You may notice changes in your mood or stress levels since your seizures began. That’s because living with seizures can affect your mental health as much as it does your physical health. It can shape how you feel, think, and move through your day. Understanding that connection can help you care for yourself better.
“Mental health symptoms can impact your quality of life as much or even more than the seizures themselves,” says Chadrick Lane, MD, assistant professor of psychiatry at the Peter O’Donnell Jr. Brain Institute at the University of Texas Southwestern Medical Center.
Depression and anxiety are the most common mental health issues for those living with epilepsy. You might feel persistently low, lose interest in things you used to enjoy, or feel constantly worried or tense. These symptoms may be reactions to your seizures, or they can be part of the condition itself.
The relationship between seizures and mental health goes both ways. Seizures can affect your mood, and your mental health can influence your seizures. What’s more, some medications for epilepsy, such as the anti-seizure medication phenobarbital, can affect the mood center of your brain, which can increase your risk of depression.
Getting a proper diagnosis and working to manage your mental health with support can improve not only your well-being but your epilepsy, too.
“In a perfect world, every epilepsy center would have a mental health clinician embedded,” says Lane. “Treating mental health is treating epilepsy, and treating epilepsy is treating our mental health because of how intertwined and inseparable the two are.”
The Stress/Seizure Cycle
Even when you’re not having a seizure, thoughts about having one can affect how you live. You might worry about when the next one will happen or avoid certain situations because of them.
Experts call this fear of seizures “anticipatory anxiety.” Studies show it can lead you to withdraw socially or limit your activities. In turn, this can cause feelings of isolation and depression. Over time it can also affect your sleep, relationships, and work or school life.
This creates a cycle where stress lowers your “seizure threshold,” meaning it takes less to trigger a seizure and you become more likely to have one. Then having more seizures can increase your stress and anxiety, and the negative loop goes on.
Signs You May Need Help
It can be hard to tell when everyday stress or low mood crosses over to something more concerning. But there are some patterns to watch for.
Feeling persistently sad, emotionally flat, or hopeless for days or weeks at a time, or losing interest in things you used to enjoy can signal you’re dealing with depression. With anxiety, you might feel constantly on edge or unable to control your worries.
Anxiety may also show up as fear of having seizures in public or concern about losing your independence. Both depression and anxiety can lower your energy and motivation, make you irritated, and cause cognition problems.
“If tough days become multiple days in a row or weeks in a row, that can absolutely be an indication of a clinical depression or mental health condition,” says Lane.
But the good news is there’s help.
“There are treatments and medicines that can be used safely and effectively to treat depression and to treat mental health conditions across the board in people living with epilepsy,” says Lane.
Mental Health Tools
First, talk to your doctor. They help recognize mood patterns and accurately diagnose any issues. They can also refer you to therapists or other specialists or prescribe medications that help stabilize your mood.
Therapy
One of the most powerful medicines available doesn’t come in a bottle, says Lane. Studies have shown that psychotherapy (also called “talk therapy”) with a trained counselor or therapist can have a powerful and positive effect on your mood.
“I don't really think about psychotherapy as a second line or an afterthought treatment,” says Lane. “I think about it as a core first-line treatment for people, and it can have a great deal of benefit.”
Cognitive behavioral therapy (CBT) is based on the idea that your thoughts shape how you feel and act, so changing your thinking can help improve both. Studies show it can help reduce or alleviate depression. Relaxation therapies such as mindfulness can have a positive effect on anxiety and even reduce seizures in some people.
Medication
Anti-anxiety medications and antidepressants are typically safe when you have epilepsy. Your neurologist and a mental health professional can work together with you to choose options that won’t interfere with your epilepsy treatment and vice versa.
Whole-person health
Part of protecting your mental health is making space for the parts of your life that have nothing to do with epilepsy. Lane says that means staying connected to your loved ones and thinking about what really matters to you.
“Three critical ingredients for everybody, and especially people living with epilepsy are people, places, and purpose,” says Lane. “Who makes up your sense of community and gives you a feeling of belonging? Where do you experience purpose and meaning in the world? What brings you joy? Give energy to those things and foster them in a purposeful, structured way.”
When to Seek Urgent Help
In some cases, mental health symptoms can become more serious. Having epilepsy may put you at higher risk for suicidal thoughts, especially if you have untreated depression or anxiety.
If you’re thinking about harming yourself or you’re in other emotional distress, it’s important to get help right away. You can call 911, go to the nearest emergency room, or contact the confidential 988 Suicide & Crisis Lifeline by dialing or texting 988 anytime, night or day.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Chadrick Lane, MD, assistant professor of psychiatry, Clinical Neuroscience Scholar, Peter O’Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center.
Epilepsy Society: “Mental health and epilepsy.”
Focus: “Mood Disorders in Epilepsy.”
Epilepsy Foundation: “Epilepsy and Psychological Disorders,” “Cognitive Therapies.”
UT Southwestern Medical Center: “Prioritizing mental health care in patients with epilepsy.”
