Please note that the strategies in this article do not and cannot replace a personalised rehab plan developed with you by FND specialist health professionals.
What do we mean by a trigger?
A trigger is something that seems to bring on or worsen symptoms for a particular person. It might be physical, environmental, emotional, or related to things such as pain, illness, sleep or fatigue. Triggers differ from person to person. Some people do not find a clear trigger, and identifying one does not necessarily explain what caused FND.
FND symptoms are real and involuntary. A trigger does not mean that symptoms are imagined or anyone’s fault. A person may also have FND alongside other health conditions, so new or changing symptoms should not automatically be put down to FND.
Looking for patterns without blaming yourself
If it feels helpful, you could make brief notes for a short time about when symptoms change and what was happening around then. You might note the activity, sleep, pain, illness, surroundings or stress, as well as what helped you feel safer or more settled.
The aim is to notice useful patterns—not to monitor every sensation or find a perfect explanation. A pattern in a diary does not prove that one thing caused a symptom. If keeping notes makes you more worried or focused on symptoms, stop and discuss another approach with your clinician.
Responding when symptoms increase
Your FND team can help you make a plan for symptom flare-ups. Depending on your symptoms and goals, that plan might include pausing, making an activity easier, using a strategy practised in rehabilitation, or returning to the task in a manageable way.
Managing a trigger does not always mean avoiding it. Avoidance may be sensible for safety or in some situations, but avoiding more and more activities can restrict daily life. If an activity has become difficult, ask your clinician whether and how to work back towards it safely. Do not push through severe symptoms or start a new exercise programme without advice suited to you.
Keep your rehabilitation goals in view
FND symptoms can change from day to day and over the course of the condition. Your goals will help guide your rehabilitation, and there may be times when you and your clinician focus on a particular symptom or activity.
At the same time, rehabilitation can consider how symptoms affect your daily life as a whole. Focusing on each symptom separately can sometimes feel like “whack-a-mole”—as one problem settles, another takes its place. A joined-up plan can help you work towards activities and goals that matter to you. Improvement may look different for different people, and no approach can promise that every symptom will improve.
Emotions and recovery
Emotions, stress and difficult life events can affect symptoms for some people, but they are not the explanation for everyone’s FND. FND is not less real when emotions are involved.
Some people notice changes in how they experience or manage emotions during rehabilitation; others do not. This is not a fixed stage of recovery and does not prove that your brain is “rewiring”. If difficult feelings come up, tell your clinician. They can help you decide whether additional support would be useful and how to approach it at a pace that feels manageable.
Simple, sustainable self-care
A simple routine can add predictability to the day and help you make space for the things that support your wellbeing. Self-care means taking your needs seriously—not getting everything right.
When health needs are complex, it can seem as if the solutions must be complex too. Often, a small and realistic change is easier to keep going. You might choose one routine to work on, such as a regular wind-down before bed, planned breaks, or balancing activity and rest in line with your rehabilitation plan. Adapt it when your symptoms or circumstances change.
When to seek medical advice
Contact a health professional if you have concerns about a new symptom or a significant change. Seek urgent help for symptoms that are sudden, severe or otherwise require urgent medical attention. Having an FND diagnosis does not rule out other health conditions.