A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. Having a seizure may be a one-time event, or you might have recurrent seizures over time.
Many factors can affect your brain and contribute to seizures, including genetics, brain injuries or disorders, chemical imbalances, problems with brain development and blood vessel abnormalities in the brain.
Seizures are very common — about 4% of people worldwide have had a seizure. Up to 10% of people will have a seizure sometime during their life.
Seizures often last from a few seconds to a few minutes. In some cases, a seizure may last longer or progress into a continuous seizure state.
Most seizures end naturally and don’t require treatment. Some may require emergency care.
Seizures can affect your thinking and behavior in many ways, both during and after a seizure. Here are some quick answers about the mental changes that can occur with seizures:
– Seizures can temporarily affect your awareness, emotions, memory, and movements.
– You may feel confused, fearful, detached, or euphoric during or after a seizure.
– Most seizure-related mental changes resolve once the seizure ends, but some may persist.
– Having a seizure raises your risk of later developing depression, anxiety, sleep disturbances, and memory deficits.
– The more severe and frequent your seizures, the higher your risk of long-term mental changes.
– Anti-seizure medications also contribute to mental side effects like fatigue, mood changes, and memory problems.
– Counseling, behavioral therapy, SSD/SSI, and joining a support group can help manage mental health after seizures.
In this article, we’ll explore in more detail how seizures can influence your mental health, behavior, cognition, and quality of life. We’ll also provide tips for managing common psychological challenges after seizures.
Altered awareness and consciousness
During a seizure, you may have changes in your awareness or level of consciousness. Here are some common alterations:
– Feeling detached or disconnected from yourself or your surroundings. This is called dissociation.
– Confusion about time, place, or identity. You may not know where you are or what’s happening.
– Loss of awareness with staring, unresponsiveness to stimuli, and amnesia of the event afterward. This can occur with complex partial or absence seizures.
– Impaired consciousness or passing out, which can happen with generalized tonic-clonic seizures.
These awareness changes are temporary and typically improve once the seizure activity stops. But having frequent seizures with altered awareness can take a toll on your daily functioning and quality of life.
Dissociation
Up to 65% of people with epilepsy report feeling detached from themselves, others, or their surroundings before, during, or after seizures. This dissociative experience is sometimes described as:
– Feeling detached from one’s body, thoughts, or emotions
– Feeling disengaged from people and activities
– Having a vague sense of unreality, as if you’re in a dream-like state
– Having difficulty relating to yourself or your environment
Dissociation appears linked to the abnormal electrical bursts during a seizure, especially in the brain’s frontal lobe regions.
People with temporal lobe epilepsy seem especially prone to chronic dissociative symptoms between seizures. This may relate to temporal lobe influences on emotion, memory, and perceptions.
Confusion
Many people emerge from a seizure feeling confused about:
– Where they are or how they got there
– What time it is or what day it is
– What they were just doing before the seizure
– Details about themselves or other people
This post-seizure confusion and amnesia tends to resolve as the brain recovers. But it can be frightening and emotionally disturbing in the moment.
Some people even wander off in a confused daze after a seizure, which is called a post-ictal fugue state. Advice includes keeping seizure diaries and medical ID bracelets to help orient you after a seizure.
Loss of responsiveness
Some seizures involve total loss of awareness without losing muscle control. This is called absence status epilepticus.
Generalized or focal impaired awareness seizures may involve:
– Staring blankly into space
– Not responding to questions or prompts
– Performing meaningless, automatic movements like rubbing clothes or smacking lips
– Being very confused and unable to interact afterward
Impaired awareness seizures can lead to brief pauses in speech, activity, driving, or social interactions. They disrupt your ability to properly perceive your environment and respond.
Loss of consciousness
Generalized tonic-clonic seizures usually cause loss of consciousness due to intense electrical signals spreading across the brain.
