Survey after survey of people with epilepsy indicates that stress is one of the most common seizure triggers. Most people think of stress as being related only to unpleasant or sad times in their lives. However, even “happy” stress can trigger seizures.

Doctors are not sure why stress makes seizures more likely to happen in some people with epilepsy. Some possible reasons include:

• Stress may cause you to miss your medication, leading to an increase in seizures.
• Stress can cause hormonal changes that may influence seizure activity.
• Negative emotions related to stress, such as worry or fright, may cause seizures. This may happen because the limbic system, the portion of the brain that regulates emotion, is one of the most common places for seizures to begin.
• Stress can interfere with sleep, or sleep can be a symptom of stress. As a result, people who are under a lot of stress may get sleep deprived, which can also be a trigger to seizures!

Sometimes, seizures occur immediately after a sudden and very stressful event. Other times, there might be a delay of hours or days. There are some people who have seizures when there is a release from stress that had been present for a long time. For example, these individuals might have a seizure on a Saturday or Sunday after a particularly stressful week.

Of course, avoiding stressful situations would be helpful. But if it’s not possible to modify your lifestyle to remove the source of your stress, then you should consider learning relaxation techniques or take yoga or tai chi classes. Also, make an extra effort to get enough sleep and to take your seizure medicine on time.

If you have a child with epilepsy, you should know that stress can also be a problem for children. Sometimes it can be a factor in seizures that are difficult to control for unexplained reasons. As a parent, you should try to recognize what is stressful to your child. Perhaps you can work out a plan with your child that reduces the stress but also encourages him or her to remain active. If the stress is serious, it may be helpful to talk to a mental health professional.

Tips to manage stress

• Look at what causes 'stress' for you.
• Keep a journal to write down how you feel when the stressor occurs.
• Talk to a counselor about ways to manage the stress. Consider exercise, reading, listening to music, relaxation exercises, yoga, writing in a journal, talking to friends, or going to a movie. Different things help different people and it's a good idea to find a few different things that help you.  That way if one thing doesn't work, there's always something else to try!
•  Look at your daily schedule and when the stress occurs. If stress is highest in the evening, then consider a way to manage the stress before bedtime! If worries from stress are interfering with sleep, make sure to talk to your doctor about what to do next.
• Note in your seizure calendars when stressful events occur, and what you used to deal with it. This will help you track what works, and what doesn't.

Topic Editor: Steven C. Schachter, MD and Patricia O. Shafer, RN, MN.
Last Reviewed:9/30/08