Epilepsy is more common in people with depression. This is partly due to the brain regions, hormones, and social factors affected by the two conditions.

Epilepsy is a health condition that can affect your life in many ways, leading to challenges in your social life, stress levels, and overall mental well-being.

When paired with depression, epilepsy can be even more challenging. If you live with epilepsy, your risk for experiencing depression is higher than the general population.

Both epilepsy and depression can be difficult to manage. The relationship between them is not well understood, but researchers have uncovered various treatment options that can help.

Epilepsy is a type of neurological disorder that results in seizures. According to a 2017 study from the U.K., epilepsy is associated with several other disorders, including:

Depression is the most common mental health condition associated with epilepsy.

The study reported that 16.3% of people with epilepsy had depression, compared to 9.5% of people without epilepsy. Other research suggests that depression occurs in around 23% of people with epilepsy.

Depressive episodes typically occur in between seizure episodes, according to research from 2022. So if you recently experienced a seizure and are having a period of low mood, know that this is common.

It’s also possible that depression may predispose people to epilepsy. Research from 2017 supported this relationship and noted the following:

  • those receiving treatment for depression had a high likelihood of developing epilepsy
  • those living with depression were more likely to develop epilepsy than those without depression
  • those with past or current depression were less likely to be seizure-free at the end of 1 year

Experts do not know exactly why depression occurs with epilepsy. The specific causes might be related to the factors below, though more research is needed.

Hormones

After a seizure, your hormone levels change, and hormonal changes can also affect your mood.

According to 2021 research, the levels of the following hormones may change:

  • growth hormone
  • cortisol
  • prolactin
  • adrenocorticotropic hormone (ACTH)
  • sex hormones

Brain regions

Some brain regions are impacted more than others in epilepsy. The specific region depends on the type of seizure you have, but the sides of the brain (temporal lobes) are frequently involved and experience a high level of electrical activity during a seizure.

In depression, the opposite happens. Electrical activity in the temporal lobes seems to be underactive. This can negatively affect mood and energy, and may lead to depression.

Epilepsy and depression also involve changes in serotonin, a neurotransmitter (brain messenger) that can influence the onset of either condition.

Social factors

Depression is a multifactorial disorder, meaning that there is more than one risk factor for depression.

The contributing factors are not always changes in body function — they can also be social and psychological. One major psychological factor that contributes to depression is overwhelming life stress.

If you experience epilepsy then you know firsthand how stressful and difficult your daily activities can become. Seizures can occur anywhere and are difficult to predict, which can affect how you live your life.

Finding a suitable medication is the main goal of epilepsy treatment, especially if you also have depression. The use of antiepileptic medications that can both control seizures and stabilize your mood is the most desirable outcome.

Common antiepileptic medications include:

Both lamotrigine and oxcarbazepine are prescribed for epilepsy but can also be used to manage depression. However, it’s important to note that some antiepileptics such as gabapentin can cause mood changes like depression.

Medications used for depression are typically SSRIs and SNRIs. Experts caution around their use in epilepsy due to a lack of evidence and the potential to cause seizures.

However, antidepressant medications are still considered suitable in some cases, according to the National Health Service in the U.K. Finding an effective medication can be challenging because there are no solid guidelines.

If a doctor prescribes you an antidepressant they will typically use a low dose. Finding the right dose is critical and your prescribing team should monitor the dose carefully.

SSRIs are considered low risk antidepressants for use in epilepsy. These include:

Likewise, doctors typically avoided prescribing the following for people with epilepsy because they may increase the chance of having a seizure:

Part of depression treatment in people with epilepsy is to prevent seizures altogether. Experts believe that preventing seizures may also prevent depression. This is partly because of the common factors involved in epilepsy and depression, such as electrical activity in specific brain regions and serotonin levels.

Aside from medication, psychotherapy and counseling are considered effective for treating depression in people with and without epilepsy. They aim to help improve some of the social considerations that may lead to depression.

Having a strong support system can also be a big help. Communicating with your trusted friends and family about what you’re going through can help you cope with your symptoms.

Living with depression and epilepsy can feel overwhelming. If you’ve just experienced a seizure or depressive episode for the first time, there are steps you can take can make your life easier and start feeling better.

Talking with a provider such as a psychotherapist can help you manage both depression and epilepsy. Similarly, a psychiatrist or neurologist can help you find an appropriate medication.

Looking for a therapist, but not sure where to start? Psych Central’s How to Find Mental Health Support resource can help. You can also find a psychotherapist by using the APA’s psychologist locator.

Suicide prevention

If you’re currently in crisis or are feeling suicidal:

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