Emotional trauma, also known as psychological trauma, refers to distress caused by stressful events or experiences. Trauma can result from a single event, such as a serious accident, or from ongoing abuse or violence over a prolonged period of time. Traumatic events overwhelm a person’s ability to cope and leave them feeling helpless and vulnerable. Trauma is highly individualized, meaning people react differently to similar traumatic events. While trauma may not directly cause long-term physical health issues, many studies show links between trauma and conditions like chronic pain, autoimmune disorders, and digestive problems. One health condition some researchers have looked at in relation to emotional trauma is seizures. But can trauma actually cause someone to start having seizures even if they have never had one before? Let’s explore this complicated question.
What Are Seizures?
A seizure occurs when there is sudden abnormal electrical activity in the brain that results in involuntary changes in body movement, function, sensation, awareness, or behavior. Epilepsy is a brain disorder characterized by recurrent, unprovoked seizures. Several different types of seizures can occur:
– Focal (partial) seizures start in one area of the brain. There are two categories:
– Focal aware seizures where the person remains conscious
– Focal impaired awareness (previously called complex partial) where consciousness is altered
– Generalized seizures involve the entire brain. Types include absence (staring spells), tonic-clonic (convulsions), atonic (drop attacks), clonic, myoclonic (sudden jerks), and tonic seizures.
– Status epilepticus refers to continuous seizure activity lasting more than 5 minutes or recurrent seizures without regaining consciousness in between. This is a medical emergency.
Around 3.4 million people in the United States have active epilepsy, with 150,000 new cases diagnosed each year. Epilepsy can develop at any age and occurs slightly more often in males than females. For many people with epilepsy, the cause is unknown. Possible causes include brain injury, infection, stroke, brain tumor, and faulty brain wiring.
The Link Between Trauma and Seizures
Research over the past few decades has revealed a complex bidirectional relationship between psychological trauma and seizures/epilepsy. Let’s unpack some of the key findings on how trauma is associated with seizures:
– **Trauma can trigger first seizures or worsen epilepsy** – Studies show that traumatic experiences sometimes immediately precede a first seizure or make seizures more frequent and severe in those with epilepsy. The stress of trauma is thought to lower the seizure threshold.
– **PTSD correlates with increased seizures** – Rates of PTSD are higher in people with epilepsy compared to the general population. Multiple studies link PTSD to increased seizure frequency and severity.
– **Childhood trauma may increase epilepsy risk** – Several studies have found that adults with epilepsy are more likely to have experienced childhood trauma like abuse or family dysfunction compared to adults without epilepsy. The trauma may predispose them to developing epilepsy.
– **Sexual abuse correlates with seizures** – Childhood sexual abuse has been most prominently linked to higher rates of seizures and epilepsy, especially for women. The mechanism is not fully understood.
– **Trauma can cause PNES** – Psychogenic non-epileptic seizures (PNES) physically resemble epileptic seizures but are psychological in origin as a way for the brain to cope with overwhelming trauma or stress. Between 2-33% of those diagnosed with refractory epilepsy actually have PNES.
So in summary, research shows bidirectional relationships between trauma and seizures. Traumatic experiences can act as triggers for those with epilepsy. Ongoing trauma like PTSD seems to exacerbate epilepsy symptoms. Childhood adversity may predispose some people to developing epilepsy later. And in some cases, trauma causes a pseudo-seizure disorder called PNES. However, there are still many unanswered questions about the links between trauma and seizures.
Can Trauma Cause Seizures in Someone Without Epilepsy?
The evidence above indicates trauma can worsen seizure control and increase risk among those with epilepsy. But can trauma actually cause someone to have their first seizure if they have never had epilepsy or a seizure disorder before?
The answer is complicated and without definitive answers yet. A few key points:
– **Seizures require an underlying neurological condition** – In order for seizures to occur, there must be some underlying dysfunction or changes to the structure and wiring of the brain. Trauma alone does not rearrange brain wiring to suddenly allow seizures. There would need to be an existing predisposition.
– **Most first seizures have no identifiable cause** – For around 60% of people who have a first unprovoked seizure, doctors never identify an exact trigger or underlying neurological issue that would cause seizures. The brain’s seizure threshold varies naturally, and can be exceeded without an explainable cause.
– **Trauma may potentially lower seizure threshold enough to cause first seizure** – It is biologically plausible that an extremely stressful or traumatic event could potentially lower someone’s seizure threshold just enough to push them over the edge into having a first seizure if they had some underlying predisposition. However, there is not enough evidence to confirm this can directly cause first seizures in an otherwise healthy person.
– **Pseudo-seizures are triggered by trauma** – As mentioned, trauma can directly generate pseudo-seizures in someone without previous epilepsy due to PNES. These seizures are psychological rather than epileptic in cause. The trauma basically triggers a protective physical reaction from the brain.
