Epilepsy and Mental Health: What You Can Do for Depression, Anxiety and Stress

Connecting epilepsy to mental health

People with epilepsy tend to experience mental health challenges more often than the general population, for any number of reasons. For example, researchers think it’s possible the same changes in brain development that cause epilepsy may also lead to mental health symptoms.

We also know that a seizure can leave you feeling exhausted. Seizures disrupt sleep and interfere with areas of the brain tied to emotions.

Seizure medications can impact mental health with their side effects, too. Some may actually improve mood. But other medications may cause fatigue. They can also increase anxiety, depression, and irritability. Occasionally, some drugs lead to psychotic behavior — intense changes in thoughts and perception.

On top of these factors, living with epilepsy is stressful, particularly when medications don’t control seizures. All told, epilepsy and mental health is a complicated mix, but one that effective seizure management and the right support can address.

Feeling depressed from epilepsy challenges

In addition to possible treatment side effects and the physical aftermath of seizures, life can change in many ways with epilepsy. Anywhere from 25% to 50% of people with epilepsy experience depression — a lingering sense of sadness and loss of interest in daily life.

You might have to leave school or work. You might lose your independence, no longer able to live alone or drive. And you might worry what others think or start to feel isolated. In short, you experience a change not only in relationships, but in sense of self.

“I felt really frustrated,” says Heather from North Carolina, who had to give up her driver’s license and leave college when her seizures grew worse. “Between the stress and high doses of medications, I ended up gaining weight and struggling with depression, insecurity, and anger issues.”

Experiencing fear and anxiety with epilepsy

At least 25% of people with epilepsy experience ongoing anxiety — fears and worries that don’t go away. You might fear:

• Certain situations, activities, or behaviors — seizure triggers — that could set off an attack
• Embarrassment in social settings
• Having a seizure alone or in public
• SUDEP, sudden unexpected death in epilepsy

In a study published in Epilepsy Research, half of participants said the worst part of the condition was fear. For Josh in Texas, it came from the prospect of holding his nieces when they were babies, should he suddenly have a seizure. A passionate fisherman, he wouldn’t cast from shore by himself, let alone go out in a boat. Being so close to the water reminded him of a friend who experienced a seizure in her bathtub and drowned.

With no help nearby, “I was worried that I might have a seizure and tumble face-first into the water,” Josh says.

Managing stress while seeking seizure relief

Stress poses another mental health burden when you have drug-resistant epilepsy — seizures that at least two medications fail to control. Studies show that adding a third medication rarely works, but many people still try.

Just like Florida native Ouida, who lost nearly half of the year — up to 150 days — to seizures, the perceived lack of options — and the struggle to find effective treatment — can cause stress. So can worrying about when your next seizure may come, especially when they are frequent.

“It interferes with your productivity and quality of life,” she says.

Improving mental health when living with epilepsy

Like others with mental health needs, people with epilepsy can seek counseling or techniques to reduce stress, such as meditation. Doctors can also prescribe medications for anxiety or depression. Don’t be afraid to ask for help.

Should seizure medications cause side effects, you can work with your doctor to potentially lower your dose or try another drug option. But many people find there are limits — other drugs may introduce new side effects, and seizures may stay uncontrolled or worsen.

Neuromodulation devices, such as the RNS System, provide another option when medications aren’t providing enough relief. At three years, responsive neurostimulation reduces seizures on average by more than 80%. And 1 in 5 people were seizure-free at their last checkup.¹

Other RNS benefits include fewer worries about seizures² and a lower SUDEP risk³. People using the therapy report improved emotional well-being and increased energy². While many people continue to take medication, some reduce the number or the doses, for fewer side effects.

Since starting therapy with the RNS System, Heather, Josh and Ouida say they’ve regained confidence and independence. Heather reclaimed her license and planned to go back to school. Josh became a father. And Ouida has seen her seizures greatly reduced.

“My life is so much better now,” Heather says.

1. Razavi, et al. Epilepsia. 2020.
2. Meador, et al. Epilepsy Behav. 2015
3. Nair, et al. Neurology 2020.