Having epilepsy seems to increase the likelihood that you’ll suffer from chronic depression and multiplies the risk for suicide by five times. Researchers from the University of California Los Angeles don’t believe it results from dealing with the stress of having epilepsy, but may simply be a part of the disease process.
As many as 35 percent of epileptics suffer from some type of depression. Women seem particularly susceptible, but the statistics may be misleading because women are more willing to seek help for health problems.
For some people, depressive symptoms may be part of the prodromal stage, the symptoms experienced before a seizure. For others, the depression may occur during, after, or in between seizures. In many cases, the depression becomes chronic, lasting more than six months.
Historically, studies have shown that if the seizure-causing lesion(s) can be located in depressive epileptics, it’s usually in the left temporal lobe. However, one recent study at the University of Pennsylvania found that in two specific types of epilepsy, gelastic and dacrystic, the lesion was usually found in the right temporal lobe.
In people who experience a psychological aura, rather than one of sensation or movement, the lesion(s), if located, tends to be in the temporal lobe–limbic system area of the brain. The limbic system is associated with emotional responses triggered by a stimulus. For example, if you have joyful memories of your grandmother baking you gingerbread cookies when you where a child, simply smelling gingerbread later in life may produce a feeling of happiness and well-being.
Hormones also influence the limbic system. Estrogen has an antidepressant effect but contributes to seizure activity. Too much estrogen may promote panic attacks or obsessive compulsive disorder. Progesterone tends to decrease seizure activity and anxiety, but excessive levels may induce sleepiness and depression. Testosterone is believed to have an antiseizure and energizing influence, but in excess it causes aggressive and hypersexual behaviors.
To complicate this delicate interplay, hormonal effects are unpredictable in those with temporal/limbic epilepsy. The effects may be exaggerated or they may be the exact opposite of what is expected.