What is Anxiety and Depression?
Worry, fear and panic are words that are often used to describe anxiety. While low mood, unhappiness and sadness are words that describe depression. Symptoms of anxiety and low mood are normal human experiences that affect everyone from time to time. But, when these symptoms become too severe or occur too often, they can start to have a big impact on our emotional and physical wellbeing.
Anxiety usually occurs when we fear the consequences of certain events, situations or symptoms and when we have concerns about being able to manage or cope with the consequences of those situations, events or symptoms. For example, people with epilepsy often have anxiety about public seizures and losing control and being embarrassed, which is understandable. But, for some this anxiety can become severe and lead people to avoid going out in public or leaving the house altogether.
Low mood or depression usually occurs in response to significant challenges and losses and when we find it hard to get enjoyment or pleasure out of things. For example, people with epilepsy often face challenges to their independence (e.g., loss of driving license) and maintaining employment as well as difficulties with their memory. These challenges, if unmanaged, can increase the risk of people experiencing low mood and sadness.
The symptoms of anxiety and depression can classified into one of three types:
|Physical Symptoms||Behavioural Symptoms||Thought Symptoms|
|Anxiety||Muscle tension, panic attacks (racing heart, hyperventilation, shaking, upset stomach).||Avoidance and procrastination.||Excessive worries and fears of things going wrong and not being able to cope.|
|Depression||Tiredness, changes in sleep and appetite, reduced sexual interest, walking or moving more slowly.||Irritability and avoidance of people and places, things you used to enjoy doing.||Excessive self-criticism and negative thoughts about yourself and the future.|
Anxiety and depression not only affect the way people feel about themselves and their future, but can negatively impact their relationships, physical health, quality of life and ability to self-manage epilepsy. As such, it’s common and understandable for people with epilepsy to seek information and support about managing these symptoms.
Why do people with epilepsy get anxiety and depression?
Anxiety and depression are very common in our community and affect about 20% of Australians every year. We know that anxiety and depression are more common in people with chronic health conditions, like epilepsy, and as many as 1 in 2 people will experience anxiety or depression at some point in their lives. Research also indicates that more than 50% of people who experience anxiety and depression will experience both anxiety and depression together.
It is generally accepted that the development of anxiety and depression is influenced by a whole range of things, including biological factors, medications, available social supports and the use of coping skills:
- Biological: Some scientists believe that depression and epilepsy share common brain pathways that mean people with epilepsy are at greater risk of depression and vice versa. Possibly reflecting this, some people also experience increased low mood and anxiety before, during and after seizures.
- Medications: There is some evidence that the antiepileptic medications, prescribed for some people with epilepsy, can also affect people’s mood.
- Social: Research indicates that people who have good social support from family, friends and their community, and who stay as active socially as they can often, do best.
- Coping: Lots of research shows that how we think and what we do can have a very big impact on whether we experience anxiety and low mood, especially when we have a chronic health condition. For example, people who try to cope and maintain the different areas of their life as much as possible, despite epilepsy, often do best.
The Management of Depression and Anxiety in PWE
Unfortunately, some people believe depression and anxiety are an inevitable consequence of living with epilepsy. The good news is that this is incorrect and that both depression and anxiety can be treated. The two most common types of treatment include:
- Medication: People with epilepsy are sometimes prescribed antidepressant or anti-anxiety medications by a medical professional (e.g. GP, neurologist, psychiatrist).
- Psychological Treatments: Psychological treatments are usually provided by psychologists and involve learning good information about emotional wellbeing and practical, proven, skills for managing anxiety and low mood when one has a chronic medical condition.
It is common for people with epilepsy to be unsure when it might be appropriate to seek treatment for symptoms of depression and anxiety. This decision usually depends on how severe the symptoms are and how much they affect one’s day-to-day life.
If you are interested in a brief online assessment designed to measure the presence and severity of recent symptoms of anxiety and depression you are welcome to visit this link, which will take you to the e-CentreClinic online assessment. These brief measures are confidential and no-one else will see or receive your results.
Importantly, while these measures can provide good general information about your symptoms, only a health professional can properly assess your symptoms and make a diagnosis. So, if you are concerned about your symptoms or emotional wellbeing, please consult your GP or a health professional as soon as possible.
If you are feeling suicidal or in crisis, please act immediately by contacting:
- Lifeline on 13 11 14
- Suicide Callback Service on 1300 659 467
- Emergency services on 000.
Epilepsy Action Australia and the eCentreClinic at Macquarie University Australia are working towards improving access to online treatment courses for people with epilepsy experiencing symptoms of anxiety and depression. If you would like to find out more about these internet-delivered courses please visit the eCentreClinic.
Click on the video to hear Dr Milena Gandy, a clinical psychologist involved in the development of these on-line treatment courses for epilepsy and managing emotional wellbeing in people with epilepsy, share more information on this work.
Dr Milena Gandy
Psychosis is a serious psychiatric condition which can involve hallucinations, delusions and disordered thoughts. People with psychosis may feel a lack of or inappropriate emotions and may display decreased drive and motivation, social withdrawal, paranoia, or extreme levels of physical activity, becoming either hyperactive or immobile.
A small percentage (0.2%) of people with epilepsy experience psychotic symptoms. For some people their psychosis is no different to that found in people without epilepsy. For others psychosis can be related to the occurrence of seizures and is sometimes known as post-ictal (after seizure) psychosis. Post-ictal psychosis usually occurs a few hours or days following a cluster of focal dyscognitive or tonic-clonic seizures. These psychotic episodes can involve disordered thoughts, delusional ideas and aggressive behaviour. Importantly, these episodes are usually brief and can be effectively treated with medication.