Getting mental health support
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How could talking therapies help with epilepsy?
Mental health problems like anxiety and depression are common in people with epilepsy. This can affect general wellbeing and may worsen your epilepsy too. Psychological or ‘talking’ therapies may help to improve mental health if you have epilepsy. It’s possible they may also help you to manage your epilepsy better.
Some types of therapy are focused on listening and helping you to work through your problems. Others are about developing your skills in coping with difficult situations.
What types of talking therapies are there?
Below we list some examples of psychological therapies that may be helpful if you have epilepsy. But many others are also available. You may be offered therapy sessions on your own or in a group. These might be face-to-face, over the phone, or online. There are also online courses available for different types of therapy.
Not all psychological therapies are suitable for everyone, so talk to your GP or specialist about which one might work best for you. You may find that therapy brings up some difficult feelings. Talk to the therapist if this affects you.
At the end of the page, we explain how to access mental health services, and provide some links to help you find a therapist.
Epilepsy and your wellbeing
Learn how you can improve your wellbeing and manage the impact of epilepsy in your life.
Counselling
Counselling allows you to talk about your problems and feelings privately. A trained counsellor listens to you and can help you find ways to manage any difficulties you’re having.
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.
Some studies have shown that CBT may improve wellbeing in people with epilepsy. However, its effect on depression and anxiety symptoms tend to be small, and not everyone with epilepsy finds it helpful. It’s still usually the first type of talking therapy you’ll be offered if you have epilepsy and mild symptoms of depression. Talk to your therapist about the risks and benefits of the therapy, and let them know if you don’t feel it’s working for you.
Mindfulness-based therapies
Mindfulness is a type of CBT. It is about paying attention to the present moment. It involves being aware of your thoughts, feelings and body sensations, and calmly accepting them.
Mindfulness-based therapies include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-based Cognitive Therapy (MBCT), which combines elements of mindfulness with CBT. They can include techniques such as meditation, breathing and yoga to try and break negative thought patterns.
Research suggests mindfulness therapy may be helpful for people with depression and epilepsy. But more research is needed in larger groups of people with epilepsy to confirm how well it works.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) is a different form of CBT that aims to help you accept negative feelings or challenges you have. This could be about living with seizures or lifestyle changes as a result of having epilepsy. There is some research that it may be helpful in improving wellbeing for people with epilepsy.
Accessing mental health services
Your doctor should ask about your mental health when you’re first diagnosed with epilepsy, and at your review appointments. They may use screening questionnaires to assess you. You can also contact your GP or specialist doctor if you have symptoms of depression or anxiety, and you are not due a check-up.
If you are having problems with mental health and need some support, your GP or specialist may arrange for you to have therapy. This will usually be a CBT-based therapy. Whether or not you can have mindfulness-based therapy or ACT through the NHS will depend on if it is offered in your area.
In some areas of England it may be possible to refer yourself to an NHS talking therapies service without asking your GP or specialist. Ideally, it’s best to see someone who has knowledge of mental health problems in people with epilepsy. But this isn’t always possible.
You can also pay for a private counsellor or therapist. Use the links below to find a qualified mental health professional. You can often search for a therapist offering specific types of therapy, such as CBT, mindfulness or ACT.
Where to find mental health support
Some examples of places to look for mental health services and trained practitioners are listed below.
- NHS talking therapy services (self-referral)
- The Counselling Directory
- British Association for Counselling and Psychotherapy
- British Association for Mindfulness-Based Approaches
- Hub of Hope
- UK Council for Psychotherapy
- The Black, African and Asian Therapy Network
- Epilepsy Action has free counselling services available for those living in Wales and Northern Ireland.
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Sources
Michaelis, R. et al. (2020) ‘Psychological treatments for people with epilepsy’, Cochrane Database of Systematic Reviews, 8(8). Available at: https://doi.org/10.1002/14651858.cd012081.pub3
Mula, M. et al. (2021) ‘ILAE clinical practice recommendations for the medical treatment of depression in adults with epilepsy’, Epilepsia, 63(2), pp. 316–334. Available at: https://doi.org/10.1111/epi.17140
Counselling Directory (n.d). What is counselling? Available at: https://www.counselling-directory.org.uk/what-is-counselling.html (Accessed 19 October 2023)
Makris, T. and Dorstyn, D.S. (2022) ‘Third-wave psychotherapies to promote mental health in epilepsy: An updated systematic review’, Epilepsy & Behavior, 134, p. 108766. Available at: https://doi.org/10.1016/j.yebeh.2022.108766
Mind (2021). Cognitive behavioural therapy (CBT). https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/ (Accessed 19 October 2023)
NHS (2022). Types of talking therapy. Available at: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/types-of-talking-therapies (Accessed 19 October 2023)
Noble, A.J. et al. (2018) ‘Cognitive-behavioural therapy does not meaningfully reduce depression in most people with epilepsy: a systematic review of clinically reliable improvement’, Journal of Neurology, Neurosurgery & Psychiatry, 89(11), pp. 1129–1137. Available at: https://doi.org/10.1136/jnnp-2018-317997
NICE (2022). Epilepsies in children, young people and adults. 9 Psychological, neurobehavioural, cognitive and developmental comorbidities in epilepsy. Available at: https://www.nice.org.uk/guidance/ng217/chapter/9-Psychological-neurobehavioural-cognitive-and-developmental-comorbidities-in-epilepsy (Accessed: 19 October 2023)
SIGN (2018). Diagnosis and management of epilepsy in adults. SIGN 143. Available at: https://www.sign.ac.uk/media/1079/sign143_2018.pdf (Accessed: 19 October 2023)
NICE (2009). Depression in adults with a chronic physical health problem: recognition and management. 1.4 Step 2: recognised depression in primary care and general hospital settings – persistent subthreshold depressive symptoms or mild to moderate depression. Available at: https://www.nice.org.uk/guidance/cg91/chapter/Recommendations#step-1-recognition-assessment-and-initial-management-in-primary-care-and-general-hospital (Accessed: 19 October 2023)
Got any questions?
Our expert advisors can help you with any questions you might have about mental health or anything else related to living with epilepsy.
