Depression And Epilepsy: What Is The Link?

Depression and epilepsy are two distinct conditions, and many believe they have little in common. However, there are some surprising links between the two. 

Depression is the most common psychiatric disorder in people with epilepsy. And the relationship goes both ways, with epilepsy strongly linked to depression.

More research is coming to light that suggests epilepsy can be caused by depression, with a 4–6 times greater risk of a person developing epilepsy if they have a history of depression. 

People with epilepsy have a significantly higher chance of having suicidal thoughts, and suicide rates among people with epilepsy are considerably greater than in the non-epileptic community. 

What is epilepsy?

Epilepsy is a brain condition characterized by frequent seizures. A range of symptoms may occur during seizures, including blackouts, muscle spasms, and memory loss. 

Epilepsy is a common condition, affecting almost three million people¹ in the USA and 65 million globally. 

What is the link between epilepsy and depression?

Studies² have found that up to 43% of people with epilepsy have experienced at least one episode of depression. If you have more severe epilepsy, you’re more likely to become depressed. 

Unfortunately, it’s common for depression to go undiagnosed and untreated in people with epilepsy. Depression in people with epilepsy may look slightly different than in others, making it easier for doctors to miss it. 

Some specialists may be focused only on the specific condition they’re treating and may not think to screen for depression.

Although epilepsy can cause depression, the link between the conditions goes the other way, too. People with depression have an increased risk of developing epilepsy: The risk is 4–7-fold higher than those without depression.

How are epilepsy and depression linked?

Researchers are still working to understand the specific nature of the link between these two disorders. There are several possible ways epilepsy and depression may be linked:

Levels of brain chemicals

Changes in the levels of certain chemicals in the brain are linked³ both to changes in mood and seizures. These chemicals include dopamine, serotonin, norepinephrine, and GABA. Medications that change the levels of these chemicals can treat both depression and epilepsy.

Many researchers believe there are underlying changes in the brain that make people more likely to develop both depression and epilepsy.

Challenges for people living with epilepsy

Living with epilepsy can be challenging for many people. You may fear stigma and try to keep people from finding out about your condition. Many people with epilepsy have a hard time working, leading to financial struggles. Relationship complications and social isolation can also occur.

In addition, everyday life presents several practical challenges for people with epilepsy.

All these challenges can lead to high-stress levels. Stress is linked⁴ to depression, so the stress of epilepsy could make depression more likely.

This theory could explain why people with epilepsy are more likely to develop depression. However, it doesn’t explain why people with depression are more likely to develop epilepsy, so it doesn’t completely explain the link between the conditions.

Effects of seizure medication

Another possible explanation for the link between epilepsy and depression is the effects of antiepileptic drugs. These medications control your seizures. It’s well-known that some antiepileptic drugs can cause depression. 

Doctors recommend monitoring people closely after they start a new antiepileptic medication, particularly if they have a personal or family history of depression. It’s crucial to look out for suicidal thoughts. If any mood changes occur, mention this to your doctor right away.

Once again, this theory doesn’t explain why depression can lead to epilepsy, so we still need more research in this area.

Simple tips for caring for someone with epilepsy

You can do little to stop an epileptic seizure once it starts. Seizures stop on their own, so it’s usually a matter of waiting. However, protecting your loved one from experiencing physical harm during a seizure is vital. This may be especially important for more vulnerable people, such as older adults. 

Focal seizures

Focal seizures occur in an isolated region of the brain, making it difficult to tell when someone is having a seizure. It may cause only small signs, such as twitching in the facial muscles or small muscle movements in the hands. In older adults, a seizure can look a little like the symptoms of a stroke.

A doctor can tell that it’s a seizure, and if the person is known to have epilepsy, the seizures will usually follow a pattern. 

Although a person having a focal seizure may seem alert and awake at the time, they will likely not remember what happened after the seizure is over. You will not generally need to intervene, but if a person has many focal seizures in a row and their prescribed medication doesn’t stop the seizure cluster, they may need medical evaluation.

Generalized seizures

These involve many different areas of the brain at once, which means people experiencing this kind of epileptic seizure are rarely aware of what is happening. Often, these are the most obvious kind of seizures and can even escalate into a medical emergency.

What to do during a generalized seizure: 

• Try to keep other people away from the person having a seizure.

• Ensure the area is safe and clear of dangerous materials or objects. 

• Don’t attempt to hold or pin down the person having the seizure. Older adults may be more fragile, so try to minimize the accidental harm they can do to themselves while having the seizure. This involves making sure they’re in a safe space.

• People having a seizure sometimes enter a state similar to sleepwalking, which can be dangerous if they’re driving or walking in a busy area. Stay with the person and do your best to keep them safe.

• Timing the seizure can be important for later medical care. If you can, use a timer to estimate how long it lasts. You may need to call for emergency medical care if the seizure lasts for more than five minutes without stopping. You should also call if they go into another seizure before recovering from the first or have several seizures close together.

Many seizures are mild and only last for short periods. These are not medical emergencies, but monitoring a person’s symptoms and keeping them safe is still essential. 

Always approach the topics of mental illness or epilepsy with care, as it may be difficult for your loved one to talk about their concerns. It’s important they know you are safe to talk to and won’t judge them.

If your loved one is depressed, suggest they discuss their concerns with their doctor. It may be helpful to let them know that epilepsy and depression are linked, and it’s very normal to have both of these conditions.

When to talk to a doctor

When starting a new antiepileptic medication, it is always a good idea to discuss the potential side effects of the drug with your doctor. Tell your doctor if you’ve ever had depression, particularly if you have a history of suicidal thoughts. They may choose a different medication for you and offer you help for depression.

Your doctor will never judge you for raising these concerns. They need to know the complete truth about your experience to ensure that you get the best possible medical care, and they will be happy if you shared this information.

There is nothing to be ashamed of or afraid of when attempting to discuss these topics with your doctor or someone else you trust. 

The lowdown

If you have epilepsy, you’re more likely to develop depression, and those with depression are more likely to develop epilepsy. Researchers believe this is because the brain controls mood and epilepsy similarly. It is important to monitor people with either condition for signs of the other. 

If you’re concerned about symptoms of either condition, speak to your doctor for diagnosis and treatment.