The Epilepsy Depression Connection

Written by Erica Roth | Published on June 25, 2014
Medically Reviewed by George T. Krucik, MD, MBA on June 25, 2014

What Is Epilepsy?

Epilepsy is a seizure disorder and a neurological condition. Seizures occur when your brain’s electrical activity becomes abnormal. Convulsions (shaking) or loss of consciousness are common.

Some people have “absence seizures.” This causes you to lose awareness and stare blankly until the brain returns to normal patterns.

Having one seizure doesn’t mean you have epilepsy. Your doctor might test for epilepsy if you have more than one seizure or other symptoms like traumatic brain injury.

Medication can help control seizures in people with epilepsy.

What Is Depression?

Depression is a common mood disorder. People who are depressed often lose interest in hobbies and have changes in their appetite. They may feel sad, scared, or angry and have trouble sleeping. Depression can interfere with your personal relationships and make it hard to enjoy life.

Depression can be managed with medication and talk therapy.

The Epilepsy-Depression Connection

Chances are good that if you have epilepsy, you could also be depressed. The epilepsy-depression link has been the subject of many studies. Researching epilepsy and depression helps doctors know how to treat symptoms of both conditions.

Studies published in the Journal of Neurology, Neurosurgery & Psychiatry and Epilepsy & Behavior suggest that between 30 and 55 percent of people with epilepsy also have depression.

Women with epilepsy are more likely than men to experience depression. In fact, more women than men are diagnosed with depression in general. According to evidence published in Neurology, hormonal changes could be a reason that depression is more likely in women.

Of all of the medical conditions that people with epilepsy could also have, depression is at the top of the list.

Causes of Depression in People with Epilepsy

There are many possible causes of depression in people with epilepsy. One of the most common is brain injury. The area of the brain responsible for mood may be affected in people whose epilepsy is cause by brain injury. This may lead to a variety of mood changes, including depression. This is a physical cause that links the two conditions.

Dealing with a chronic medical condition can be challenging. For some people, it can lead to sadness that’s difficult to overcome. The possibility of a seizure at any time or place can cause anxiety, embarrassment, or anger. These and other negative emotions may bring on depression.

Hormone levels can also play a role in triggering depression in people with epilepsy. Researchers found that low estrogen levels are common in those with depression. Changes in hormone levels can also affect seizure frequency.

Side effects from medication can also increase the risk of depression. Anti-seizure drugs may affect the mood centers in the brain. Many different medications are used to treat epilepsy. Barbiturates, including Phenobarbital, may contribute to depression more than other anticonvulsant medications. Benzodiazepines, levetiracetam, topiramate, and vigabatrin may also dampen your mood. Your doctor may switch you to another drug if your medication is the cause of your depression.

Depression as a Pre-Cursor to Seizures

Some people with epilepsy have an “aura” right before a seizure. An aura can be a certain smell, vision, headache, or other warning sign that a seizure is coming. Sinking into a depression may mean that you’re going to have a seizure soon.

A downturn in your mood in the few hours before a seizure hits may be how your body functions. Other people may feel depressed for several days after a seizure without the mood-based aura beforehand.

Treatment of Depression in Epilepsy

Treating depression and epilepsy at the same time can be tricky. Medications can interact with each other and lead to a worsening of symptoms in one or both conditions. It’s common to try a variety of medications to determine which combination is the best fit.

Studies published in the US National Library of Medicine caution doctors and patients to “start low, go slow.” This means to use the lowest possible dose of a medication for either depression or epilepsy and assess how it’s working. Generally, the higher the drug dosage, the increased risk of depression or other side effects.

People who are being treated for epilepsy shouldn’t take buproprion (Wellbutrin) for depression. Buproprion may increase the frequency of seizures.

Your doctor will help develop a treatment program that is right for you based on your specific symptoms. This may include counseling to talk about how you’re feeling and medications.

What’s the Takeaway?

It’s important to remember that depression and epilepsy are both manageable medical conditions. You may be at a higher risk for depression if you have epilepsy. But there are steps you can take to overcome your challenges and live a happy, productive life.

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