Characteristics of loss of consciousness with seizures include:
– Collapsing and falling down suddenly
– Having rigid muscle contractions (tonic phase)
– Having jerking arm and leg movements (clonic phase)
– Being unarousable and non-responsive during the seizure
– Feeling tired and sleepy after regaining consciousness
Loss of consciousness raises the risk of physical injury during seizures. It also impairs your ability to sense and protect yourself from harm.
Mood and emotional changes
Seizures involve sudden, intense bursts of electrical activity that can abruptly alter your mental state. As a result, many people with epilepsy experience mood and emotional changes during or after seizures.
Common mood changes
– Feeling anxious, fearful, or panicked before or during a seizure
– Experiencing euphoria, laughter, or giddiness during or after some seizures
– Feeling depressed, sad, irritable, or frustrated after seizures
– Having rapid mood swings or mood lability associated with seizures
– Developing depression due to the challenges of living with epilepsy
Emotional reactions
Seizures can also provoke or amplify various emotional reactions such as:
– Embarrassment or shame over having a seizure in public
– Frustration over losing control during a seizure
– Fear about having another seizure
– Anxiety over how seizures impact your life
– Anger about activity restrictions or side effects from medications
– Feeling distressed, upset, or traumatized by seeing video of your seizures
Contributing factors
Both seizures and anti-seizure drugs can affect neurotransmitters linked with mood, like serotonin and dopamine. Seizures in certain brain regions like the temporal and frontal lobes also seem tied to emotional symptoms.
Psychosocial factors like adjustment challenges, social stigma, uncertainty about the future, and reduced quality of life contribute to mood issues too.
Managing mood changes typically involves medication adjustments, therapy, developing coping strategies, and joining support groups.
Memory and cognitive changes
Seizures can also temporarily disrupt your thinking, memory, and cognition in various ways.
Memory loss
You may experience:
– Losing memories from right before, during or after a seizure
– Having trouble learning and recalling new information after a seizure
– Having seizures interrupt your ability to form or retain memories
– Noticing slowly worsening memory over time if seizures persist
This can happen with any seizure type, but complex partial seizures focused on the temporal lobes especially impair memory functions.
Cognitive deficits
Other cognitive problems associated with seizures include:
– Shortened attention span and concentration difficulties
– Impaired thinking, judgment, or problem-solving
– Reduced processing speed for mental tasks
– Trouble finding words or expressing thoughts (aphasia)
– Declines in overall intelligence and cognition over time
Studies show 20-50% of people with chronic uncontrolled seizures have cognitive impairments between seizures. This relates partly to the cumulative effects of repeated seizure activity interfering with normal brain functioning.
Learning disabilities
– Children with epilepsy are more prone to delays in language, reading, writing, and mathematics.
– Seizures during key learning periods can impair developmental processes.
– Attention deficit disorders also commonly co-occur with childhood epilepsy.
Identifying and addressing learning issues early is key to proper academic support and growth.
Contributing factors
Both repeated seizures and anti-seizure medications can impair cognition. Early onset of seizures causes greater cognitive impact. Frequent generalized tonic-clonic and complex partial seizures, multiple anti-epileptic drugs, and enduring uncontrolled seizures increase cognitive side effects.
| Seizure-Related Cognitive Impairment | Contributing Factors |
|---|---|
| Memory loss | Seizure activity in memory centers like the temporal lobes; Post-seizure confusion and amnesia |
| Attention and concentration problems | Disruption of frontal-subcortical brain networks |
| Reduced mental processing speed | White matter damage affecting brain connectivity |
| Language deficits | Seizures affecting language dominant hemisphere |
| Impaired learning | Seizure interference during development; Associated attention deficits |
Behavioral and personality changes
Seizures can also influence your behavior, energy levels, and personality over time.
Common behavioral changes
Seizure-related brain activity may transiently provoke unusual behaviors like:
– Random purposeless movements
– Laughing, screaming, crying
– Lip smacking, chewing, swallowing motions
-pulling at clothes or fidgeting gestures
– Nonsensical speech
You usually won’t remember displaying seizure-related behaviors afterward.
