Anxiety and seizures share a complex relationship that is often misunderstood. While anxiety itself does not directly cause epilepsy, it can significantly influence seizure activity and manifest in ways that resemble seizures. Understanding these connections is important for individuals seeking clarity on their symptoms or those of others.
The Connection Between Anxiety and Seizures
Chronic stress and anxiety can influence the brain’s excitability, potentially lowering the seizure threshold in individuals predisposed to seizures, making them more susceptible to experiencing a seizure. The body’s stress response system, centered around the hypothalamic-pituitary-adrenal (HPA) axis, is involved. When activated by stress, the HPA axis releases hormones like cortisol, which can impact neuronal function and increase seizure susceptibility.
The balance of neurotransmitters, the brain’s chemical messengers, can also be affected by anxiety. Imbalances in inhibitory neurotransmitters like gamma-aminobutyric acid (GABA) and excitatory neurotransmitters like glutamate can contribute to increased brain excitability. Reduced GABA activity, which normally calms brain signals, is associated with both anxiety and seizures. These physiological changes can make the brain more prone to abnormal electrical discharges.
Understanding Psychogenic Non-Epileptic Seizures (PNES)
Beyond influencing epileptic seizures, anxiety can be a central component in psychogenic non-epileptic seizures (PNES). These events resemble epileptic seizures but do not stem from abnormal electrical activity in the brain. Instead, PNES are considered a physical manifestation of psychological distress, often linked to significant stress, trauma, or underlying anxiety disorders.
PNES episodes are involuntary and a manifestation of psychological distress. They can present with a wide range of symptoms, including convulsive-like movements, changes in awareness, and other behaviors that mimic epileptic seizures.
Differentiating Seizure Types and Anxiety Symptoms
Distinguishing between epileptic seizures, psychogenic non-epileptic seizures (PNES), and severe anxiety or panic attacks can be challenging due to overlapping symptoms. Epileptic seizures typically involve a sudden onset, often with a loss of consciousness, and can include tonic-clonic movements, where the body stiffens and then jerks rhythmically. Following an epileptic seizure, individuals frequently experience a period of confusion or fatigue, known as the post-ictal phase.
PNES, while appearing similar to epileptic seizures, often exhibit certain characteristics that aid in differentiation. These can include asynchronous limb movements (limbs moving out of sync), prolonged duration (sometimes exceeding several minutes), and sometimes preserved consciousness or a fluctuating level of awareness. Unlike epileptic seizures, PNES do not show abnormal electrical brain activity on an EEG.
Panic attacks, a manifestation of intense anxiety, can also mimic seizure symptoms with physical sensations like a pounding heart, sweating, shortness of breath, chest pain, and dizziness. They may also involve a sense of impending doom or fear of losing control. However, panic attacks generally do not involve the complete loss of consciousness typical of many epileptic seizures, and their duration is usually shorter than PNES, often peaking within 10 minutes. Accurate diagnosis, often involving video-EEG monitoring, is important for appropriate treatment.
Strategies for Managing Anxiety and Seizure Risk
Managing anxiety effectively can be an important part of a comprehensive approach to reducing seizure risk, particularly for individuals with epilepsy or PNES. Lifestyle adjustments are a primary component of this strategy. Regular exercise, a balanced diet, and consistent, adequate sleep can significantly contribute to overall well-being and help regulate mood, which may reduce anxiety levels. Stress reduction techniques, such as mindfulness, deep breathing exercises, or meditation, can also help individuals cope with daily stressors and prevent anxiety from escalating.
Therapeutic interventions, such as cognitive behavioral therapy (CBT), have shown effectiveness in managing anxiety and improving outcomes for both epilepsy and PNES. CBT helps individuals identify and challenge negative thought patterns and develop coping mechanisms for stress and fear related to their condition. For some, medication may be considered to address anxiety symptoms, and certain anti-seizure medications can also have beneficial effects on anxiety. Always consulting with healthcare professionals for personalized advice and treatment plans is recommended.