Depression In Epilepsy

Mood of human beings is determined by the preponderance for some specified emotions. It is also based on logical mindsets, interactive tendencies, and nervous control potential. It puts a strong effect on one’s ability to deal with different social conditions. The mood is amazingly steady in most people and rare variation naturally withdraws within few hours. At least one-third of patients with active epilepsy suffer from significant impairment of their emotional well-being.
Depression in epilepsy is linked to seizures, common depression disorder is known as inter-ictal depression. Which includes:
· reduced appetite
· poor energy
· impulsive self-harm than is depression in people without epilepsy
· symptoms of anhedonia (lack of enjoyment)
· sleep disturbance
· agitation
Based on psychiatric symptoms epilepsy can be classified (according to their temporal relation to seizure occurrence) as and listed here:

Peri‑Ictal

It includes,irritability, frequent mood changes and, dysphoria. It maylead seizure impact by hours to days. It is defined as an intense and out of the way feeling of anhedonia (guilt with suicidal ideas). It may last from a few seconds to minutes with preserved consciousness. Pre-ictal depression may appear hours before a seizure.Clobazam can be used abort seizures in this case.

Ictal

Nonmotor, focal aware type seizures and long-lasting emotion losing continuous for few minutes (about 15 minutes) is the ictal fear. It is more recurrent, localizing and non-dominant temporal structures, primarily the corpus amygdaloideum. To diagnose an detect ictal depression EEG is mandatory.

Post-Ictal

I this type of depressive indications and behavior lasting for a day or more. postictal symptoms include control polar mood swings such as manic/hypomanic indications.

Interictal

It is characterized by a unique mood disorder called a pleomorphic pattern of depression signs. It is a combination of euphoric moods, anergia, irritability, pain, fear, insomnia, and anxiety.

Epilepsy and Suicide

Suicide the rate in epilepsy depression is 3.5% more than the common suicide deaths in the whole population. The young male community (from 25 years of age to 49 years) is reported to an increased risk factor of suicide under epilepsy depression. It also leads to psychopathological impacts counting:
· personality disorders
· difficulty in handling social problems
· Difficulty in managing official work
· Long duration seizures
· Temporal lobe epilepsy
· scary seizure control
People using antiepileptic drugs get overdoses which causes80–90% of suicide attempts.

Recognition of depression

Not all patients who are depressed appear weepy and withdrawn.
· lack of energy
· weight loss
· poor concentration
· Negative attitude

Management of Depression

After the diagnosis of depression in a person with epilepsy can be solved in a number of different ways, depending on the type of symptoms, mood swings, and what impact it has on one's health, daily life, and safety. Similar to epilepsy, there is no permanent way to treat depression. Treatment needs to be personalized according to the individual's signs and behavior/ situation.

Medicines

Antidepressants are used as Medicines in epilepsy depression. It controls the variations of neurotransmitters in the brain. Medicine needs to be taken according to the doctor’s prescription. Overdoses of antidepressants lead to seizures and provoke suicidal ideas. The risk of seizures is very low with a controlled dose. Patients eating antiepileptic medicines may turn out to be depressed as an impact of their epilepsy handling method. The indicators of which include nervousness, non-specific and abnormal thinking.

Psychotherapy or Counselling

Psychotherapy is talk therapy (counseling) for the treatment of depression under epilepsy. There are various kinds of talk therapy:
· Counseling of individual person with depression.
· Counseling of family/ relatives and friends
· mixture of both types

Therapy may focus on

· Educating people about depression, how to recognize and treat symptoms, and its effect on your life
· Teaching ways of coping with depression
· Addressing family relationships or conflicts
· Changing or reframing the the way people think about problems and how to respond to them called cognitively behavior therapy.