Epilepsy Action

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of everyone affected by epilepsy ”

Depression

In this section

This information was written by Epilepsy Action’s advice and information team with guidance and input from people living with epilepsy and medical experts. 

Introduction

Many people have depression, and it’s common in people with epilepsy. This information describes what depression is and how, for some people, it is linked to their epilepsy. It also gives information about some of the treatments available for both epilepsy and depression.

Depression – what it is and what causes it

What is it?

We all feel sad from time to time. Sometimes, we feel sad for a few hours, sometimes for a few days. If your sadness lasts for longer, and interferes with your everyday life, you may have depression.

When you are depressed, you might feel gloomy and hopeless. You might find it difficult to concentrate, and have problems with sleeping. You might have trouble falling asleep, or you might wake up in the early hours of the morning. Depression can affect your sexual desire. It can also cause you to eat more, or to lose your appetite.

What causes depression?

There are lots of reasons why people become depressed. It could be because you were born with a genetic tendency to depression, or that something has happened to make you feel depressed. For example, if you have been recently told you have epilepsy, your lifestyle might have had to change. This could be because you have lost your driving licence. Or it might be that you have had to make changes to your work.

You might be depressed because other people are treating you differently because of your epilepsy. If you have had epilepsy for some time, it could be because you have had more seizures than usual. Or it might be that your seizures have come back after a long time.

There is research that suggests that being diagnosed with a long-term condition like epilepsy, puts you at a higher risk of becoming depressed.

And of course, your depression could be caused by something completely unrelated to your epilepsy. This could be the death of someone you love, or a recent divorce, or redundancy from work. Whatever the cause, it’s important that your depression is diagnosed and treated properly, so that you can begin to enjoy life again.

Seizures, anti-epileptic drugs and depression


Seizures and depression

People who are still having seizures are more likely to be depressed than people with controlled epilepsy. Some studies also suggest that depression
can make epilepsy worse. So, it’s really important to get the best treatment available for your epilepsy, as well as your depression.

Anti-epileptic drugs (AEDs) and depression

Depression can sometimes be a side-effect of AEDs. This is particularly the case for older drugs such as phenobarbital, phenytoin and primidone. These side-effects are dose-related. This means that the higher the dose you are taking, the more likely you are to become depressed. If you take more than one kind of AED, this can also increase your chance of becoming depressed.

Talking about depression, treatments and support

Talking about depression

If you are affected by depression, don’t suffer in silence. If you live in the UK, speak with your family doctor, epilepsy nurse or epilepsy specialist. Tell them as much as you can about when you started feeling depressed, and how it is affecting you.

Treatment for depression

The treatment you are offered for your depression will depend on how seriously it is affecting you. In the UK you might be offered antidepressants or talking treatments, such as counselling or cognitive behavioural therapy. Some people will need a combination of treatments.  If you are very unwell, and drugs don’t help, or you are considered to be at risk of suicide, you could be admitted to hospital.

Antidepressant drugs for depression

When your doctor is making a decision about your treatment, they will have to carefully consider the benefits and risks. This is because some antidepressant drugs can make seizures more likely. This is particularly the case if they are given in high doses.

Anti-epileptic drugs (AEDs) for depression

Some AEDs such as sodium valproate, carbamazepine, lamotrigine and oxcarbazepine can help to stabilise people’s moods. This can lessen the risk of depression coming back in the future.

Complementary treatments for depression

It’s really important to speak with your doctor or epilepsy nurse, if you live in the UK, before you try any complementary or alternative treatments. This is because these treatments may interfere with your anti-epileptic drugs. An example of this is St John’s Wort. 

Organisations for information and support

Telephone numbers for the UK only

Our thanks

Epilepsy Action wishes to thank Dr Mike Kerr, Professor of Learning Disability Psychiatry, Department of Psychological Medicine, Cardiff University School of Medicine, for reviewing this information before publication.

This information has been produced under the terms of The Information Standard.

  • Updated March 2011
    To be reviewed March 2013

Comments: read the 5 comments or add yours

Comments

Hello. I am desperately worried about my dear friend. She has epilepsy and takes a low dose of medication to control it (Tegratol). However, she is very depressed relating to complicated difficulties with her adopted child. She suffers with anxiety and is constantly crying, she's like a broken person. She has got to the point where she is completely unable to cope. She has seen her doctor several times over the past year but has been told that any anti depressant medication may interfere with her epilepsy medication. As a result, she is too frightened to take the risk of having an attack. If she lost her driving licence, it would be the end (seriously). Can anyone suggest something to help her? I'm so worried about her. Please help. Thank you.

Submitted by Marilyn on

Hi Marilyn

It sounds like your friend is having a really tough time just now, with her depression, epilepsy and family problems. It's good that she can talk to you about how she is feeling.

As you will have seen from our information, sometimes depression can be linked to epilepsy. If this is the case for your friend, meaning that her epilepsy is not controlled, then it may affect her privilege to drive. It may also mean that her low dose of Tegretol needs increasing. If her family doctor isn't confident to do this, then she could ask to be referred to an epilepsy specialist.

You don't say where your friend lives, but if she would like to find out where her nearest epilepsy specialist is, you or your friend could contact us, in total confidence, and we will do our best to tell you. You can speak to an adviser on the Epilepsy Helpline, freephone 0808 800 5050, or email them at helpline@epilepsy.org.uk.

Sometimes, a person's depression can be separate from their epilepsy, and so the treatment will need to be different to anti-epileptic drugs. Although some types of depression treatments have to be used very carefully if a person has epilepsy, it is usually possible to be able to get some treatment that doesn't affect a person's epilepsy. The Depression Alliance may be able to give you more information about this and may have other services that could benefit your friend.

If your friend would like to speak to someone about her difficulties with her adoptive child, she could contact Parentline Plus. Parentline Plus is a national charity that works for, and with, parents. They can be called for help and advice at any time on 0808 800 2222. If she needs someone to talk to about her anxiety and general concerns, the Samaritans may also be able to help.

Kathy
Advice and Information Team

Submitted by Kathy@Epilepsy ... on

i would like to reply to the lady whos freind has epilepsy and is very depressed, i to hav epilepsy and was once on tegratol this drug made me very down and depressed i spoke to my neuro and my drug was changed to epanutin and a few weeks later was a differant person and almost back to normality says my wifealthough this may not help her freind it is worth a shot

Submitted by robert on

My boyfriend has epilepsy and has been very depressed in the past. This page is very confusing because in one place it says epilepsy medication causes depression and then further down it says doctors prescribe epilepsy medication to reduce depression! Which is it? Or is it the case, that no one knows for sure and it's just trial and error between patient and doctor as to which ones work?

Submitted by kate on

I am also on tegratol and epinutin and epilim and get very depressed from time to time. I always said I will never get suicide thaughts, but its like something else controlling my thaughts. But I can't tell my mother cause I don't want her to stress. And I've seen that I tend to get less seizures when I'm depressed.

Submitted by Aubrey on

We can provide references and information on the source material we use to write our epilepsy advice and information pages. Please contact our Epilepsy Helpline by email at helpline@epilepsy.org.uk.

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