Epilepsy and Anxiety

What is Anxiety?

Everyone experiences feelings of anxiety such as worry, stress, and nervousness from time to time. For people with epilepsy, it’s normal to worry about the possibility of having a seizure or to find it stressful coping with the impact of epilepsy. These experiences become problematic when the feelings are frequent or intense, are produced by trivial things or nothing at all, and interfere with our functioning. Anxiety disorders are more common among people with epilepsy than in the general population, and anxiety can have an enormous impact on quality of life for someone with epilepsy. Anxiety can also affect memory, the experience of medication side effects, and seizure control. Despite this impact, anxiety is often underrecognized and undertreated in people with epilepsy. It’s important to talk to your healthcare provider if feelings of anxiety or stress are interfering with your ability to work, study, socialize, or manage daily tasks.

  • Cognitive: Anxious thoughts, predictions, and beliefs (Eg. “I’m going to have a seizure at the party, everyone will laugh at me, so I won’t attend”)
  • Physical: Pounding heart, sweating, nausea, dizziness, muscle tension, shortness of breath. It’s possible for these physical symptoms to be mistaken for a seizure, or for a seizure to be incorrectly identified as anxiety
  • Emotional: Feelings of fear, stress, nervousness

It isn’t well understood why anxiety is more common in people with epilepsy, who can experience a complicated mix of anxiety symptoms. Anxiety related to epilepsy may be caused by a variety of factors:

  • Anxiety can be a part of seizures themselves. This may occur at the start of a seizure, during a seizure, or immediately afterwards. For example, some people who have focal seizures feel sudden fear at the start of a seizure.
  • Anxiety may result from the psychosocial impacts of having epilepsy, including the stress of an epilepsy diagnosis or the worry or fear of having a seizure
  • There may be associated neurological or psychiatric disorders
  • Genetics may play a role
  • Underlying brain mechanisms related to epilepsy may also influence anxiety
  • Effects of medication

There hasn’t been a lot of research showing what treatments are most effective for people with epilepsy and anxiety. Generally, many psychological treatments, such as relaxation training, meditation, biofeedback and stress management, can help with anxiety disorders. Many people also benefit from supportive counselling or couples or family therapy. One of the most common forms of treatment for anxiety disorders is cognitive-behavioural therapy (CBT). Medications may also help, and many people receive CBT and medication in combination.

There are many strategies to try when you are feeling anxious or stressed. These ideas may work best if you do them regularly.

      • Try relaxation techniques such as muscle relaxation or breathing exercises. Try taking steady breaths that are not too deep or too fast. Do this several times to feel calmer
      • Focus on something enjoyable that distracts you: music, a picture, an activity.

Regular exercise helps keep you fit and can improve sleep. It can contribute to a sense of well-being by providing a break from day-to-day worries and by giving a sense of control and achievement. Gentle movement, such as simple stretching, can relax and calm the body.

  • Eat a healthy, well-balanced diet. Limit caffeine, alcohol, and nicotine.
  • Plan small, achievable tasks for each day.
  • Talk to someone. Tell friends and family how you’re feeling, and let them know how they can help you. Talk to a social worker or counsellor.
  • Learn what triggers your anxiety. Write in a journal when you’re feeling stressed or anxious, and look for a pattern.

Anxiety and depression can also happen together. For more information about depression and epilepsy, see our resource sheet Epilepsy and Depression. For help in finding mental health services in your community, call the Mental Health Helpline at 1-866-531-2600 or visit https://www.connexontario.ca/

  • Work with your healthcare provider to get your seizures under control

This material is intended to provide basic information about epilepsy to the general public. It is not intended to, nor does it, constitute medical advice. Readers are warned against changing medical schedules or life activities based on the information it contains without first consulting a physician. Adapted from Anxiety and Epilepsy: What Neurologists and Epileptologists Should Know (H. Munger Clary, Current Neurology and Neuroscience Reports, 2014); Stress, Anxiety and Epilepsy (The Epilepsy Centre)

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