What is depression?

Depression is the most common mood disorder worldwide. One in five people in the United States will experience depression in their lifetime. Depression affects how a person thinks, feels, and acts. It can also interfere with healthy functioning. Depression can

  • Cause people to feel sad or angry
  • Change their sleep and eating habits
  • Interfere with their relationships
  • Affect productivity at home, school, and work

Depression usually lasts at least two weeks and challenges all aspects of daily life. This is different than sad feelings, which are brief and can happen to anyone who is having a bad day, hears distressing news, or is dealing with a difficult situation.

Depression can be mild, moderate, or severe. It can be a single episode, a chronic or recurrent issue, or a lifelong illness. Depression can happen to anyone regardless of their ethnicity, race, gender, age, or socioeconomic status. Fortunately, depression is very treatable, even in serious cases.

What is the relationship between depression and epilepsy?

In a study of adults aged 18 years and older, researchers found that adults with epilepsy were twice as likely to report feelings of depression in the previous year compared to adults without epilepsy. Also, adults with active epilepsy were three times more likely to report depression in the prior year as adults without epilepsy.

Additional research results show the following:

  • Some of the brain areas responsible for certain types of seizures also affect mood and can lead to depression.
  • A strong relationship has been shown between the severity of epilepsy and depression. The more severe the epilepsy, the more severe the depression.
  • The link can go both ways. People with depression may be at risk for developing epilepsy.
  • Hormone levels can also trigger depression, especially low estrogen levels.
  • Living with the challenges of epilepsy (such as stigma; fear of disclosure; the unpredictability of seizures; bullying; financial troubles; and changes in relationships, work, or school), can also lead to depressive thoughts or feelings.
  • Seizure medications may contribute to changes in mood. Some medicines may help mood, while others may worsen mood. In 2008, the U.S. Food and Drug Administration (FDA) issued a general warning that antiepileptic drugs may increase the risk of suicide or suicidal thoughts. A 2009 review found that many other factors were not addressed, including the risk of depression in people with epilepsy. People taking any seizure medication should be advised of possible changes in mood, suicidal feelings, or other changes and consult with their health care team if these occur.
  • People with epilepsy are more likely to develop depression and other mood disorders, even before they have their first seizure. This suggests that the changes in the brain that make a person susceptible to seizures also make them more susceptible to depression than the general population.

What are the different types of depression?

There are many types of depression. There also are many terms used to describe different types of depression. Diagnosing depression can be complicated.

Following are the medical terms used. Do not use these descriptions to diagnose your own symptoms or those of your loved ones. Seek help from your primary care provider or mental health specialist if any of these problems are present.

  • Major depressive disorder is the most serious type of depression. Symptoms must be present all day, every day, for at least two weeks.
  • Persistent depressive disorder (dysthymia) is when depression symptoms last for at least two years in adults or one year in children, but are not as serious as in major depressive disorder.
  • Premenstrual dysphoric disorder (PDD) is when depressive symptoms are related to the monthly menstrual cycle.
  • Perinatal or postpartum depression occurs in a woman during pregnancy or after delivery.
  • Substance/medication-induced depressive disorder is when using substances or medications cause depressive symptoms.
  • Depressive disorder due to another medical condition is diagnosed when a medical condition causes depression.
  • Disruptive mood dysregulation disorder is diagnosed in children 7 to 18 years old. Symptoms must have been present for 12 months or more and include chronic, severe, and persistent anger and irritability that lasts most days and temper outbursts (verbal or behavioral) that happen three or more times per week.
  • Seasonal affective disorder (SAD) is when changes in mood are related to the change of seasons, starting in the late fall or early winter and going away in the spring or summer. It is based on reduced daylight.

There are other mental health disorders that can have similar symptoms to depression. Read about diagnosing depression to learn more.

What causes depression?

There are many reasons why someone develops depression. A full assessment with a mental health professional will help identify the causes. Here are a few possible reasons.

  • Heredity – Depression tends to run in families.
  • Having epilepsy – Sometimes the same part of the brain that causes seizures also causes depression. When both epilepsy and depression occur, they are referred to as “comorbid.”
  • Antiseizure medications – Some seizure medications may have mood side effects. Some medicines help mood, while others may cause anxiety, depression, or other mood changes. Most antiseizure medicines also have FDA warnings about an increased risk of depression and suicide. Talk with your doctor or prescribing health care provider if mood changes happen when taking seizure medications.
  • Social factors – long-term stress; traumatic experiences, such as abuse or neglect in childhood; persistent sleep problems; social isolation; and poor health.
  • Medical conditions, such as cancer, diabetes, Parkinson’s disease, and heart disease, to name a few.
  • Medications for other chronic conditions, such as those used for high blood pressure or irregular heartbeat.
  • Life circumstances – A marital conflict or divorce, a difficult job situation, or the death of a loved one can all cause symptoms. However, sadness can come and go and improves with time or a change of circumstance. Depression is chronic and can be debilitating.

Other life circumstances can increase the risk of developing depression. Depression can be present even if you feel like there is no clear cause or trigger. Start by learning all you can about depression. Know the signs and symptoms of depression and your risk factors. Then find help to manage depression.

Authored By: 
Susan Vosburgh MSW, LCSW-C and Patty Obsorne Shafer RN, MN
Authored Date: 
Reviewed By: 
Katherine Noe MD, PhD
Thursday, June 14, 2018