In most cases of first seizures, trauma may act as a precipitating factor but there is also underlying susceptibility. Overall the data is conflicting on whether extremely stressful situations alone could directly cause someone with no seizure history or neurological conditions to suddenly start having epileptic seizures. More research is needed. But we do know that trauma itself can cause pseudo-seizures due to conditions like PNES in vulnerable individuals.
Examples of Traumatic Experiences That May Trigger Seizures
Many different types of emotional trauma have been reported to act as seizure triggers in some people. While severity and duration of trauma exposure matters, it is also very individualized. Here are some examples reported in research studies of trauma linked to onset of seizure disorders or worsening of existing seizures:
– Childhood abuse – physical, emotional, or sexual
– Bullying, assault, violence
– War or terrorism experiences
– Serious accidents and injuries
– Sudden loss of loved ones
– Emotional neglect and lack of support system
– Natural disasters
– House fires
– Car crashes
– Sexual assault or rape
– Childbirth/postpartum trauma
– Physical trauma from sports, military combat, etc.
– High stress jobs like emergency responders
– Financial stress or job loss
– Bad news or major life changes
– Exposure to extreme violence
Again, trauma impacts each person differently based on nature and severity of events, underlying genetics and biology, coping abilities, and support systems. Ongoing stressors seem to generally carry higher seizure risk than isolated traumatic events. The key is how the stress overwhelms an individual’s ability to cope with and process the emotions such trauma ignites.
Biological Mechanisms Behind Trauma-Induced Seizures
Research into the body’s complex stress response systems has uncovered some biological mechanisms to help explain how traumatic stressors can directly impact seizure activity and lower the seizure threshold in the brain. Key mechanisms include:
– **Hypothalamic-pituitary-adrenal (HPA) axis** – This system controls reactions to stress and regulate cortisol. Trauma can cause dysfunction in the HPA axis that leads to cortisol imbalance, inflammation, and excitability changes in the brain.
– **Sympathetic nervous system** – Trauma activates the body’s “fight or flight” response, controlled by the sympathetic nervous system. Chronic stress leads to excess release of norepinephrine which can increase seizures.
– **Imbalance of neurotransmitters** – Traumatic stress alters regulation of brain chemicals like dopamine, serotonin, and glutamate. This affects mood and cognition as well as reducing seizure threshold.
– **Changes in brain anatomy and function** – Imaging studies show trauma can cause shrinkage of the hippocampus and cerebellum as well as altered connectivity between brain regions that help regulate mood and seizure activity.
– **Neuroinflammation** – High levels of inflammatory proteins called cytokines are released in response to traumatic stress. This inflammation in the brain can directly increase neuronal excitability and seizures.
– **Oxidative stress** – Too much glutamate and stress hormone release leads to a buildup of free radicals and neural damage from oxidative stress. This can exacerbate seizures.
– **Disruption of circadian rhythms** – Trauma can impair circadian clock processes regulated by the hypothalamus which are important for maintaining normal seizure thresholds.
So in summary, complex neurological and chemical changes occur both acutely and long-term within the brain and body in response to extreme traumatic stress, lowering seizure thresholds. However more research is needed to fully map out these pathways.
Other Factors In Seizure Susceptibility
While emotional trauma clearly impacts seizure activity and risk, there are many additional factors that influence who will develop epilepsy after trauma exposure:
– **Genetics** – Many genes are linked to epilepsy susceptibility. Those with a family history have higher seizure risk when faced with trauma.
– **Biological sex** – Females seem more likely to develop seizure disorders tied to anxiety disorders and trauma compared to males. Estrogen fluctuations may play a role.
– **Age** – Childhood trauma carries higher risk of later developing seizures compared to trauma only in adulthood. The developing brain is more vulnerable.
– **Previous concussion or stroke** – Those with previous brain injuries have higher post-traumatic seizure risk. Trauma is more likely to further destabilize vulnerable areas of injury.
– **Substance abuse** – Alcohol and drug abuse worsen seizures and withdrawal can directly induce seizures during trauma.
– **Medication use** – Some psychiatric medications like antidepressants lower seizure threshold, increasing risk.
– **Chronic diseases** – Conditions like sleep apnea, heart disease, and diabetes make people more prone to develop seizures under high stress.
– **Nutritional deficiencies** – Deficiencies in nutrients like magnesium, vitamin D, B6, and iron that help regulate nerve impulses can enable seizures.
While trauma exposure is clearly tied to worse seizure control and may predispose some people to developing epilepsy, other biological and lifestyle factors interact to determine who ultimately has seizures following trauma.
Can You Develop Epilepsy From Emotional Trauma?
Based on the research explored above, some key conclusions can be drawn:
– Extreme emotional trauma alone does not seem to directly cause chronic epilepsy with recurrent, spontaneous seizures in someone with no previous seizure history or genetic susceptibility. More factors are in play.
– Highly traumatic events can potentially trigger a first seizure in someone, but only if other seizure risk factors are already present.
– Ongoing traumatic stress more clearly exacerbates existing epilepsy and seizure frequency/severity.
