recognizing and appropriately coping with stress, anxiety, frustration, or other difficult emotions. PNES may also result from unrecognized or unaddressed underlying mental health difficulties or trauma. Other times, PNES are not necessarily linked with a specific mental health disorder and may be considered a symptom of autonomic neurological system dysregulation and/or a learned bodily response to specific stimuli.

PNES is a real and treatable condition, not something your child is “faking” or doing intentionally.

Common characteristics may include:

• Sudden shaking or body movements

• Loss of awareness or responsiveness

• Episodes triggered by stress or emotional distress

• Normal EEG results during events

• Improvement with psychological treatment

PNES is often addressed through psychotherapy, stress management, emotional regulation skills, and family support.

Why Returning to School Matters

After diagnosis, some parents consider keeping their child home for long periods. While short breaks may be necessary, prolonged absence from school can actually worsen anxiety and stress, which may increase PNES episodes.

Returning to school can help your child:

• Re-establish routine and normalcy

• Maintain academic progress

• Stay connected with friends and social support

• Build confidence and coping skills

• Reduce avoidance behaviors linked to anxiety

The key is a gradual and well-supported return.

Preparing the School Before Your Child Returns

One of the most important steps is educating school staff about PNES. Many teachers and school nurses are more familiar with epilepsy and may initially misunderstand the condition.

Consider scheduling a meeting with:

• The school principal

• Teachers

• School counselor or psychologist

• School nurse

• Special education coordinator (if applicable)

Topics to discuss include:

1. What PNES Is (and What It Is Not)

Explain that PNES:

• Is not epilepsy

• Is not dangerous in the same way epileptic seizures can be

• Is a stress-related neurological response

• Benefits from calm and supportive responses

2. How to Respond to an Episode

School staff should know how to respond calmly and safely. A simple response plan may include:

• Ensuring the child is safe from injury

• Staying calm and reassuring

• Avoiding excessive attention or alarm

• Allowing the episode to pass

• Informing parents if needed

Emergency services are usually not required unless there is an injury or unusual symptoms.

3. Identify Triggers and Warning Signs

Some children notice early signals such as:

• Feeling overwhelmed

• Headaches

• Dizziness

• Emotional distress

• Panic symptoms

Teachers can allow the child to take a short break or visit a safe space when these signs appear.

Creating a School Support Plan

A structured support plan can make returning to school much smoother.

Possible accommodations may include:

• A quiet space where your child can go if overwhelmed

• Permission to leave class briefly if early symptoms appear

• Reduced workload during the transition period

• Flexible deadlines if episodes occur

• Access to the school counselor or support staff

In some cases, students may benefit from a 504 plan or individualized education plan (IEP) depending on their needs.

Helping Your Child Cope at School

Children with PNES often benefit from learning practical coping strategies they can use during the school day.

Helpful tools include:

Emotional Regulation Skills

Children can learn techniques such as:

• Deep breathing

• Grounding exercises

• Progressive muscle relaxation

• Mindfulness

These skills can reduce the stress response that triggers episodes.

Identifying Stress Early

Encourage your child to recognize:

• Emotional overwhelm

• Social stress

• Academic pressure

Catching stress early helps prevent escalation.

Building Confidence

Children with PNES sometimes worry about embarrassment or judgment from peers. Remind them:

• They are not alone

• PNES is treatable

• Many children improve significantly with therapy

Encouragement and reassurance from parents and teachers make a big difference.

Talking to Classmates (If Appropriate)

Some families choose to explain the condition in simple terms to classmates to reduce confusion or stigma.

For example:

“Sometimes my body reacts to stress in a way that looks like a seizure. It’s not epilepsy, and I’m working with my doctor to get better.”

This step is optional and should always respect the child’s comfort and privacy.

When School Anxiety Is Severe

If your child experiences intense anxiety about returning to school, a gradual reintegration plan may help.

Examples include:

• Starting with half days

• Attending specific classes first

• Increasing school time gradually

• Providing regular counseling support

Working with a psychotherapist experienced in PNES can significantly improve outcomes.

The Role of Psychotherapy in PNES Recovery

Evidence shows that psychotherapy is one of the most effective treatments for PNES.

Therapy may focus on:

• Understanding stress triggers

• Processing emotional experiences

• Developing healthy coping strategies

• Improving emotional regulation

• Strengthening resilience and self-confidence

Family involvement is also important because supportive environments help children recover faster.

A Message of Hope for Parents

Receiving a PNES diagnosis can feel frightening at first, but many children recover and lead full, active lives.

With the right combination of:

• Psychological treatment

• Supportive school environments

• Strong family encouragement

• Healthy coping skills

children with PNES can successfully return to school and regain their confidence.

When to Seek Professional Support

If your child is struggling with:

• Frequent PNES episodes

• Severe school anxiety

• Emotional distress

• Trauma or stress triggers

working with a qualified mental health professional experienced in PNES can make a significant difference.

Get Support for Your Child

At Ezer Psychotherapy, we help children, adolescents, and families navigate conditions like psychogenic non-epileptic seizures, anxiety, trauma, and stress-related disorders.

Our therapy approach focuses on:

• Emotional regulation skills

• Trauma-informed care

• Family support

• Evidence-based treatment strategies

If your child has recently been diagnosed with PNES and you need guidance on returning to school and managing symptoms, professional support can help.

Contact Ezer Psychotherapy today to learn how we can support your child’s recovery and wellbeing!