epilepsy It can be stressful or difficult. After diagnosis, people may naturally feel anxious about their health and seizures. It is estimated that about 20% of people with epilepsy also exhibit symptoms of anxiety.
Clinical anxiety is a psychiatric disorder distinct from episodic mild anxiety. Anxiety overlaps and can be a symptom of epilepsy, so the two conditions are linked in many ways. Appropriate treatment for both conditions should be part of the treatment plan.
Read on to learn more about epilepsy and anxiety, their diagnosis and treatment, and how to deal with them.
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The relationship between anxiety and epilepsy
Epilepsy is associated with stress and anxiety as part of the disease process and as aggravating factors. Certain anxiety symptoms can occur as part of the aura, along with the attack, or before the attack begins. The exact cause or connection between brain abnormalities and anxiety is unknown, but there is a connection.
About 20% of people with epilepsy also show symptoms of anxiety. Although this is a significant number, the relationship between the two conditions has not been well studied.
Complications of Anxiety and Epilepsy
Panic attacks are sometimes misdiagnosed as seizures. Some symptoms can be seen with both, such as increased heart rate, sweating, flushed skin, and hyperventilation (hyperventilation).
If panic attacks are severe, hyperventilation may cause spasms (uncontrolled muscle contractions), further confusing the diagnosis.
Chronic stress, including anxiety, can increase seizures in people with epilepsy. More research is needed to investigate this further, but stress is associated with increased seizures, and anxiety is a common disorder that co-occurs with epilepsy.
when to go to the hospital
Epilepsy can become serious if not managed. Go to an emergency room (ER) or call 911 immediately if:
- This is your first seizure.
- A seizure lasts more than 5 minutes.
- Multiple seizures within a short period of time.
- People with you are unconscious or injured.
Anxiety and Epilepsy Diagnosis
A diagnosis of epilepsy is usually made by a neurologist (a specialist in nervous system conditions), whereas a diagnosis of anxiety is usually made by a mental health professional. However, a neurologist may notice clinical signs of anxiety and offer a referral. The symptoms of both are very different.
In addition to taking a medical and family history and doing a physical examination, a neurologist may:
- Perform a neurological examination, assess mental function, and ask questions to test reflexes, muscles, and sensations
- Run EEG (EEG) looks for changes in brain electrical patterns associated with seizures
- Order a brain scan, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), to detect brain changes that may lead to seizures
Health care providers and mental health professionals should Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) When Evaluating and Diagnosing a Person for Anxiety Disorders.
anxiety self test
Self-testing can be a good motivation to seek professional help if you are worried that your symptoms are more than just adjusting to a new diagnosis or epilepsy symptoms. should not be used in place of a valid clinical diagnosis.
Self-tests to screen for anxiety include:
How to Ask for Help in a Crisis
If you are considering suicide, dial 988 to contact a trained counselor and contact the 988 Suicide & Crisis Lifeline. Call 911 if you or someone you love is in immediate danger.
Anxiety and epilepsy treatment
There is no cure for epilepsy, but there are ways to treat and manage it. Epilepsy can be treated with a variety of options, including medication, surgery, seizure devices, and special diets.
What works for one person may not work for another, so you and your provider will create a management plan tailored to your specific symptoms and needs.
Anxiety is usually treated with a combination of medication and psychotherapy. That said, research on anxiety disorders in epilepsy is lacking, and there is no knowledge of anxiety response and remission rates in people with epilepsy compared to people without epilepsy.
Anxiety may influence epilepsy treatment, as drug interactions can cause serious side effects, but more research is needed.
medicine
For people without epilepsy, much research has focused on agents known as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). There is no evidence that SSRIs are associated with an increased risk of seizures, but more research is needed to see how these drugs affect people with epilepsy.
Two commonly used drugs for people with anxiety and epilepsy are:
- Buspar (buspirone): This is a serotonin receptor agonist, meaning it inhibits the release of serotonin, a chemical messenger that facilitates communication between cells in the nervous system.
- Lyrica (Pregabalin): This anticonvulsant drug calms damaged or overactive nerves that cause pain and seizures.
Pregabalin is the only antiepileptic drug approved to treat both anxiety and epilepsy. If you are taking anxiety medications, talk to your healthcare provider about possible interactions between anxiety medications and epilepsy medications, or whether these medications are suitable for people with epilepsy. please.
psychotherapy
Psychotherapy is often combined with drug therapy to treat anxiety. There are many different types of psychotherapy for anxiety, and what works for one person may not work for another.
A mental health professional will perform a detailed assessment to determine the most effective treatment for you. Different types of treatments for anxiety include:
- Cognitive-behavioral therapy (CBT): This therapy examines problematic patterns of thinking and behavior so you can change them.
- Acceptance and Commitment Therapy (ACT): This therapy focuses on mindfulness and teaches skills to identify, accept and contextualize problematic thoughts and feelings.
- Dialectical Behavioral Therapy (DBT): This therapy combines CBT techniques with the concepts of mindfulness, emotional balance, and changing thought patterns.
Coping with Anxiety and Epilepsy
Living with a chronic illness or mental health disorder can be stressful. Developing appropriate coping strategies is important to managing your condition and staying as healthy as possible.
lifestyle change
A 2021 study found a link between chronic stress and seizures in people with epilepsy. Better coping techniques, such as mindfulness-based stress management, cognitive-behavioral therapy, and participation in relaxation techniques, may help reduce the overall stress load. Helps alleviate
Diet can also help manage both epilepsy and anxiety. When combined with seizure medication, diet can help manage epilepsy. Dietary changes include:
- Ketogenic Diet: High Fat, Low Carb Diet
- Medium-chain triglyceride diet (MCT diet): a ketogenic diet with fat supplements consisting exclusively of MCT fats
- Modified Atkins Diet (MAD): A diet containing high fat, low carbohydrates and unlimited amounts of protein
- Low Glycemic Index Therapy (LGIT): Focus on carbs that have a lower impact on blood sugar (e.g., eating fat with fiber or carbs).
Diet can also help with anxiety. A low-carbohydrate, high-fat diet (ketogenic diet, MCT diet, MAD, etc.) may help reduce anxiety. This may be due to the anti-inflammatory effects of the diet or its effect on the gut microbiota. Further research is needed to articulate the relevance.
These lifestyle changes do not replace treatment, but can be used in conjunction with a treatment plan.
support group
Epilepsy support groups can help you connect with other people in a similar situation. It can be done online or in person and includes:
Anxiety support groups are also beneficial. Notable things are:
overview
Epilepsy is intertwined with stress and anxiety as a response to diagnosis, as an aspect of symptoms, and as coexisting (comorbid) symptoms. Accurate diagnosis of both conditions is critical to receiving the most appropriate treatment.
Lifestyle modifications, such as diet and stress management, can help, but these are best used in conjunction with a treatment plan that your healthcare provider implements for epilepsy and anxiety. This includes seizure medication, anxiety medication, surgery, seizure devices, psychotherapy, and diet.
A word from Verywell
Having one chronic illness can be overwhelming. If you have two, like epilepsy and anxiety, it can be even more serious. It’s natural to need help with coping, and this includes support groups and therapists.
If you feel overwhelmed and anxiety is disrupting your life, tell your treatment team. You don’t have to do this alone. We can provide resources to reduce anxiety and improve quality of life.
