Seizures caused by anxiety

Anxiety and seizures: Here’s what you need to know

February 4, 2022

Lifestyle & Wellness

It is very common for people with epilepsy to experience anxiety. Find out about anxiety and seizures, diagnosis and ideas for coping.

Anxiety is a perfectly normal response to a stressful situation, and it often goes away when the problem has passed. People can sometimes feel excessively anxious - even when there is no obvious danger. This is known as an anxiety disorder.

Anxiety disorders are the most common mental health issue in the USA - almost 20% of Americans experience anxiety problems each year. Anxiety is particularly common for people with epilepsy - four people in 10 with epilepsy have an anxiety disorder.

Here is everything you need to know about anxiety and seizures.

What is an anxiety disorder?

While feeling anxious is perfectly normal during stressful periods, sometimes people can feel anxious most - or even all - of the time. Anxiety disorders can cause many different kinds of symptoms:


  • Constantly feeling worried
  • Tiredness
  • Inability to concentrate
  • Poor sleep
  • Feeling depressed
  • Feeling easily annoyed


  • Fast or irregular heartbeats
  • Dry mouth
  • Sweating
  • Muscle tension
  • Numbness or tingling in fingers or toes
  • Feeling sick or dizzy

Can anxiety cause seizures?

Maybe. If you have been diagnosed with epilepsy, intense feelings of anxiety could become a seizure trigger for you. Anxiety makes you feel stressed, and stress is widely believed to be a major cause of epileptic seizures. 

Learn more: 7 common seizure triggers‍

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Anxiety and seizures: a complex relationship

It is very common for people with epilepsy to experience psychiatric disorders such as anxiety. There are several ways that anxiety and seizures feed into one another, and the exact relationship between the two is not always clear:

  • Anxiety after epilepsy diagnosis: People often feel anxious when they are diagnosed with a new medical condition.
  • Fear of seizures: Seizures are highly stressful – and unpredictable - events. Not knowing when they might ‘strike’ can cause people to worry.
  • Anxiety induced seizures: Feeling highly stressed is generally seen as a trigger for epileptic seizures. Feeling anxious increases stress levels and could therefore induce a seizure.
  • Anxiety after seizures: It is also common for people to feel intense feelings of anxiety in the aftermath of a seizure. This could be because of chemicals released in the brain during the seizure. But it could also be related to social factors (people might feel embarrassed of losing control in front of others).
  • Anti-seizure medication side effects: Some anti-seizure medications can cause people to feel anxious.
  • Epilepsy syndrome and anxiety: Research suggests that people with certain kinds of epilepsy (particularly temporal and frontal lobe epilepsies) are more likely to have anxiety disorders - although anyone can have them.

Panic attack / anxiety or seizure?

A panic attack or anxiety attack is an extreme form of anxiety that causes severe physical reactions. These can include heart palpitations, sweating, trembling and shaking, headaches, dizziness, hot flashes and chills. They are accompanied with a feeling of intense fear.

Many of these symptoms can appear similar to epileptic seizures. However a panic attack is not the same as an epileptic seizure (seizures are caused by unusual electrical discharges in the brain).

If you are unsure if you are having panic attacks / anxiety or seizures it is important to seek medical help.

Related: The difference between epileptic and dissociative seizures

Anxiety and seizures treatment

If you notice that you are feeling highly anxious over a period of two weeks or more and there is no specific cause of the feelings, speak with your doctor. There are various treatments for people with epilepsy who have anxiety disorders, including:

  • Counseling
  • Cognitive Behavioral Therapy
  • Medication

There are also several things you can do to treat yourself. These include talking about your worries with friends and family, going to epilepsy support groups, and using self-calming techniques - such as breathing methods, physical exercise and things like yoga.

Anxiety can feel overwhelming. But remember, it is treatable and with the right support you can overcome these feelings of panic and fear. 

Can Stress Cause Seizures? Understanding the Link

Stress can cause seizures known as psychogenic nonepileptic seizures (PNES). PNES differ from neurological seizures with causes such as epilepsy. Learn about stress’s relationship to PNES, panic attacks, and more.

For most people, feelings of stress are short-lived. For some people, stress can become chronic and greatly affect their quality of life.

Stress can cause a wide range of physical and mental symptoms, which may include psychogenic nonepileptic seizures (PNES). PNES were previously known as pseudoseizures, but that term is now outdated.

In this article, we’ll explain what PNES are, how they differ from neurological seizures, and the connection between stress and PNES.

A seizure is a brief period of uncontrolled electrical activity in the brain. Seizures can provoke a wide variety of changes in the body.

The chronic condition epilepsy causes unpredictable, recurrent seizures.

Epileptic seizures can occur due to a variety of triggers, including increased stress and anxiety. However, the Epilepsy Foundation suggests that it’s hard to know exactly how often stress triggers seizures. This is because stress has different meanings for different people.

Stress and anxiety can also trigger PNES in people without epilepsy. PNES are physiologically different from the neurological seizures found in epilepsy.

PNES aren’t the same as neurological seizures that occur due to uncontrolled activity in the brain. Instead, PNES can be an extreme response to stress and anxiety. Doctors consider them psychiatric in nature.

According to a 2016 literature review, PNES are indicative of a functional neurological disorder (or conversion disorder). This type of disorder occurs when emotional stress causes physical symptoms that can’t be explained by an underlying health condition.

When certain emotions become overwhelming enough, the body may shut down as a defense mechanism. In some people, this can present as PNES.

PNES most often occur in people living with stress, anxiety, personality disorders, or other traumatic emotional conditions.

