Epilepsy and seizures are a tough burden to bear. It might feel like more than you can handle on your own. Luckily, you don't have to. Your doctor probably can refer you to other members of the health care team, such as neuropsychologists, psychiatrists, or social workers, who specialize in helping people with epilepsy and their families to improve their lives.

There are a variety of treatments aimed at helping you to understand the impact of your disorder. Each treatment listed here provides different insights into your life with epilepsy. Each one shows a way to take mental control over your seizures and points out a path towards living a more balanced life.

Cognitive behavioral therapy: "It's the thought that counts"

Since this type of therapy began in the early 1960s, it has become a successful way to help people through a variety of problems. It has been shown to reduce depression, anxiety, or anger (or more than one of these) in some people with epilepsy. Cognitive behavioral therapy is grounded in the belief that your thoughts guide your feelings and actions. So if you want to manage your feelings and change your actions, you must first focus on changing your thinking patterns. By focusing on your own thoughts instead of outside events or other people, you have more control over your progress and a greater chance of improving your life. Your thoughts count, and so does what you do with them.

Although you attend therapy sessions, the average number of sessions is relatively low (around 16 for most people). They are very interactive -- you probably will have homework! The therapist will not tell you how to feel, but will help you see how negative feelings only make a situation worse and cause more problems. He or she will suggest new ways to deal with tricky situations and will show you how and why you are improving. This way, you can continue your progress after the formal therapy has ended.

Before starting cognitive-behavioral therapy, talk to your physician to make sure that your concerns are not directly related to things like your seizure frequency or medicines—things that your doctor can help you with. Your doctor also may know a good therapist for you to visit. If not, one place to look is the National Association of Cognitive-Behavioral Therapists (http://nacbt.org). They have a referral database of trained therapists in your area.

Educational intervention

Even though you and your family may deal with epilepsy every day, you may not know as much about it as you'd like to. Maybe that's why you are doing research here. Educating yourself about epilepsy can help you in many ways. One study showed that people who were given education about their epilepsy showed more understanding and less fear of seizures. They were less likely to follow harmful self-treatment practices like changing their medication dosage on their own.

Another study showed that children with epilepsy who received education about it behaved better, saw themselves as being more socially able, and participated in more normal activities than children with epilepsy who were not educated about it. Parents of children with epilepsy felt less anxious after receiving educational intervention on epilepsy.

Relaxation therapy

It is well known that stress can be a major contributor to poor sleep habits, changes in hormone levels, and seizures. The goal of relaxation therapy is to reduce your response to stress in your life. Among the many types of relaxation therapies are:

• Massage
• Acupuncture
• Progressive muscle relaxation
• Meditation
• Deep breathing

Relaxation therapies have been used in Eastern medicine for centuries, but Western medicine is just beginning to explore their effects on epilepsy and other chronic conditions.

Other therapies

A mix of different approaches is used in the Andrews/Reiter program. Relaxation, cognitive behavioral therapy, biofeedback, and counseling are combined in a formal program that can be completed on an ongoing basis or as an intense course.

Many other types of therapy may be helpful for you even though they are not specifically focused on epilepsy. Creative arts therapies (music therapy, art therapy, and more) use creative methods to promote self-expression, self-awareness, and make personal change easier. The goal is not to create a masterpiece, but to find an outlet for releasing stress and feelings. Pet therapy is often used for the elderly, the depressed, and the hospital population. A simple visit from a friendly animal is sure to raise the spirits of most people. A variety of animals can provide pet therapy—dogs, cats, even snakes or llamas!

Which one works best?

Therapy is a very individual thing. What works for you may not help someone else, and vice versa. A combination of relaxation and behavior modification (a process of goal-setting with clear rewards and feedback) has reduced anxiety in some people and helped their adjustment to home, school, and social situations. Some kinds of therapies have even helped to decrease seizure frequency while they were improving mood and behavior. Clearly, a deeper look into the results of various types of therapy for people with epilepsy will help you to find the most effective type for you.

Topic Editor: Steven C. Schachter, MD
Last Reviewed:12/15/06