Psychogenic Nonepileptic Seizures and Stress…the Mystery!

Introduction to Psychogenic Nonepileptic Seizures (PNES) 

Psychogenic Nonepileptic Seizures (PNES) are a complex and often misunderstood condition that affects individuals who experience episodes that resemble epileptic seizures but do not have abnormal electrical activity in their brains. 

These seizures are believed to be caused by psychological factors rather than physiological ones. People with PNES often struggle with their mental health due to the challenges and stigma associated with their condition. This article will explore the link between stress and PNES and how it impacts mental health.

Understanding the Link Between Stress and PNES

Stress has been identified as a significant trigger for PNES episodes. When a person with PNES experiences high-stress levels, it can overwhelm their coping mechanisms and lead to the manifestation of seizures. Stress can be both a cause and a consequence of PNES, creating a vicious cycle that is difficult to break.

Research has shown that individuals with PNES experience higher stress levels than the general population. This stress can be related to various factors, such as traumatic life events, emotional turmoil, or ongoing mental health issues. Understanding the link between stress and PNES is crucial in developing effective treatment strategies that address the underlying causes of the seizures.

The Impact of Stress on Mental Health

Stress not only triggers PNES episodes but also profoundly impacts mental health. Prolonged exposure to stress can lead to developing or worsening mental health conditions such as anxiety and depression. The constant fear of experiencing a seizure can further contribute to feelings of anxiety and distress. 

Moreover, stress can disrupt sleep patterns, impair cognitive function, and negatively affect overall well-being. It is essential to recognize and address the impact of stress on mental health to provide comprehensive care for individuals with PNES.

Coping Mechanisms for Stress 

Developing healthy coping mechanisms is crucial for individuals with PNES to manage stress effectively. Engaging in activities that promote relaxation and self-care can help reduce stress levels and improve overall well-being. Some effective coping mechanisms include:

1. Mindfulness and Meditation: Practicing mindfulness and meditation techniques can help individuals with PNES cultivate a sense of calm and reduce stress levels. These techniques involve focusing on the present moment, allowing individuals to manage stress more effectively.
2. Regular Exercise: Regular physical activity has been shown to reduce stress and improve mental health. Exercise releases endorphins, known as “feel-good” hormones, promoting a sense of well-being and reducing anxiety and stress.
3. Journaling: Writing down thoughts and feelings can be a therapeutic way to express emotions and release tension. Journaling allows individuals to gain insights into their triggers and emotions, providing a sense of control and empowerment.

The Role of Brain Injury in PNES

While stress is a significant factor in PNES, some cases may also be associated with a history of brain injury. 

Traumatic brain injury (TBI) can lead to changes in brain function, which may contribute to the development of PNES. Understanding the role of brain injury in PNES is crucial for accurate diagnosis and treatment.

Individuals with a history of brain injury should be carefully assessed for PNES, as the symptoms may overlap with those of post-traumatic stress disorder (PTSD) or other seizure disorders. 

Collaboration between neurologists and mental health professionals is essential to provide comprehensive care for individuals with PNES and brain injury.

Stress Management Techniques

Managing stress is essential for individuals with PNES to prevent or reduce the frequency of seizures. In addition to healthy coping mechanisms, various stress management techniques can be beneficial:

1. Deep Breathing: Taking slow, deep breaths can activate the body’s relaxation response and help reduce stress. Deep breathing exercises can be practiced anywhere and anytime, making them convenient for managing stress.
2. Progressive Muscle Relaxation: This technique involves tensing and relaxing different muscle groups to promote relaxation and reduce stress-related muscle tension.
3. Cognitive-Behavioral Therapy (CBT): CBT is a therapeutic approach that identifies and changes negative thought patterns and behaviors. It can help individuals with PNES develop healthier coping strategies and manage stress more effectively.

Seeking Professional Help for PNES and Stress-Related Issues

Individuals with PNES often require professional help to manage their condition effectively. Seeking support from healthcare professionals, such as neurologists, psychiatrists, and psychologists, is crucial for accurate diagnosis and comprehensive treatment planning. 

These professionals can provide guidance and support in managing PNES and addressing the underlying stressors.

In addition to medical professionals, individuals with PNES may benefit from working with mental health counselors or therapists. 

These professionals can help individuals develop coping strategies, address trauma or emotional issues, and improve overall mental well-being.

Case Studies: Exploring the Connection Between Stress and PNES

To gain a deeper understanding of the link between stress and PNES, as some have been diagnosed with the disorder, I will give you an in-depth view of my world of living with and handling it.

Case Study:

I was a woman in her fifties with no history of brain injury or difficulty handling high-stress situations. It all began twelve years ago during a particularly demanding time at my job and personal life. 

1. The sudden and tragic death of my younger sister, who was there one moment and gone the next, leaving behind her ten-year-old son. Before she passed away, she entrusted me with custody of her child. 
2. Dealing with a deceitful spouse is incredibly stressful, especially when they are repeatedly unfaithful. 
3. Additionally, working in an environment filled with backstabbing colleagues and unhinged, overly ambitious-managers only adds to the toxicity that threatens to drive you out of your job. 

On January 19, 2010, I fainted at work and hit the back of my head on the hard concrete floor. I remained unconscious for a brief period before regaining consciousness. 

Since those incidents occurred, my life has never been the same. Following those traumatic events came episodes known as PNES (Psychogenic Nonepileptic Seizures), depression, and anxiety.

At The University of Maryland Medical Center, a teaching hospital in Baltimore, Maryland, A substantial proportion of patients seen in epilepsy clinics – about 1 in 5 in an outpatient setting and 1 in 3 in an inpatient monitoring unit – experience seizures with nonepileptic etiology. I was one of those patient.

 For patients who have nonepileptic seizures of a physiologic etiology, treatment of the underlying cause can often relieve seizures. 

While seizures cannot be fully eliminated for about 7 in 10 patients with psychogenetic nonepileptic seizures (PNES), evidence-based targeted treatments can reduce the frequency and severity of PNES so that quality of life is improved and unnecessary disability is avoided.

Therefore, I learned to manage stress and develop strategies to prevent seizures through a collaborative approach involving neurologists, psychologists, occupational therapists, and medication. 

Therapy revealed that these seizures were triggered by stressors related to the incident where I blacked out and sustained a traumatic brain injury. 

I hope my case study shows the intricate relationship between stress, PNES, and mental health, highlighting the importance of addressing stress in PNES management.

 The Importance of Addressing Stress for Mental Health and PNES Management

In conclusion, stress plays a significant role in the development and exacerbation of PNES. Understanding the link between stress and PNES is crucial for effective management and treatment. 

Stress not only triggers seizures but also profoundly impacts mental health. Developing healthy coping mechanisms and seeking professional help is essential to managing anxiety and depression and improving overall mental well-being for individuals with PNES. 

Moreover, addressing stress can better support individuals with PNES and promote their mental health and quality of life.

Remember, sharing is caring. If you found this blog informative, share it with others who may benefit from understanding the link between stress and PNES.

More information

Psychogenic Nonepileptic Seizure (PNES)

Thanks for reading, 

JUSMEE TALKIN