Exploring the Connection Between Epilepsy and Mental Health

Epileptic seizures are due to abnormal brain activity, but it’s wrong to think epilepsy is a mental illness.

When you have a seizure, you may appear to be mentally impaired to others. That’s because the episodes of seizures last on average for a few seconds to minutes and are accompanied by confusion, staring, acting aggressively, or slurring speech. 

Epilepsy is not a mental illness, but some studies have found it to be linked with various mental health issues.

What is Epilepsy?

A neurological condition characterized by two or more unprovoked seizures is known as Epilepsy. According to WHO, it is a chronic neurological condition estimated to affect 50 million people worldwide.

Epilepsy can pose a multidimensional effect on the body, with mental, physical, and behavioral functional limitations associated with a substantial risk of premature death due to factors like trauma to the brain and choking on food.

Mental issues linked with epilepsy

People with autism, attention deficit hyperactivity disorder (ADHD) symptoms or depression are more likely to develop epileptic seizures. Until now, the reasons for the similarities aren’t clear. 

Each of these conditions, including epilepsy, involves a lot of changes in brain functioning. Let’s look at the link between different mental health issues and epilepsy:

Epilepsy And Intellectual Disability

Epilepsy does not cause any intellectual problems, but the two can happen together and by the same thing. For example, low oxygen, infection, or injury at birth may lead to mental retardation and epilepsy.

Intellectual (cognitive) problems are related to:

  • Early age epilepsy
  • Multiple seizures
  • Underlying brain lesion
  • Poor seizure control

People with severe intellectual problems have higher brain abnormalities that may cause different seizures in early life.

Epilepsy And Depression

Depression in people living with epilepsy is quite common. Symptoms of depression can be constant over time. They can vary from mild to severe and may significantly affect daily activities and quality of life. 

Depressed persons lose interest in hobbies; have changes in appetite; feel sad, angry, or scared; and have trouble sleeping.

Antiepileptic medications, like phenobarbital, affect mood centres and increase the risk of depression. But, do remember, depression, with or without epilepsy, is curable.

Taking a low dose of anti-seizure medications and antidepressants can help to maintain seizure control and improve depression.

Besides, psychotherapy, education, and family support can also be beneficial. 

Epilepsy And Cognitive Disorders

Common cognitive problems in adults include feeling slowed down mentally, attention problems and memory impairment.

Memory problems such as short-term memory loss are the features of seizures arising from epilepsy. Sometimes even dementia has been detected in people with poorly controlled epilepsy.

Epilepsy And Anxiety

Epilepsy is related to anxiety in several ways. Stress can occur as a reaction to the diagnosis of epilepsy or even a side effect of some anti-seizure medications.

Anxiety also appears after the first seizure and can involve the fear of having another episode.

Feeling socially isolated or rejected because of epilepsy may induce anxiety symptoms.

The best way to address these problems includes counselling, behavioural therapy, psychotherapy, and, sometimes, anti-anxiety medications. 

Epilepsy And Behavioral Issues

Epilepsy influences people’s lives as it restricts activities and forces specific behaviours. 

Factors associated with behavioural problems include stress, fear, frustration, and embarrassment of having seizure attacks.

Brain areas that control behaviour and emotions may not function correctly due to epilepsy.

Finally, anti-seizure medications also change the chemical balance in the brain affecting a person’s behaviour.

Read More: Can Epilepsy Be Cured?

Side Effects Of Medications

Some anti-seizure medications can also lead to psychological changes. For example, drugs like phenytoin, carbamazepine, and phenobarbital used for epilepsy are related to memory difficulties. In addition, levetiracetam may cause changes in mood or behaviour and worsen other psychiatric conditions.

High doses of topiramate are linked to word-finding difficulties. However, newer medications are less likely to cause these side effects. In addition, some seizure medications can help and work as mood stabilizers (such as lamotrigine, carbamazepine, valproic acid). These tend to affect memory, behaviour, and anxiety positively.

Watch this video by the Epilepsy Foundation to know more about the effect of epilepsy on emotional health.

Conclusion

Epilepsy is not considered a mental illness. Many people living with epilepsy show no cognitive or psychological problems. For the most part, psychological issues in epilepsy are limited to people with uncontrolled and severe forms of epilepsy. 

Various treatment options are now available for managing epilepsy. Besides medications (antiepileptic drugs), surgery helps with seizure control and retaining memory. Neurostimulation is another technique to improve mood and quality of life.

For information on epilepsy, connect with our team of experts now!

About Author

Dr. Eshan Nerkar

Neurologist And Neurosuegeon

Dr. Eshan Nerkar, Consultant Brain & Spine Surgeon in Nashik specializes in Spine Surgery. He practices at AXON Brain & Spine Clinic. He is one of the best neurosurgeons in Nashik with more than 10 years of experience. He has performed more than 1000 surgeries related to brain and spinal surgery procedures.

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