Anxiety and epilepsy

What is anxiety?

Anxiety is a feeling we are all likely to get when we find ourselves in a threatening or difficult situation. And it usually goes away when we get used to the situation, or when it changes. However, anxiety can become a disorder if we begin to feel anxious all the time, or for no obvious reason.

Who develops anxiety?

In any medical condition, people may become anxious after they have been given a diagnosis of their condition. 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

But anxiety is not just purely due to psychological reasons, it can happen:

  • As a result of an epileptic seizure
  • As a side-effect of epilepsy medicine

Anxiety during pregnancy

Women often have depression and anxiety during and after pregnancy. This is more likely if you have epilepsy. If you are affected by anxiety or depression, please contact your midwife, GP, epilepsy specialist nurse, or epilepsy specialist for advice.

What does anxiety feel like?

Anxiety affects different people in different ways, but can include some, or all, of the following:

Mind

Body

Feeling worried all the time

Feeling tired

Not being able to concentrate

Feeling irritable

Sleeping badly

Feeling depressed

Having fast or irregular heartbeats (palpitations)

Sweating

Having a pale face

Having a dry mouth

Having muscle tension and pains

Trembling

Having numbness or tingling in fingers, toes or lips

Breathing fast

Feeling sick

Feeling dizzy

Having stomach problems

Panic attacks

Some people get sudden, intense episodes of anxiety called panic attacks. Symptoms of panic attacks include feelings of fear, nervousness, a fast heartbeat, flushing skin, sweating, deja vu and very fast breathing.

Can epilepsy be mistaken for anxiety?

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. 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, which can also complicate a diagnosis.

It’s important to get the right diagnosis to make sure you get the right treatment and tests. It can be difficult for doctors to tell the difference between seizures and panic attacks. That’s why 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.

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. See Epilepsy Action’s information about getting the right treatment and care for your epilepsy.

What is the treatment for anxiety?

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

Relaxation

Learning relaxation won’t make your problems go away, but can help you feel more in control of your situation. You can use self-help material to teach yourself how to relax, or join a relaxation group.

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. And counselling can help if you feel isolated because of your seizures.

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 family doctor may be able to arrange for you to do a CBT course through the NHS, or you can pay privately to do one.

Medicines

If you have anxiety and epilepsy, your neurologist 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 drugs from the following classes:

  • Antidepressants
  • Benzodiazepines
  • Beta-blockers

It is important that you tell your neurologist or your epilepsy nurse that you have been offered this treatment. This is to make sure that they work well with your epilepsy medicines.

Sources of advice and support for people with anxiety disorders, their families and carers

Anxiety UK -  Tel: 03444 775774

Mind - Tel: 0300 123 3393

No Panic - Tel: 0844 967 4848

OCD Action  -  Tel: 0300 636 5478

OCD UK - Tel: 03332 127 890

Rethink Mental Illness - Tel: 0300 5000 927

If you would like to see this information with references, visit the Advice and Information references section of our website or contact our Epilepsy Action freephone helpline on 0808 800 5050.

Code: 
F154.02

Epilepsy Action is grateful to Dr Marco Mula, consultant in neurology and epileptology, and reader in neurology St George’s University Hospital and St George’s University of London, who has provided much of this information.

Dr Marco Mula has declared no conflict of interest.

This information has been produced under the terms of Epilepsy Action's information quality standards.

  • Updated September 2020
    To be reviewed June 2021

Comments: read the 2 comments or add yours

Comments

I have epilepsy and GAD! I sometimes have a seizure-type-thing on the bus to work, that feels like a panic attack:
When the sun is lower in the sky, especially during early spring, the sun acts like a strobe light driving by the many trees in my city. I sometimes get extreme heart palpitations and dizziness, and then light headedness. I have to then get off the bus, almost fainting. I once puked after getting off the bus in between stops. I feel certain it was seizure activity.

However, I have also had panic attacks with the same symptoms. Yesterday I had a panic attack out of the blue on a happy day. My symptoms were depersonalization, dizziness, heart palpitations, numbness in my hands and feet, and a short lived feeling of dread (like 30 seconds). No seizure-y feelings. Honestly no thoughts of anxiety either. After the panic attack (the tingling hands and feet and heart palpitations lingered for about half an hour), I was good to go and in a good mood. This was only my third panic attack in my life, not including my bus rides.

I am by no means a doctor or very knowledgeable in this subject, but thought I'd share my experience on the subjects.

Thanks!

Submitted by S

Hi there – thanks for sharing this. These both sound difficult symptoms to manage. Epilepsy and anxiety can happen together and can have very similar symptoms. But as you mentioned there are some differences. You might build up knowledge of what happens for you but if you aren’t sure sometimes keeping a diary can help.

Mags

Epilepsy Action Helpline Team

Submitted by Mags - Epilepsy...

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