The psychology of epilepsy: common mood disorders

Does having epilepsy have any affect on a person’s mood? If so, is it the disease-causing the mood disorder or is it the medication? Because epilepsy is caused by problems with brain chemistry, it can mean that those who suffer from seizures may be more susceptible than others to some mood disorders.

Depression and epilepsy

Depression and epilepsy

Anyone can suffer from depression, but it appears that those who have epilepsy are more likely to suffer the effects of depression than others. The seizures themselves might be the cause of mood changes. This depends on the location of the seizure within the brain. When a seizure takes place within the area of the brain that controls moods and emotions, there will likely be some mood change.

It is possible that the medications are also a cause of depression. The medications used for treating epilepsy are very strong and because the drug therapy needs to be individualized, the medicines tend to affect people differently.

Treating depression with anti-depressants is not the first choice for those who have epilepsy. This is partly to avoid over-medicating the patient. Usually, the first course of action is talk therapy, where the patient meets with a counselor to talk about issues that are contributing to mood problems. Lifestyle changes are another reason for depression. Someone diagnosed with epilepsy as an adult is more likely to suffer from mood disorders. People diagnosed with epilepsy are encouraged to allow themselves time to grieve and to adjust to the changes in their lives.

Personality changes in epilepsy

If a person has been suffering from epilepsy for many years, he can acquire the so-called epileptic character. The patient’s thinking also changes, with an unfavorable course of the disease reaching the typical epileptic dementia.

The range of interests of patients is narrowing, they are becoming more selfish. Patients become picky, pedantic, like to teach other people. The mood often changes. They are either very friendly, good-natured, frank, sometimes obsessively flattering, sometimes unusually vicious and aggressive. The tendency to the sudden onset of violent fits of anger, in general, is one of the most striking features of an epileptic nature. At the same time, patients with epilepsy are characterized by inertia, inactivity of emotional reactions, which is outwardly expressed in vindication, “getting stuck” on insults, often imaginary, revenge.

Psychotic episodes

Although it is much less common than depression, some people will have psychotic episodes due to their epilepsy. The symptoms usually show themselves after a series of seizures. Psychotic episodes are often an anxiety-related event lasting a few days.

Psychotic episodes are triggered by seizures. However, they are usually caused by deeper factors, such as the early onset of epilepsy, which is known to have an adverse affect on health or psychosocial factors such as a lack of relationships or a dysfunctional family background.

In order to treat these events, the initial goal of most physicians is to try to lessen the frequency of seizures. If that does not help, careful use of antipsychotic drugs might be administered.

Psychotic seizures can lead to suicide. Therefore, it is necessary to determine the type of epilepsy in time and take psychotic drugs.

A silent disease in men

Men are more reluctant to come forward when they have seizures and many will only seek out help at the urging of a woman in his life. It is also possible that men see seizures as a sign of weakness or mental instability.

Instead, men ought to recognize that a seizure is a warning sign that there is a problem. Even though the seizure can be brief, it can be devastating. By admitting that what is happening is a biochemical problem, doctors can begin treatment. Controlling epilepsy with medication means the individual can have more control of his own life. Studies have shown that men are more likely to stop using medication or avoid using it as prescribed. When medications are misused like this, the individual can often experience what is called a breakthrough seizure, which can make it more difficult to control the seizures a second time.

Men should understand that there is no stigma to having epilepsy or needing to take medication to keep the condition under control.

When to tell others

A person who has epilepsy understands that life now has some changes, but can be fairly normal. Unfortunately, other people do not always see it that way. For this reason, many epilepsy sufferers are reluctant to tell others.

Telling families

The people closest to the person with epilepsy should be informed of the illness. Of course, if epilepsy has begun in childhood, parents and siblings already know. Immediate family or anyone who lives with the person with epilepsy should be told right away. These are the people who will most likely be around when and if there is a seizure.

Young people or their parents should inform teachers, coaches, and other adults who supervise activities about their epilepsy. They should at least be aware of the possibility of a seizure, and should a coach or activities leader not feel comfortable, the parent will know to stick around, just in case.

Telling friends and lovers

Unless the friend will be a roommate, when and if the person with epilepsy decides to share the information it is an individual and person-by-person decision. Close friends will probably be told, but it does not have to be information shared with everyone.

Telling a potential spouse is a different matter. Epilepsy is not necessarily something to be revealed on the first date, but as the relationship develops, it should be disclosed. The significant other should be assured that the sexual relationship will not cause a seizure, and it is unlikely that epilepsy will be passed along to future generations.

Telling an employer

Should an employer be told that an employee has epilepsy? Not necessarily. However, if the seizures are frequent enough to have an effect on job performance, the boss should probably be told. The question cannot come up during the interview, under the Americans with Disabilities Act, and if the job can be done by the person, the company is required to make accommodations.

However, it may be necessary to explain epilepsy to an employer. If that is the case, the person should explain with confidence what the medical situation is. If it has been years since the last seizure, say this. Describe what the seizures are like so the employer has an idea of what to expect.

The right attitude to this disease will help you avoid depressive disorders and enjoy a full life.

Dr. Ali Elahi

This article is written by Dr. Ali Elahi, a specialist in neuromuscular disorders, certified by the American Board of Psychiatry and Neurology (ABPN). His expertise includes evaluation and treatment of patients with epilepsy, stroke, headache, neuromuscular disease, and cerebral palsy.He also manages neurological emergencies in the Intensive Care Units.

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