Living with epilepsy can create stress and anxiety. Generalized anxiety, panic attacks, and fear of having a seizure are common among people with the condition.
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Knowing that a seizure can occur at any time without warning can create powerful feelings of anxiety for someone with epilepsy. They may fear being hurt during the episode, feel anxious about their long-term health, or have concerns about social stigma.
This article explains the connection between anxiety and epilepsy, the difference between seizures and panic attacks, diagnosis, and treatment.
Epilepsy and anxiety have strong links, and the two conditions may worsen each other.
A person with epilepsy might feel anxious about being injured during a seizure or being judged socially for having seizures. The nature of seizures, which occur due to atypical electrical function in the brain, may worsen anxiety. This can lead to more seizures.
Researchers do not yet fully understand the biology that causes one condition to worsen the other, but the connection is clear.
One 2021 study found that people with epilepsy and anxiety were seven times more likely to have recurrent seizures than those without anxiety.
By comparison, a 2018 study that examined anxiety symptoms and seizures during the previous year found that people with anxiety did not experience more seizures. However, the researchers noted that anxiety leads to a lower overall quality of life.
People can confuse symptoms of a panic attack with symptoms of a seizure. Like seizures, panic attacks can occur suddenly and without warning.
Panic attacks produce intense feelings of fear along with
- a pounding or racing heartbeat
- sweating
- chills
- trembling or shaking
- problems breathing or hyperventilating
- dizziness or weakness
- tingling in the hands, feet, arms, or legs,
- chest pain
- nausea or stomach pain
Many of these symptoms also occur during a seizure, making it difficult to determine which is happening.
Sometimes, an onlooker can better differentiate the two according to visible symptoms, such as repeated swallowing during a seizure. The length of the attack may also be an indicator, as seizures tend to be shorter than panic attacks, which can last 5–20 minutes.
Read about the signs and symptoms of a seizure.
Can a panic attack trigger a seizure?
One symptom of a panic attack — hyperventilation, which involves breathing too fast — can trigger a seizure.
A 2022 study of seizures in children found that 87–100% of children with epilepsy could trigger a seizure by purposefully hyperventilating. A 2019 review reported similar results in adults, with
Hyperventilating causes a person to rapidly exhale carbon dioxide, leading to an imbalance of oxygen and carbon dioxide in the blood. Doctors call this respiratory alkalosis and believe it causes these seizures.
A doctor relies on a description of the event to determine whether a person has experienced a panic attack or seizure. It may be helpful to keep a journal of symptoms to make it easier to remember and accurately report to the doctor.
Sometimes, the doctor may order a brain scan called an electroencephalogram or an MRI to look for abnormalities. If a person believes the doctor misdiagnosed them, they may ask for a referral to an epilepsy specialist.
There are several treatment options for anxiety in someone with epilepsy. These may include:
- speaking with a therapist or counselor
- cognitive behavioral therapy
- anti-anxiety medications — these can be habit-forming, and a person must use them as a doctor prescribes
- selective serotonin reuptake inhibitors with anti-anxiety effects
- seizure medications with anti-anxiety effects
- beta-blocker medications
In addition, proper self-care can help people manage anxiety and epilepsy. People may wish to try the following:
- talking about feeling with friends and family
- peer support groups
- exercise
- maintaining a healthy sleep schedule
- eating a nutritious diet
- relaxation and meditation techniques
Anxiety may come and go depending on what is happening in a person’s life. Making appropriate lifestyle choices, including undergoing counseling, can help.
There is no cure for epilepsy, but doctors can prescribe medications that help people manage their condition. If someone has co-occurring anxiety, doctors may prescribe medications with anti-anxiety effects.
Taking medications as a doctor prescribes can help control seizures and reduce the fears relating to epilepsy.
Epilepsy can trigger feelings of anxiety. A person may fear being hurt during a seizure, social judgment, and stigma. They may also have concerns about their long-term health. Additionally, changes in the brain can trigger biochemical effects that cause anxiety.
Panic attacks can look similar to seizures, and some people may confuse them. One clue is the episode’s length —seizures are usually short, while panic attacks can last up to 20 minutes.
Anxiety is common in people with epilepsy, and treatments are available. Medications, counseling, and lifestyle management can work together to provide relief.
If someone with epilepsy has anxiety symptoms, they can talk with a doctor for diagnosis and treatment.