If you’re experiencing a connection between your anxiety and what feels like seizures, you’re not alone. The relationship between anxiety disorders and seizures is more common and complex than many people realize. It can be incredibly frightening and confusing when symptoms of a panic attack mimic those of a seizure, or when anxiety seems to trigger an episode. This article will break down this complex topic, offering clarity, actionable advice, and a comprehensive overview of the different ways these two conditions can intersect.
The Different Connections Between Anxiety and Seizures
The link between anxiety and seizure-like events isn’t a single phenomenon. There are several distinct ways these two conditions can be related, each with its own underlying cause and treatment path. Understanding which category you fall into is the first step toward finding relief.
1. Anxiety as a Seizure Trigger
For individuals diagnosed with epilepsy, anxiety and stress are widely recognized as potential seizure triggers. When you experience chronic anxiety or a sudden, intense bout of panic, your body releases stress hormones like cortisol. This can alter brain activity and lower the seizure threshold, making it more likely for an epileptic seizure to occur. The link is often a vicious cycle: the fear of having a seizure causes anxiety, which in turn can trigger a seizure, creating even more anxiety.
2. Seizure Symptoms Mimicking Anxiety or Panic Attacks
This is one of the most confusing aspects of the relationship. Some types of epileptic seizures—especially focal seizures originating in the temporal lobe—can present with symptoms that look and feel exactly like a panic attack. These “ictal” symptoms can include:
- Sudden, overwhelming feelings of fear or dread
- Racing heart (palpitations)
- Sweating and trembling
- Numbness or tingling sensations
- A feeling of “déjà vu” or unreality
The key difference is duration. An ictal panic-like episode usually lasts for only a minute or two, whereas a panic attack can last anywhere from 5 to 20 minutes or longer. A careful diagnosis is crucial to distinguish between the two.
3. Psychogenic Nonepileptic Seizures (PNES)
This is a critical distinction that many people don’t know about. PNES (previously known as “pseudoseizures”) are events that look like epileptic seizures but are not caused by abnormal electrical activity in the brain. Instead, they are a physical manifestation of severe psychological distress, such as an anxiety disorder, PTSD, or a past trauma.
Unlike epileptic seizures, which often have a predictable, short duration and stereotyped movements, PNES episodes can vary in length and may involve:
- Side-to-side head movements
- Non-synchronized, thrashing body movements
- Eyes that are closed or fluttering
- Crying or emotional outbursts during the event
Because PNES are a neurological manifestation of a psychological issue, they require a different treatment approach than epilepsy.
4. Anxiety as a Comorbidity of Epilepsy
Anxiety disorders are significantly more common in people with epilepsy than in the general population. This can be for several reasons:
- The diagnosis itself: The fear of unpredictable seizures can lead to social anxiety, agoraphobia, or a general feeling of helplessness.
- Brain chemistry: The same brain regions and neurochemical pathways involved in epilepsy (e.g., the limbic system, amygdala) also play a central role in regulating mood and anxiety.
- Medication side effects: Some anti-seizure medications can have mood-altering side effects that can increase feelings of anxiety or depression.
How to Tell the Difference: Seizure vs. Anxiety Attack
Differentiating a true epileptic seizure from an anxiety or panic attack can be challenging, but it’s essential for getting the right treatment. Here are some key factors to consider:
- Timing: Seizures typically have a very sudden onset and are often much shorter in duration (seconds to a couple of minutes). Panic attacks usually build in intensity over several minutes.
- Consciousness: During an epileptic seizure, a person may lose consciousness or awareness and be unable to respond to you. During a panic attack, the person usually remains aware and interactive.
- Movements: While both can involve shaking, an epileptic seizure often has rhythmic, repetitive movements. PNES, on the other hand, might have more random, thrashing, or “non-stereotyped” movements.
- Aftermath: After an epileptic seizure, a person is often confused, sleepy, or disoriented (known as the postictal state). After a panic attack, the person may feel exhausted but quickly returns to normal mental clarity.
Effective Management and Treatment Strategies
The good news is that no matter what the connection is for you, there are effective ways to manage both anxiety and seizures. The best approach often involves a team of specialists.
For Anxiety as a Seizure Trigger
If you have epilepsy and anxiety is a key trigger, the focus should be on both seizure control and managing your emotional state. Consider:
- Seizure Management: Work with your neurologist to find the right combination of anti-seizure medications (ASMs) to achieve maximum control.
- Therapy: Cognitive Behavioral Therapy (CBT) is highly effective for managing anxiety. It helps you identify and reframe negative thought patterns and develop coping skills.
- Mindfulness & Relaxation: Practices like meditation, deep breathing exercises, and yoga can help calm the nervous system and reduce stress hormones.
For PNES and Anxiety-Related Episodes
If your episodes are diagnosed as PNES, the primary treatment is not anti-seizure medication but rather psychotherapy. This is because the underlying issue is psychological, not neurological. A psychologist or psychiatrist who specializes in functional neurological disorders can help you process and cope with the emotional distress that is manifesting physically.
When to See a Doctor
If you are experiencing any seizure-like symptoms or intense panic, it is crucial to consult a medical professional. An accurate diagnosis is the most important step. A neurologist can use diagnostic tools like an EEG (electroencephalogram) to measure brain activity during an episode, which can definitively determine if the event is epileptic in nature. A mental health professional can then work with you to address any underlying anxiety disorder.
The link between anxiety disorder and seizures is complex, but with the right knowledge and a professional medical team, it is a manageable condition. By understanding the specific way your body responds and seeking the appropriate help, you can break the cycle and regain control of your life.
