6 Ways to Better Manage Your Epilepsy

If you ask a neurologist for their best advice on managing your epilepsy, chances are that they’ll strongly recommend taking your medications exactly as prescribed.

“Being late by a few hours, even, can lower the threshold or lower the level enough that you’re more prone to having seizures,” said Brin Freund, MD, a neurologist who specializes in epilepsy and clinical neurophysiology with the Mayo Clinic in Jacksonville, Florida.

However, even if you’re vigilant about taking your medication on time, there’s still more that you can do to make life with epilepsy a little better. And indeed, it’s a challenging condition to have. Depression is a significant challenge for many people with epilepsy, with a prevalence rate about twice as high as in the general population. Plus, the more severe the epilepsy, the more severe the depression symptoms are likely to be.

Try These Six Strategies

Here are some strategies that might help you manage or cope with your epilepsy better:

1. Practice mindfulness. Meditation won’t cure your depression or anxiety. However, if you consciously allow yourself some time each day to focus on the present, it could help you feel better. According to research, mindfulness-based interventions may help improve your quality of life. A 2021 study in Epilepsy & Behavior found that people with epilepsy who embraced a six-week mindfulness practice experienced fewer symptom of depression.

2. Try cognitive behavioral therapy. Cognitive behavioral therapy, or CBT, can reduce stress, anxiety and depression, which can go a long way toward improving your mood and outlook on life. A 2023 systematic review of research found that while CBT didn’t have an effect on people’s seizures, it did improve their depression symptoms and quality of life.

How it works: In CBT, you learn to recognize negative thought patterns that lead you to act in ways that wind up making your life harder. Then you can reframe those thoughts and ideas and change your behavior as a result. It’s considered a short-term treatment, although the specific length of a course of CBT can vary. However, you can apply the skills that you learn to future problems too.

3. Revamp your sleep routine. As a 2022 study noted, sleep and epilepsy are bedfellows. When you’re not sleeping well—or sleeping enough—you may experience more seizures. That makes it imperative that you take sleep seriously. Dr. Freund suggested brushing up on the basics of sleep hygiene, including keeping the bed (and bedroom) for sleep and sex only, instead of letting work and other things creep in. He also emphasized the importance of keeping a regular sleep-wake cycle, even on weekends and holidays. Recent research also suggests that fluctuations in a consistent sleep routine can increase the risk of seizures.

4. Write it down. Keeping a journal can help you monitor your thoughts and mood, but it can also give you a chance to keep a record of factors that influence your seizure activity. “I always encourage patients to start tracking their seizures and daily routines, like sleep, stress, physical activity and medication timing,” said Kayela Arrotta, PhD, a neuropsychologist at the Cleveland Clinic. “Patterns often emerge that help both the patient and their doctor fine-tune treatment. Tracking also helps patients notice early warning signs or triggers, understand how lifestyle factors influence their seizures, and recognize changes in mood or cognition that might otherwise go unnoticed.”

5. Try the HOBSCOTCH program. HOBSCOTCH stands for Home-Based Self-Management and Cognitive Training Changes Lives. It’s an evidence-based self-management program that can help you deal with memory challenges that might come along with having epilepsy, such as remembering names or appointments.

How it works: A certified coach meets with you to help you learn how to set goals and then work through cognitive or memory problems you have developed. Then you have a toolbox for coping with future problems. Experts suggest it can help you feel more in control, which may help you feel less anxious. “There’s evidence that it’s extremely helpful and effective,” Dr. Freund said. “It gives patients ownership.”

6. Make an appointment with a neuropsychologist. If you’ve noticed any changes in your memory, attention or thinking, you might want to get evaluated by a neuropsychologist. “It can provide a clear picture of cognitive strengths and weaknesses, as well as practical strategies to optimize cognition,” Dr. Arrotta said.

Give Yourself Grace

It would be very easy to fall into a trap of believing you’ve somehow failed if you still have seizures or feel depressed or anxious—even if you’ve diligently worked to reduce your stress levels, maintain a regular sleep schedule, improve your diet, cut back on alcohol, exercise more and so on.

“We may unintentionally give patients the impression that you’re not trying hard enough to care for yourself,” said Jessica Templer, MD, a neurologist who specializes in epilepsy at Northwestern Medicine in Chicago.

But that’s false, she said. Maintaining a regular routine, including taking your medications correctly and avoiding your triggers, can help you better manage your epilepsy. It may help reduce the frequency of seizures. But sometimes seizures will happen anyway, and you may not be able to connect it to a definitive cause. “Give yourself grace,” Dr. Templer said.