In addition, anxiety is common in people with PNES (and in people with stress).

Although PNES and neurological seizures may appear similar, there are some differences in symptoms between the two.

PNES symptoms that occur during other seizures

For example, PNES may feature some of the symptoms found in neurological seizures, such as:

  • lowered awareness
  • loss of body control
  • flailing or thrashing
  • head arching
  • tongue biting

A distinguishing feature of PNES is that these symptoms tend to appear more gradually and last longer than in neurological seizures.

Symptoms unique to PNES

In addition to the symptoms above, PNES may also have symptoms that don’t traditionally occur in neurological seizures, such as:

  • side-to-side head movements
  • nonsynchronized body movements
  • muscle contractions
  • closed or fluttering eyes
  • crying during the episode
  • avoidant behaviors
  • memory problems

Stress and mood changes

Stress affects everyone differently. In some cases, chronic stress can lead to rapid changes in your mood.

A 2014 study on different types of psychosocial stress found that it can have a negative effect on mood.

A 2017 literature review concluded that people who experience stress-induced rapid mood changes might be more likely to experience PNES that last over 12 hours.

If you experience both rapid mood changes and PNES, it’s important to mention these when talking with a healthcare professional. This could help them make your diagnosis more precise and prescribe tailored treatment.

Anxiety symptoms can sometimes manifest as a sudden, intense episode called a panic attack.

Panic attack symptoms mimic many of the symptoms you may feel when you’re anxious. You may also notice other severe symptoms, such as:

  • feelings of panic or dread
  • feelings of disconnection from yourself or reality
  • difficulty breathing or swallowing
  • sharp chest pains
  • chills or hot flashes
  • numbness or tingling in the extremities

Panic attacks aren’t a known cause of neurological seizures in people without epilepsy. However, there may be a correlation between panic attacks and PNES.

In one literature review from 2018, researchers analyzed 26 studies for a potential relationship between panic attacks, hyperventilation episodes, and PNES.

According to the results, between 17% and 83% of those who had PNES also reported having accompanying panic attacks. In addition, the researchers found that 30% of people with voluntarily induced hyperventilation also experienced PNES.

While these results seem to suggest that panic attacks and panic attack symptoms may be a trigger for PNES, more research is still necessary.

Panic attacks and PNES can both happen as a result of stress and anxiety. There are differences between the two experiences that distinguish them from each other, though.

Panic attacks feature many, if not all, of the characteristic symptoms of anxiety.

Panic attacks come on suddenly and usually pass within 10 minutes. Many people who have them are still able to retain some level of function during the attack. The severity of symptoms can vary from person to person.

Many people who have PNES also experience panic symptoms, but some don’t. Episodes of PNES may not feature any symptoms of panic or anxiety at all. PNES also tend to come on gradually and last longer than panic attacks.

In some cases, panic attacks can even help a doctor differentiate between PNES and neurological seizures. In a 2014 study, researchers found that panic attack symptoms were more likely to appear in PNES than in epileptic seizures.

If you’ve been experiencing PNES, a doctor will most likely refer you to an inpatient setting for testing.

The following tests are important for building a full picture of why PNES are happening:

  • Video-electroencephalography (vEEG): During your hospital stay, a doctor will connect you to an electroencephalography (EEG) machine and a video monitoring system. The EEG machine tracks electrical activity in the brain, while the video monitoring system records any physical symptoms. vEEG is the most common diagnostic test for PNES.
  • Seizure analysis: To determine the correct diagnosis, a healthcare professional may analyze any seizures that happen during your stay. If you appear to have a seizure but there’s no unusual brain activity, the most likely diagnosis is PNES.
  • CT or MRI imaging: Your doctor may need to request further imaging of the brain with a CT scan or an MRI. They may also want to rule out any other underlying conditions, such as nutrient deficiency or infection.
  • Psychological testing: They may also recommend additional psychological testing to narrow down potential causes or triggers.

Since PNES are often psychological in nature, it’s important to address the underlying causes and triggers. Treatment options for stress-induced PNES may include:

  • psychotherapy
  • medications
  • lifestyle changes


Cognitive behavioral therapy (CBT) is the first-line treatment for anxiety disorders. With CBT, you can learn how to better cope with stressful or anxious thoughts, feelings, and behaviors. This may help lower the frequency of your PNES.

In addition, trauma-focused therapy may be helpful for those who live with both trauma-based disorders and PNES.


Antiepileptic drugs aren’t effective for treating PNES, because the seizures aren’t neurological.

Instead, if you have anxiety, a healthcare professional may prescribe selective serotonin reuptake inhibitors (SSRIs) to help reduce the symptoms of anxiety and lower the number of PNES you have.

A 2017 literature review suggests that SSRIs may be most effective for anxiety when they’re used in conjunction with psychotherapy.

Lifestyle changes

Lifestyle changes can also help to reduce the symptoms of stress and anxiety.

Focusing on the following can further lower your stress and anxiety and greatly improve your quality of life:

  • good sleep
  • a balanced, nutritious diet
  • daily exercise
  • mindfulness practices such as yoga or meditation

You and a doctor can work together to come up with the best treatment approach for your personal situation.

While stress and anxiety are unlikely to trigger neurological seizures in people without epilepsy, they can trigger PNES in individuals with underlying mental health conditions. Since these episodes have a psychiatric origin, addressing the underlying stress and anxiety can help reduce or eliminate these episodes.

If you’re concerned that you’ve been having PNES, reach out to a doctor for an appropriate diagnosis and treatment.

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