Depression

We all feel low and depressed sometimes, without it being a medical problem. Like anxiety, depression is a problem when the unhappy feelings do not go away and it affects daily life: eating, sleeping, or being able to get out of bed.

Depression is not just about feeling sad or down. It is about losing interest and enjoyment in the things you used to enjoy.

If you are depressed, you may feel worthless, hopeless, tearful, tired, restless, or anxious. You may lose interest in sex, or not care about your appearance. You may not be able to make decisions, remember, or concentrate. You may sleep badly or wake too early. Your appetite or weight may go up or down. You may think that life is not worth living, or think about taking your own life, or death in general.

Depression is common

According to NHS England one in four adults experience mental illness (including depression). Sometimes depression is triggered by an upsetting or life-changing event, such as bereavement, unemployment, family problems, debt, an accident, or an illness. Some people are more likely to become depressed than others because of a family history of depression. Frequent stress (too much pressure) may make depression more likely.

Depression can be more likely in someone with epilepsy for various reasons, but this does not necessarily mean that one condition has caused the other. Nor does it mean that depression is something you just have to put up with.

See our information on links between epilepsy and mood.

Helping yourself – some ideas

• Exercise and hobbies - When you exercise brain chemicals are stimulated that may improve your mood, and exercise, and hobbies are good ways of getting out and meeting people. Feeling fitter can also help you feel more positive about yourself. If you are tired or depressed, you may not feel like being active, but exercise can boost energy levels.

  You are more likely to stick to exercise that you enjoy and that you notice helps you. Having a hobby that you enjoy, like gardening or dancing, can also help to improve your mood

• Regular, well-balanced meals - Eating regular, nutritious meals can help to increase your energy levels and boost your immune system, which may help you feel more positive and reduce the risk of seizures. Reducing caffeine and sugar may help avoid highs and lows in your energy levels, and in your mood.
• Notice your feelings - Note the times when you feel especially low. What helped you cope last time? Notice when you feel more positive. What is it that has helped you to feel better?

Asking for help

Sometimes helping yourself feel better is not enough on its own and you may need extra help. Your GP can suggest other treatment options. It can be hard to ask for help and you may not like the idea of seeing a doctor about mood problems. But looking after your mental health is positive, and getting treatment can make a big difference.

You can help your GP by telling them about the different feelings you have. It may help to write down what you want from the appointment before you go. Your GP can help by listening, by looking at your medical history, and by asking you what you think might help you.

If you feel your depression is linked to your epilepsy or to side effects of your anti-seizure medication (ASM), you can ask your GP to review your epilepsy or refer you to a neurologist. Your GP may refer you to a local exercise programme or make suggestions about your diet. They may recommend therapy, such as counselling, medication, or a combination of treatments. Any treatment is more likely to work if you are happy with it.

'Talking' therapies

These may help reduce depression and make life more manageable. Talking in confidence about your feelings about epilepsy may be helpful. ‘Talking’ therapies include counselling, psychotherapy, and group therapy. You can also call our confidential helpline to talk through how you are feeling.

Medication

If coping with depression is very difficult, your GP may offer you medication, sometimes along with a ‘talking’ therapy. Your GP or specialist may check that you are on the right ASM first.

ASM can have both positive and negative effects on mood and will affect people differently. If you are offered medication for depression, your doctor can check which is the best drug for you, and one that is least likely to affect your ASM or your seizure control. Reporting side effects will help your GP to see which treatment suits you. You can also report side effects through the Yellow Card Scheme.

Where family and friends can help

You may not recognise that you are depressed or low. Family or friends may notice changes in your mood before you do. Comments made by others may be hard to hear but they may be worried about you.

Some people say they sometimes struggle to feel understood by family and friends, but it is important to try to keep communication going. If you are worried about someone with epilepsy who seems depressed, helpful approaches include the following:

• Ask how they are feeling, then listen without interrupting when they want to talk.
• Keep any comments factual, rather than giving opinions on what you think they should do. 

Further information

• The Royal College of Psychiatrists has information and resources about depression.
• The NHS website has information about depression and how to cope with it..
• Mind (0300 123 3393) is a mental health charity offering information about depression and how to access treatment and support. Mind has information too for staying mentally healthy at work.

Epilepsy Society is grateful to Dr F J Rugg-Gunn, Consultant Neurologist & Honorary Associate Professor, Clinical Lead, Chalfont Centre for Epilepsy, who reviewed this information.

Information updated: October 2024