– With vulnerable genetics and biological factors, substantial emotional trauma may tip the scale enough to result in an initial seizure which could later progress to chronic epilepsy with repeats seizures in some people.
– The trauma itself does not completely restructure an otherwise healthy brain to suddenly start having epileptic seizures. Some underlying dysfunction or susceptibility must already be present in order for seizures to manifest after trauma.
– Trauma can directly generate pseudo-seizures due to PNES in those with no previous seizures.
So in summary, while trauma cannot directly cause epilepsy on its own without other predisposing factors, it does appear capable of triggering first seizures and contributing to development of epilepsy in those already vulnerable. Trauma also clearly worsens seizure control in those with existing seizure disorders.
Can Therapy and Medications Help?
If emotional trauma serves as a seizure trigger, then reducing trauma effects should help minimize seizures, along with standard anti-seizure medications. Some treatment approaches include:
– **Psychotherapy** – Trauma-focused cognitive behavioral therapy and EMDR help people process traumatic memories and PTSD symptoms in a healthy manner. This can reduce chronic stress that lowers seizure threshold.
– **Medications for PTSD** – Antidepressants, particularly SSRIs, help manage PTSD symptoms for some individuals and may also increase seizure threshold.
– **Mindfulness practices** – Meditation, yoga, deep breathing, and guided imagery counteract stress effects and promote relaxation. This helps raise seizure threshold.
– **Acupuncture** – Some studies indicate acupuncture may reduce frequency of seizures and improve quality of life in those with epilepsy.
– **Better sleep habits** – Getting enough sleep prevents seizures. Trauma often impairs sleep. Using sleep hygiene techniques helps.
– **Service animals** – Specially trained dogs can detect oncoming seizures and support those with seizure disorders. This provides comfort and warning.
– **Art therapy** – Expressing oneself creatively through art, music, dance/movement can aid in trauma processing and healing. This can ease seizure triggers.
– **Support groups** – Connecting with others facing similar challenges helps reduce isolation and provide encouragement. This improves trauma coping abilities.
– **Nutritional supplements** – Magnesium, B6, and omega-3 supplements may aid in stabilizing mood and neurological function. But check with a doctor first.
A combination of psychotherapy for trauma plus anti-seizure medications tailored to seizure type and frequency can best help mitigate seizures that are exacerbated by traumatic stress and PTSD symptoms. Supportive techniques like meditation, acupuncture, and art therapy may also ease trauma effects and reduce seizure triggers.
Preventing and Managing Post-Traumatic Seizures
If you experience seizures triggered by trauma or want to prevent trauma worsening your epilepsy, here are some tips:
– Get screened for PTSD – Make sure ongoing traumatic stress is not worsening your seizures and treat any trauma-related mental health conditions.
– Consider psychotherapy – Trauma-focused therapy can teach healthy coping strategies to counteract stressors.
– Ask about medications – Discuss anti-anxiety medications or antidepressants that may reduce seizures by managing PTSD symptoms.
– Improve sleep consistency – Follow good sleep hygiene habits and try to stick to a regular sleep schedule.
– Limit alcohol – Alcohol abuse can induce seizures during trauma so avoid excess intake.
– Learn your triggers – Keep a seizure diary to identify and prepare for situations that commonly trigger your seizures.
– Practice relaxation techniques – Try yoga, meditation, deep breathing, guided imagery to calm the mind and body.
– Check on nutrient levels – Correct any deficiencies in vitamins and minerals like B6, magnesium, or vitamin D.
– Consider a service animal – A trained seizure detection dog can warn of oncoming episodes and provide comfort.
– Join a support group – Connect with others who understand what you’re going through.
– Express yourself creatively – Use art, music, or writing to get trauma feelings out constructively.
– Increase exercise – Aerobic activity can help regulate emotions and improve seizure control.
– Consider acupuncture – Some evidence indicates acupuncture can reduce seizure frequency.
– Reach out for support – Don’t isolate yourself. Spend time with loved ones who care about you.
The Bottom Line
In summary, complex bidirectional relationships exist between emotional trauma and seizure disorders:
– Traumatic experiences can trigger seizures or worsen seizure control in those with epilepsy. Ongoing trauma like PTSD seems especially epileptogenic.
– Substantial childhood adversity may predispose some individuals to developing epilepsy later on.
– Extreme trauma can directly cause non-epileptic pseudo-seizures due to conditions like PNES.
– Evidence is still conflicting on whether trauma alone could directly trigger an initial epileptic seizure in someone with no seizure history or genetic susceptibility. More research is needed.
– However, trauma likely interacts with underlying neurological vulnerabilities in some people to contribute to development of epilepsy through lowering the seizure threshold.
– Treatment of trauma-related conditions combined with standard seizure medications can help prevent and manage post-traumatic seizures.
While more studies are still needed to untangle the full links between trauma and seizures, current evidence clearly demonstrates that addressing emotional trauma and building resilience may go a long way towards improving outcomes for those living with seizure disorders.