Anxiety and epilepsy

Some people with epilepsy experience problems with anxiety.

This information explains what anxiety is and looks at the relationship between anxiety and epilepsy.

It also covers treatments and self-help resources that can help with anxiety.

A sad teenager sitting on a park bench

What is anxiety?

Anxiety is a feeling of unease, like a worry or fear. Everyone is likely to have feelings of anxiety at some point in their lives.

For example, you might feel worried about a stressful event like sitting an exam or going for a job interview. Feelings of anxiety usually go away if you get used to the situation, or if the situation improves.

However, anxiety can become a problem if you begin to feel anxious all the time, or for no obvious reason.

anxiety example

Who develops anxiety?

Anyone can develop anxiety. In England, around 1 in 6 people report having anxiety or another common mental health condition in any given week. But studies suggest that anxiety is more common in people with epilepsy compared to the general population.

With any medical condition, people may become anxious after they have been given a new diagnosis. But anxiety is related to epilepsy in more specific ways. Some people with epilepsy tell us:

  • They feel anxious because they never know when a seizure is going to happen
  • They feel they are excluded from things they previously enjoyed, because of their epilepsy

 

Anxiety is not just purely due to psychological and social reasons, it can happen:

If you think your anxiety could be caused by your seizures or side-effects of your epilepsy medicines, talk to your epilepsy doctor, epilepsy specialist nurse or GP.

 

Anxiety during and after pregnancy

Some women can also experience anxiety during and after pregnancy. And this is more likely if you have epilepsy. If you are affected by anxiety during or after pregnancy, please contact your midwife, GP, epilepsy specialist nurse, or epilepsy doctor for advice.

 

Can epilepsy and anxiety be mistaken for each other?

The symptoms of anxiety – particularly panic attacks – can look and feel a lot like the symptoms of some types of epileptic seizure.

This means that both conditions can be misdiagnosed.

A panic attack is a sudden, intense episode of anxiety. These can affect some people with high levels of anxiety. Symptoms of panic attacks include feelings of dread, a fast heartbeat, flushing skin, sweating, nausea, shortness of breath, numbness and dissociation. Panic attacks can feel very frightening and distracting and usually last for between 5 to 20 minutes.

Some people with epilepsy are told they are having panic attacks, when they are actually experiencing seizures. And some people with panic attacks are wrongly diagnosed with epilepsy.

Occasionally, breathing too fast during a panic attack can trigger an epileptic seizure. This can also complicate a diagnosis.

It’s important to get the right diagnosis to make sure you get the right tests and treatment. It can be difficult for doctors to tell the difference between seizures and panic attacks. So, it’s important to seek the advice of an epilepsy specialist.

The diagnosis is made mainly on a description of what happens, rather than the results of tests, such as an MRI or EEG. However, EEG and MRI tests may still be helpful. It can also help to keep a diary of your symptoms to help to discuss these with your epilepsy doctor.

If you believe your symptoms have been misdiagnosed, you could ask your GP to refer you to an epilepsy specialist for a second opinion. You don’t have an automatic right to a second opinion, but you do have the right to ask, and your request should be considered.

 

How is anxiety treated?

Treatment of anxiety in people with epilepsy should always be based on a careful consideration of all potential problems and risk factors.

Counselling

Counselling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues. This can be helpful if your anxiety is related to not knowing when your seizures might happen. Counselling can also help if you feel isolated because of your seizures. Your GP may be able to arrange counselling for you or you can pay privately to see a counsellor.

Cognitive Behavioural Therapy (CBT)

CBT can help you to manage your problems by changing the way you think and behave. It helps you to understand the links between your thoughts, feelings and behaviour. This can help you to manage your problems in a more positive way.

CBT is usually provided by a trained therapist, but psychiatric nurses and social workers may also be able to do this. CBT is also available through online courses. Your GP may be able to arrange for you to do a CBT course through the NHS, or you can pay privately to do one.

You may be able to use the NHS Improving Access to Psychological Therapies service (IAPT) to refer yourself for some talking and CBT therapies in your local area.

Medicines

If you have anxiety and epilepsy, your epilepsy doctor might recommend epilepsy medicines that have an anti-anxiety effect, if they are suitable for your type of seizures. Your GP or a mental health professional may offer the same medicines for anxiety that people without epilepsy use. These include medicines from the following classes:

  • Antidepressants
  • Benzodiazepines
  • Beta-blockers

It is important that you tell your epilepsy doctor or epilepsy nurse that you have been offered this treatment. This is to make sure that your new medicine works well with your epilepsy medicines.

 

How can I help myself?

Living with anxiety can be difficult. But there are things you can do which may help:

Talking about it

This could be with a friend or relative who you trust. Or you may prefer to speak to your GP or someone from a helpline. Epilepsy Action has an advice and information helpline. Some of the organisations below may also have a helpline you could talk to.

If you’re in Wales or Northern Ireland, Epilepsy Action has a counselling service that may be able to help.

Peer support

It can really help to share how you are feeling with people who have similar problems and can understand what you’re going through. Epilepsy Action has some ways of connecting with others affected by epilepsy. And some of the organisations below may know of anxiety specific peer support groups and other useful sources of help.

Complementary treatments

Some people find that complementary treatments can help with reducing stress and managing anxiety. These include things like yoga, relaxation and meditation.

Physical health

Trying to get enough sleep, having a healthy diet and taking regular exercise can all help you to cope with feelings of anxiety.

The NHS has more information about things you can try to help with anxiety.

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Published: October 2021
Last modified: September 2023
To be reviewed: October 2024
Tracking: F154.03
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