In this section you will find greater detail about mood and behavioral disorders associated with epilepsy. The information is divided into two sections: Mood and Behavior 101, gives a basic overview of mood and behavioral disorders associated with epilepsy. Advanced Mood & Behavior, provides a more indepth, intermediate level of information regarding mood & behavior disorders associated with epilepsy.

Mood Disorders

Many people with epilepsy experience disagreeable changes in their emotions, and the link between mood disorders and epilepsy has been observed for more than 2,000 years. While this link has been noticed for many years, the relationship between seizures and mood disorders has not been well understood until recently.

Importance of Mood Disorders

Mood disorders in people with epilepsy are very important and can greatly impact a person's daily activities and quality of life. These feelings may be present most of the time, or appear just before, during, or after a seizure. Some people become depressed, others may be irritable.

  • The most common mood disorders in people with epilepsy are major depression and dysthymia. Some people have milder forms of depression that may also affect quality of life and respond to treatment.
  • Anxiety, while not technically a mood disorder, is another common emotion that occurs more often in people with epilepsy.
  • In order to improve the quality of life with people with epilepsy, it is important for people with epilepsy, their families and care providers to be familiar with the commonly encountered mood disorders. 

Recognizing Mood Disorders

Many patients experience problems with mood. You may have a mood disorder if you feel anxious, depressed, irritable, or have feelings of fear, panic, or pain that are not easily explained by your seizures or other medical causes. Learn how to recognize mood disorders, potential consequences of untreated disorders and how to tell your doctor about possible symptoms. 

  • Here is a screening tool that was developed specifically to screen for depression in people with epilepsy. Your answers to this screening tool will give a score when you complete the questionnaire. Take this tool and the results to your doctor, nurse or counselor. Share the results and learn what this may mean for you. 

Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) Screening Tool.

How Do I Know If I Need Treatment?

At times, everyone experiences some feelings of anxiety, irritability, or depression. However, if these symptoms last a long time, are severe, or interfere with your relationships or job, they probably require treatment.

  • Start by telling the doctor who treats your seizures (whether it is a family doctor, internist, or neurologist) about your feelings. Explain how often these symptoms occur, how they make you feel, and how long they last.
  • If you can, bring in a calendar that tracks these symptoms, just like a seizure calendar.
  • Ask your doctor whether these symptoms might be related to your epilepsy and what to do about them. Together, you and your doctor can decide whether you need treatment for a mood disorder.
  • If you see a counselor or psychiatrist, make sure you talk about how you feel with them. They can help you decide if a change in the treatment plan for your mood is needed. 

Are There Treatments for Mood Disorders?

Many types of treatment are available for mood disorders. Psychotherapy and medication are the mainstays of treatment, which may be used separately or together. The goal is to completely eliminate your symptoms.

  • The most common type of medication treatment is called an antidepressant, of which there are several kinds. Your doctor is most likely to prescribe a selective serotonin reuptake inhibitor (SSRI), but there are many other kinds too. It is important to remember that medications for mood disorders may require dose adjustments and may take several weeks before becoming fully effective. Just like AEDs, sometimes more than one antidepressant may need to be tried before getting good results. For most individuals with epilepsy, depressive symptoms usually respond very well to low doses of medication.
  • There are many different types of counseling that can be very helpful. A few examples include:
    • Traditional psychotherapy helps people gain insight into their feelings, what may be causing them, and how to make changes. 
    • Psychoeducational therapy includes educating patients and families about moods and behaviors and ways to address these.
    • Family therapy involves the individual and their family and helps look at family issues and relationships that may be affected by or contribute to mood problems. 
    • Cognitive behavior therapy helps people understand and learn new ways of thinking about their problems, and changing how they respond or cope with the situation or issues at hand. 

 

Authored by: Steven C. Schachter, MD | Patricia O. Shafer, RN, MN | Joseph I. Sirven, MD
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 8/2013
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