Epilepsy Leads to Depression

Published by editor | Filed under Depression

Epilepsy (sometimes referred to as a seizure disorder) is a common chronic neurological condition that is characterized by recurrent unprovoked epileptic seizures. These seizures are transient signs and/or symptoms due to abnormal, excessive or synchronous neuronal activity in the brain. It affects approximately 50 million people worldwide. Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases.

It is estimated that between 1% and 2% of the population have epilepsy.

Seizures can be controlled in greater than 70% of people by the use of anti-epileptic medication, and in a large percentage of children, the seizures resolve after a few years.

People can develop epilepsy at any stage of their lives but a large number have their first seizure(s) during childhood or adolescence. Therefore, from time to time teachers will have students with epilepsy, or newly diagnosed students with epilepsy.

Who is affected?

Students with epilepsy which leads to depression may face challenges unknown to other students. These may be major obstacles or minor inconveniences depending on factors such as:

• How often seizures occur
• The type and severity of seizures
• Medications - type and dose
• Associated issues with cognition or behavior
• Social and psychological adjustment
• The level of understanding of epilepsy by school staff
• The attitudes and level of knowledge of other students and peers

Depressive disorders in epilepsy:

Depression is a common occurrence among epileptic patients and constitutes, along with anxiety disorders, the most frequent psychiatric condition in these patients.

The relationship between depression and epilepsy is two-directional, because patients with major depression also have a higher frequency of epilepsy. In epileptic patients, depressive disorders can present as unipolar, bipolar, or dysthymic disorders. More characteristically, however, they present as an atypical depression, which can often go unrecognized for long periods of time. In the diagnostic evaluation of these patients, clinicians must rule out the possibility that the depressive disorder resulted from the administration of antiepileptic drugs (AEDs; e.g., barbiturates) or from the discontinuation of an AED with mood-stabilizing properties that were masking an underlying affective disorder.

Although antidepressant drugs have been used in epileptic patients for a long time, to date there has only been one controlled study. The antidepressants of the family of selective serotonin reuptake inhibitors (SSRIs) should be considered as initial therapy for depressive disorders in these patients.

Treatment Options - benefits and risks

It is always important to seek medical advice before starting any kind of treatment. Generally, treatments for depression include antidepressant drugs and counseling. In very severe cases, electroconvulsive therapy may be needed.

When dealing with depression in people with epilepsy, the doctor and patient must carefully balance any benefits and risks of treatment. For example, some antidepressant drugs may trigger seizures in some people with epilepsy. However, as the most serious complication of depression is suicide, the issue of risk versus benefits needs to be considered very carefully by the doctor.

Where depression is related to seizure activity, this usually needs to be treated by trying to control the seizures themselves, usually with anti-epileptic medication.

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