Personality changes
Some people with recurrent seizures experience gradual personality changes like:
– Becoming more irritable, angry, or impulsive
– Increased anxiety, tension, or restlessness
– Acting more reckless, aggressive, or disinhibited
– Developing paranoia or obsessive traits
– Becoming more withdrawn and apathetic
This tends to relate to cumulative effects of seizures on the frontal lobes and limbic system, which govern personality and behavior.
Post-seizure lethargy
After having a major seizure with loss of consciousness, you’ll likely feel exhausted, sleepy, and mentally foggy for a period of time. This post-seizure lethargy and fatigue can last hours to days before you feel like your normal self again.
Getting adequate rest afterward is key. Some people even prefer to sleep for several hours after a large seizure.
SUDEP
Sudden unexpected death in epilepsy (SUDEP) is a rare but devastating complication in which uncontrolled seizures can sometimes prove fatal. Having generalized tonic-clonic seizures is a major risk factor for SUDEP.
Exact causes of SUDEP are unclear, but research suggests seizures may disrupt breathing, heart rhythms, or brain mechanisms that control vital functions. SUDEP remains difficult to predict.
Psychological health concerns
Living with recurrent seizures understandably takes a toll on mental health and quality of life. Many people with epilepsy confront psychological challenges like:
Anxiety and depression
– Up to 60% of people with epilepsy struggle with anxiety.
– About 30-50% experience clinical depression.
– Fear and uncertainty about seizures fuels anxiety.
– Depression often relates to reduced quality of life and low self-esteem.
– Stigma, discrimination, and relationship impacts also contribute.
Social isolation
Some people withdraw socially out of embarrassment, low confidence, driving restrictions, medication effects, or fears about having a seizure in public. This social isolation worsens mood problems and quality of life.
Low self-esteem
Difficulty working and driving, cognitive problems, and feeling dependent on others can hurt your self-image and confidence. Support groups help counteract this.
Sleep disorders
– Sleep is disrupted by nighttime seizures, anti-seizure medications, anxiety, and underlying brain pathology.
– Excessive daytime sleepiness affects up to 62% of people with epilepsy.
– Addressing sleep hygiene, reducing medications if possible, and treating sleep apnea may help.
Suicidal thoughts
About 11-22% of people with epilepsy experience suicidal thoughts. Risk factors include depression, drug side effects, uncontrolled seizures, and recent life stresses. Strong social support and mental health treatment are protective.
Counseling and support
Getting professional counseling to navigate psychological aspects of epilepsy is critical. Joining epilepsy support groups also provides invaluable coping assistance, resources, and reassurance you’re not alone.
Tips for managing mental health with seizures
Here are some proactive steps for safeguarding your brain health and emotional wellbeing with epilepsy:
– Take medications consistently to optimize seizure control
– Get adequate sleep and manage stress
– Avoid drug and alcohol use which lowers seizure threshold
– Track your seizure triggers to identify patterns
– Wear a medical alert bracelet to aid others if you have a seizure
– Have regular neurology visits to check seizure frequency and medication needs
– See a therapist to discuss emotional aspects of coping with seizures
– Join local and online epilepsy support communities
– Educate friends and family about how to respond if you have a seizure
– Focus on a healthy lifestyle with regular exercise
– Maintain work, social, and recreational activities you enjoy
– Make home adaptations like installing seizure sensors on beds or bath mats
– Consider brain stimulation or dietary therapies (ketogenic diet, CBD oil) if medications fail.
– Practice mindfulness, meditation, journaling, or creative arts to ease stress
– If needed, ask your doctor about anti-anxiety or anti-depressant medications
Conclusion
Seizures can profoundly impact your thinking, emotions, behaviors, and psychological health. But being proactive will help you minimize the mental health effects of seizures and maintain an optimal quality of life. Connect with your healthcare providers, support groups, and loved ones to develop effective coping strategies together.
With proper treatment and lifestyle adjustments, most people with epilepsy can thrive despite living with seizures. Arm yourself with education, support, and self-care techniques for navigating both the physical and mental aspects of epilepsy.
