Depression
It's important to remember that depression can occur separately from epilepsy. However, it may be related to epilepsy in several ways. People with epilepsy may be more likely than other people to experience emotional changes.
It's important to remember that depression can occur separately from epilepsy. However, it may be related to epilepsy in several ways. People with epilepsy may be more likely than other people to experience emotional changes.
In some people, the mood disorder may be associated with the seizure itself. Mood changes may occur before, during or after a seizure.
In other people, however, mood changes are not related to the timing of a seizure, but relate to where the seizure is coming from in the brain. A seizure that comes from an emotional center in the brain may be more likely to produce a change in mood.
How often seizures happen also plays a role in depression. People who have seizures frequently may be more likely to feel depressed than people who have well-controlled seizures.
In some instances, the side effects of treatment, such as use of antiepileptic drugs, may affect mood. If this happens, a change of treatment may help.
Lifestyle risk factors are also important in the development of depression in people with epilepsy. In one study, four factors were linked to depression: poor adjustment to seizures, increases in stressful life events, financial stress and being a woman.
In addition, people who feel "controlled" by their epilepsy and feel that it dominates their lives may be more susceptible to mood disorders.
People with Epilepsy and Depression
The results of studies to find out how many people with epilepsy have a mood disorder such as depression vary widely, ranging anywhere from 11 percent to 60 percent. A lot depends on how depression is defined and the groups of people being studied—for example, hospitalized patients or those in outpatient clinics.
In general, when standardized methods are used, about 29 percent of people with epilepsy have a major depressive disorder.
Research also shows that people with epilepsy who are depressed often are not diagnosed. About 50 percent of the time they are never treated for the problem.
Seeking Medical Help
If you suspect you are depressed, tell your general practitioner or the neurologist who treats you for epilepsy; they are first stops on the way to an answer. They may evaluate and treat you themselves, or they may suggest that you see a psychiatrist who specializes in the evaluation and treatment of mood disorders. It is important that you consider some important questions prior to the visit and be ready to discuss them with your doctor.
Depression: A Checklist
If you think you might be suffering from depression, ask yourself the following questions:
- Do I have long bouts of sadness? Do I cry for no reason?
- Have I lost my interest or joy in life?
- Have I had changes in eating habits resulting in major loss or gain in weight?
- Have I had a change in my sleeping habits resulting in difficulty sleeping or sleeping too much?
- Am I irritable, anxious?
- Do I have difficulty getting things started?
- Do I have a lack of energy? Am I always tired?
- Do I have low self-worth, or a loss of hope? Do I feel inappropriately guilty?
- Do I have poor concentration? Is it difficult for me to make decisions?
- Do I have thoughts of death or suicide that won't go away?
If you answered yes to five or more of these questions and feel this way continuously for 2 or more weeks, you may be suffering from what is called a major depressive disorder. You should contact your doctor because treatment may be needed. Additionally, if you are having intermittent or continuous thoughts that life is not worth living, depression may be present as well, and treatment is indicated. If you are thinking of suicide and have a plan to carry it out, get help right away. Call your doctor or have someone take you to the emergency room of the nearest hospital. If you are a child and thinking of suicide, tell your parent or a teacher right away and ask them to get you help.
People who have infrequent or less intense symptoms of depression may also require treatment. A good rule of thumb is to watch your own reactions to the world around you. If you feel that some of the listed symptoms are getting in the way of your enjoyment of life, especially the quality of your relationships with others, then you may be suffering from depression.
Fortunately, there are effective ways of treating depression. It is important to talk to your doctor about how you are feeling and ask about treatments that might help.
Treatment
Like epilepsy, depression may be treated with medication. However, talk therapy (counseling) is often tried first. Often counseling plus medication works better than medication alone. Some lifestyle changes may also help. Find out more about treatment options for epilepsy, including how to find a counselor or therapist
Finding Support
Family, friends and neighbors can be a good source of support for people trying to deal with depression. Just as they did with epilepsy, they will need to learn about mood disorders and how they affect people. They may not understand at first that depression is a medical illness that can be treated like any other.
If you are being treated for depression, take time to talk with your spouse, a brother or sister, or a close friend about what is happening to you and how you are coping. Ask how they feel and what kind of information they need. Including family members in counseling sessions is often helpful. They may also want to see someone by themselves.
There are other places you may look for support. A member of the clergy or other religious leader may be a good source of spiritual support for you or your family and may also have helpful information about mental health care resources.
You may be surprised to find out how common it is to experience depression, and how many people have loved ones who have gone through the same thing. Living with epilepsy and having a mood disorder such as depression might seem overwhelming at first. Learning all you can about your condition and seeking answers to your questions will help you adjust over time. With proper treatment and close communication with your health team, chances are good that one day your life will feel as it used to. Today, people with mood disorders can find support from friends, family, the medical profession and by contacting other professional and community groups. Making those contacts is an important first step in managing depression.
Resources
The following agencies and community organizations have information and services that may be of help:
National Institute of Mental Health
The Information Resources and Inquiries Branch provides listings of the types of people and places that will make a referral to, or provide, diagnostic and treatment services.
(301) 443-4513
Depression and Bipolar Support Alliance
Provides information on various ways to locate psychiatrists, psychologists, and other mental health professionals in your community.
(800) 826-3632
National Mental Health Association
Has search tool to help find mental health treatment services and support groups in your community.
(800) 969-6642
Academy of Cognitive Therapy
Can provide referrals of practitioners certified as skilled in cognitive therapy and information for the layman about cognitive therapy. Cognitive therapy helps people identify and change patterns of thinking that are causing problems in their lives. It has been shown to be an effective treatment for mood disorders.
(610) 664-1273
National Association of Social Workers
Can provide referral to a registered social worker.
Freedom From Fear
Can provide free screening referrals for your area.
(718) 351-1717
American Psychological Association
Provides information on how to get a referral to a psychologist in your local area.
(800) 964-2000
Anxiety Disorder Association of America
Helps find a treatment provider in your community.
(240) 485-1001
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