Jo Puckett's FND Story in the Daily Mail: Questions Worth Asking
FND Nope
Moderator
On 24 September 2026, the Daily Mail published an article about Jo Puckett, a 34-year-old woman whose life changed after she experienced a seizure in her sleep. Initially investigated for epilepsy, Jo was subsequently diagnosed with functional neurological disorder (FND). Her seizures became increasingly frequent, eventually forcing her to stop working and driving. She now experiences approximately five seizures a week, alongside weakness, involuntary movements, pain and overwhelming fatigue.
The article is intended to raise awareness of FND, but several aspects deserve closer examination, particularly how diagnostic certainty is presented and how the psychological consequences of illness can become confused with its causes.
What exactly confirmed the diagnosis?
The article states:
"The footage of the seizures together with the scans showing no sign of abnormal electrical activity in the brain confirmed Jo had FND."
Neither a normal MRI nor a normal routine EEG can independently confirm FND. A normal EEG also cannot exclude epilepsy, particularly when no habitual seizure occurs during recording. Video EEG monitoring can provide considerably stronger evidence for functional seizures when a typical episode is captured and appropriately assessed.
The article mentions family-recorded videos, MRI and EEG, but does not establish whether Jo's typical seizures were captured during EEG monitoring or which positive clinical features supported the diagnosis. Perhaps her neurologist had sufficient evidence, but the journalist has not provided it. Presenting the diagnosis as confirmed without explaining what established it leaves readers with an incomplete account of the diagnostic reasoning.
The chicken-and-egg problem
The article discusses stress, anxiety and psychological factors as possible contributors to FND symptoms. Yet Jo's own account raises a rather obvious question about the direction of causation.
Her first seizure occurred unexpectedly during sleep. Following another episode, she became frightened about when the next seizure might occur. She subsequently lost her ability to work and drive, suffered injuries and became increasingly dependent on others. Why would she not be anxious?
Stress can aggravate numerous neurological conditions without being responsible for their original development. The fact that someone becomes frightened by unpredictable seizures tells us little about what caused those seizures in the first place. The article acknowledges that no clear trigger was identified in Jo's case, yet still devotes considerable attention to possible psychological contributors.
There is nothing inherently wrong with investigating psychological factors. The problem arises when the consequences of illness are treated as though they explain its origins.
What about suicidality?
The same question applies to research reporting elevated rates of suicidal ideation among patients diagnosed with FND. Such findings establish an association, but they do not, by themselves, explain why those patients are experiencing suicidal thoughts.
Consider someone living with disabling symptoms who repeatedly seeks medical assistance, feels disbelieved, receives little benefit from treatment and struggles to obtain further investigation. Their psychological distress may reflect the burden of illness, their healthcare experiences, pre-existing difficulties or some combination of these.
If patients become desperate after years of feeling unheard, attributing that desperation exclusively to their diagnosis risks overlooking the contribution of the healthcare system itself. This is not an argument that medical dismissal explains every instance of suicidality in FND. It is a question about whether researchers are adequately distinguishing the effects of illness from the effects of how patients are treated.
Without investigating that distinction, we cannot confidently establish the direction of causation.
Wanting answers is not wanting to be ill
There is another interpretation that sometimes emerges when patients question an FND diagnosis or continue seeking alternative explanations: the suggestion that they somehow want to remain ill.
People really hate the idea that there are people who don’t actually want to recover. Most of the time this is likely unconscious - the person does not consciously think “wow I love being ill and I want to stay like this” but being ill can serve a purpose.
— Zachary Grin (@ZacharyGrinDPT) September 27, 2026
When I was diagnosed… https://t.co/4j7fAVYyEF
But wanting an explanation for persistent symptoms is not the same as wanting those symptoms to persist.
A patient may continue seeking answers because their condition is deteriorating, treatment has failed or they believe important possibilities remain unexplored. An identifiable, potentially treatable cause may offer targeted treatment and a clearer prognosis. It is hardly unreasonable to prefer that possibility over remaining uncertain about the underlying problem.
Rehabilitation and psychological interventions may help some patients, but improvement does not necessarily confirm the proposed mechanism of their illness. Equally, failure to improve does not establish that someone is unwilling to recover.
When a patient's continued search for answers is interpreted as resistance to their diagnosis, an uncomfortable question arises: what evidence would actually persuade the clinician to reconsider it?
Jo's story illustrates how profoundly neurological symptoms can affect someone's life. It also demonstrates why we should be careful about the conclusions drawn from a patient's response to illness.
Being anxious about seizures does not establish that anxiety caused them. Becoming desperate during a difficult healthcare journey does not establish that desperation is intrinsic to the diagnosed condition. And seeking a more satisfactory explanation does not mean someone wants to remain ill.
Sometimes patients are simply asking to be heard, properly investigated and given a reasonable opportunity to get better.
