Seven out of ten patients walking into Annett Koenig’s neurology clinic with seizure-like symptoms don’t have epilepsy at all. They arrive with stroke-like symptoms and overwhelming brain fog, often convinced something is seriously wrong neurologically, only to be told their scans and brainwaves are normal.
After more than 25 years working in neuroscience and epilepsy services, Annett discovered something impossible to ignore. Some of the people sitting in front of her weren’t suffering from epilepsy, but from chronic stress that had finally pushed the body to breaking point.
“I have always worked with epilepsy, both with young patients and adults who had complex cases,” said Annett, who began her career in Germany before bringing her work to Australia.
“A few years ago, I started noticing patients coming in with symptoms that looked like epilepsy – speech difficulties, blanking out, shaking in the arm. We’d do the EEG and the brainwaves were completely normal and I realised it wasn’t epilepsy at all; it was stress. In the last five years it’s really been seven out of ten cases and these are real symptoms that people are genuinely suffering from.”
What troubled Annett just as much as the symptoms themselves was what happened once patients were medically cleared and sent home.
“They see the neurologist but there’s nothing really to offer. There’s no medication for it. It’s also not depression so they fall into this gap where the symptoms are real but there’s no clear treatment pathway. At hospital they do the MRI and CT scan, and when they can’t find anything they send you home thinking, but I am sick. And yes, they are sick but nobody has explained what is actually happening to them or what to do next.”
The more patients she saw, the more Annett realised stress rarely arrived in one dramatic moment. It infiltrated slowly and quietly, eroding clarity, decision-making and resilience while people continued functioning on the surface. By the time many recognised something was wrong the damage was already showing up physically.
“That’s really what got me thinking. Stress doesn’t announce itself. It creeps. People still look high functioning from the outside. They are still going to work, still leading teams, still doing everything they always do, but cognitively they are already overloaded.
“The brain changes before people realise it. Clarity goes first. Decision-making changes. Fatigue increases. People become absent, they withdraw socially and they are not themselves anymore. Other people around them often see it before they do.”
Seeing patients repeatedly sent home without answers pushed Annett into undertaking years of independent research into what chronic stress was doing to the brain and body.
“I looked through the research and it’s all there. Stress factors, the effects on the brain. I collected the data from my own clinical experience and combined it with what the research was showing to develop a non-medical framework.
“I trialled it and it worked. Depending on the patient it could also reverse the symptoms, which was amazing.”
That evolved into Neuroscience in Action – translating complex neuroscience into practical tools that help people recognise overload early and sustain performance before stress reaches the point of collapse. Her work now extends beyond hospitals into high-pressure industries where fatigue, decision-making and cognitive overload can have serious safety consequences.
“The framework is the BRAIN principles – basics, regulation, anchoring in meaning, integration and noticing. It’s understanding why the brain reacts the way it does. Why am I getting brain fog? Why is my decision-making low? Why am I reacting like this?
“High achievers are often the ones who ignore it the longest because they are used to functioning under pressure. Everything can still look perfect from the outside, but the brain will stop you eventually if you are not careful.”
One patient in particular reinforced just how quickly stress can unravel someone’s life once enough pressure builds from every direction.
“A few weeks ago, I had a patient on the ward and I was called to do the EEG. His right arm was shaking. I saw how it moved and through experience you can tell if it is epilepsy or not but you still do the EEG. It showed his brainwaves were normal.
“He was in his mid-fifties and already working in a highly stressful mining role before problems in his private life piled on top.
“You work hard and you do your 12-hour days. You are stressed but you push through. Everything is fine until something happens that you can’t control. Then it all becomes too much. That’s when his symptoms started.
“As soon as you have epilepsy you can’t drive and when you can’t drive you can’t work. But when you understand it is stress-related you can actually do something about it. He was so relieved it wasn’t epilepsy. He was still sick but understanding it was stress gave him something to work with.”
What Annett keeps returning to is the idea that the body nearly always signals distress long before people collapse under it, but most people have become experts at overriding those warnings until the symptoms finally force them to stop.
“Stress will often find its way to the weakest point in the body. If you have back pain, your back will hurt more. If you are prone to migraines, you will get a migraine. Your body keeps warning you, but we don’t listen. People around you see it first. They say, ‘you’re really stressed’, and we say, ‘no, I’m fine’.
“It’s only when it tips over that it stops you. Chest pain, dizziness – something makes you stop. When cortisol levels come down the symptoms ease and when they rise again the symptoms return. The brain has learned that pathway.”
Annett said the small moments of recovery people once naturally took have largely disappeared, replaced by constant noise, screens and stimulation.
“At work, when you have your coffee put your phone away. Just sit there, even for five minutes. That is giving your brain a break.
“If you go for a walk, no headphones, no music. Just walk. After an hour, your brain starts to change. It’s like walking meditation.”
The pressure to keep pushing is something Annett sees strongly in industries like mining, where long hours, responsibility and silence around stress have become deeply ingrained in a culture of pushing through and not saying anything.
“The first time you are stressed, everyone supports you. The second time, it changes. We are all for it when someone has chest pain or a heart attack, there’s no stigma then.
“But when they can’t find anything and you still feel awful, people think it’s in your head. But these are real symptoms. Your brain is telling you something. The problem is nobody tells you how to recover properly. If people knew what to do earlier, they wouldn’t reach that point.”
Annett’s goal now is to help people recognise the signs earlier, before stress reaches the stage where it affects judgement, safety, relationships and health.
“When I talk to groups, people walk away and realise they can change small things. They feel empowered. They think ‘I can actually do something about this’.
“We can’t stop work and life but we can learn how to keep going without breaking.”
| To find out more about Annett’s work helping individuals and organisations recognise stress before reaching breaking point, visit: www.neuroscienceinaction.com.au |
