Depression in Epilepsy

In very rare cases, the brain condition underlying epilepsy (such as limbic encephalitis) can directly cause depression or other psychiatric symptoms (like increased anxiety). Mood can be significantly affected before and after epileptic seizures. Additionally, some epilepsy medications can noticeably alter mood. This is often more noticeable to family members than to the individuals themselves, for example, when a new medication is introduced.

Mostly, however, depression arises from the interplay between personality, mood changes before or after seizures, and the consequences of epilepsy in the individual's life situation, such as job loss and financial worries, relationship problems, lack of a driver's license, and so on.

Especially for those individuals in whom seizure control cannot be completely achieved, the quality of life and the emotional well-being of the individual should be carefully monitored and taking into account when therapy planning

Even (brain-healthy!) parents of children with epilepsy suffer from depression much more often than the general population as a result of the high stress caused by the child’s illness.  This is a phenomenon which generally occurs among relatives of chronically ill individuals.

Be sure to talk to your doctor if you notice any unusual changes in your mood. It may be necessary to adjust your epilepsy medication to improve your mental well-being.

What helps epilepsy patients maintain mental stability in spite of the challenges and consequences brought on by the illness?

• Never feel as though the illness has taken away your autonomy.  Always make important decisions yourself.
• Live as normally as possible.  Actively seek new opportunities if epilepsy has closed certain paths to you.
• Continue to participate in activities what you have always really enjoyed, even if there is the possibility of a seizure occurring (i.e. attending a concert).  Driving an automobile and swimming are absolutely not advisable as long as seizures could occur.
• Get informed, ask experts if there is something you do not understand, search on the internet for helpful explanations, but don’t dwell on epilepsy.  Try not to think too much about epilepsy!
• Spend time with those people that are important to you.  Find hobbies that you can share with others.  Perhaps you will find experiences companions and friends in an epilepsy support group.  Physical and creative actives, as well as volunteering, provide strength to many people. 
• Lastly, talk with your physician promptly if you experience a changed, depressed mood which does not fit with your personality or life situation.

It’s not surprising that the well-being of those individuals affected improves significantly if they were able to achieve long-term seizure freedom through medication or epilepsy surgery.  The support of family as well as friends, neighbours and colleagues also plays an enormous role.  What other therapeutic options are available?

Today, psychotherapy is the first-choice therapy recommendation. Cognitive-behavioural therapy is particularly suitable and many licensed psychological therapists are trained in this method.

If you remain in a low mood in spite of therapy, it is advisable to seek treatment from a psychiatry specialist who can promptly help you in acute crisis situations.

Treatment with medication. Physicians with neurological as well as psychiatric specialization can suggest medication treatment, especially in cases of severe depression. Treatment with antidepressants has also proved successful in epilepsy patients and is appropriate for persistent symptoms, because:

• Antidepressants are not addictive.
• The success of the therapy can be assessed after approx. 4 weeks, i.e. a trial can be carried out at any time without any problems.
• No increased risk of seizures has been found in epilepsy patients taking antidepressants.