The relationship between stress and seizures is well-established, though complex, as stress can trigger two fundamentally different types of events. A seizure is a brief, sudden electrical disturbance in the brain that affects how a person looks or acts for a short time. Stress, defined as the body’s physiological response to any demand or threat, is consistently reported as one of the most common factors that can precipitate these events in susceptible individuals. Managing the body’s reaction to stress has become an important part of comprehensive seizure management.
Stress as a Trigger for Epileptic and Non-Epileptic Events
Stress does not cause epilepsy itself, but for people already diagnosed with the condition, it acts as a powerful trigger that lowers the brain’s natural seizure threshold. The added physiological strain from stress makes abnormal electrical discharges more likely to occur. Controlling stress can help reduce the frequency of true epileptic seizures.
A separate category of events, known as Psychogenic Non-Epileptic Seizures (PNES), are directly linked to psychological distress, trauma, or chronic stress. These events physically resemble epileptic seizures but are not caused by abnormal electrical activity in the brain. PNES is considered a physical manifestation of an underlying psychological disturbance, falling under the category of conversion or somatoform disorders.
Distinguishing between these two types of events is paramount because the treatments are entirely different. The definitive diagnosis uses video electroencephalogram (video-EEG) monitoring. This procedure simultaneously records the patient’s physical behavior on video while measuring the brain’s electrical activity (EEG). A true epileptic seizure shows abnormal electrical discharges on the EEG during the event, while a PNES event shows only normal background activity.
How Stress Affects Brain Chemistry
The body’s response to stress is governed by the Hypothalamic-Pituitary-Adrenal (HPA) axis, which prepares the body for “fight or flight.” HPA axis activation leads to the release of hormones like corticotropin-releasing hormone (CRH) and cortisol. These stress hormones directly influence the brain’s excitability and lower the seizure threshold.
Glucocorticoids, such as cortisol, have proconvulsant actions, meaning they promote seizure activity. They achieve this by altering the balance of neurotransmitters and increasing neuronal excitability. Chronic exposure to these stress hormones can disrupt the function of gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the central nervous system.
Normally, GABA acts to calm the brain, but stress can compromise this inhibitory control. Persistent stress and HPA axis overactivity can alter the expression of ion channels. This change weakens GABA’s ability to inhibit neurons, making them hyperexcitable and increasing the likelihood of an epileptic seizure.
Tools for Identifying Stress as a Seizure Trigger
Identifying stress as a personal seizure trigger requires consistent, detailed observation. The primary tool for this purpose is maintaining a comprehensive seizure diary. The diary should log the date, time, and type of seizure, along with the environmental and emotional context immediately preceding the event.
Crucial information to record includes the perceived stress level using a simple rating scale, the presence of acute stressors like an argument or sudden shock, or signs of chronic stress such as prolonged anxiety or difficulty sleeping. Tracking mood changes, medication adherence, and other common triggers, like sleep deprivation or illness, helps isolate stress as the definitive factor. A pattern must occur consistently to be reliably identified as a trigger.
This information provides a neurologist with objective data to correlate emotional state with seizure frequency. Reviewing the diary helps distinguish between acute stress and chronic, long-term anxiety. Any definitive change in a seizure pattern warrants a consultation with a specialist for professional diagnostic evaluation, potentially including an EEG.
Strategies for Reducing Stress and Seizure Frequency
Proactive management of stress is a tangible way for individuals with epilepsy to reduce their seizure frequency. Non-pharmacological interventions mitigate the physiological effects of HPA axis activation and calm the nervous system. Mind-body techniques are effective because they directly target the body’s stress response.
Practices like deep diaphragmatic breathing, meditation, and progressive muscle relaxation help control stress-induced seizures. Progressive muscle relaxation involves systematically tensing and relaxing different muscle groups, which can significantly reduce seizure occurrence in people with difficult-to-treat epilepsy. Regular physical activity is another impactful lifestyle factor, as moderate exercise helps to lower overall stress levels and improve mood.
Improving sleep hygiene is a foundational strategy, as a lack of quality sleep exacerbates stress and is itself a common seizure trigger. Establishing a consistent sleep routine helps the body recover and reduces vulnerability to high-stress states. Finally, seeking therapeutic support, such as counseling or cognitive strategies, is important for managing underlying psychological distress.