For epilepsy patients, depression symptoms can vary from the classic signs. For this reason, many go without treatment and quality of life is affected.

Published: December 26, 2019 | Updated: August 25, 2022

There is a strong relationship between epilepsy and depression. The two come together so often that there are suspicions that brain changes that make people more susceptible to seizures also can bring on depression.

In a study of adults, researchers found that those with epilepsy were twice as likely as adults without epilepsy to report feelings of depression in the previous year. Depressive thoughts or feelings can result from the many challenges that come with epilepsy, including stigma, fear of disclosure, unpredictable seizures, bullying, financial troubles and relationship changes.

“It’s important for epilepsy patients to understand that depression or anxiety are often a part of their illness,” said Ambica M. Tumkur, M.D., neurologist and epilepsy specialist with Norton Neuroscience Institute. “Learning how to manage symptoms of depression and anxiety as well as psychosocial challenges can help patients cope more effectively.”

Epilepsy Patients’ Depression Can Have Different Symptoms

Depression is different from being sad. It lasts at least two weeks and challenges all aspects of daily life. Depression is often typified by an inability to find pleasure in activities, issues with sleep and appetite, or feelings of helplessness and hopelessness.

For epilepsy patients, the depression symptoms may have different characteristics. For instance, irritability, poor frustration tolerance and irregular or disproportionate emotional reactions may be more prevalent.

Depression symptoms in epilepsy patients can come and go more quickly than typically is seen in others with depression. With symptoms cycling on and off, patients and their families may come to see them as simply mood changes that come with the epilepsy. As a result, the depression goes untreated and significantly affects quality of life.

Treating depression in people with epilepsy can be challenging.

Your neurologist may want to start with low doses of antidepressants and slowly increase until you both find the lowest effective dose. Cognitive behavioral therapy also can be helpful in conjunction with antidepressants, according to Jayan.