Epilepsy and Depression

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Reader’s Question

I’m a 22-year-old man and for most of my life I’ve been unhappy. I developed epilepsy as a kid and it has really destroyed my personality. Every day is an inner struggle. I fight with myself just to get work done, get up in the morning, or take on ANY kind of responsibility. I feel like I’ve been fighting with my inner child. I, the adult, long to have a good job and do well at university, whereas I, the child, don’t want any responsibility. I see people around me with a GPA of 3.5 while mine is less than a 2.8, and I know I can do better. However, the only thing that’s holding me back is myself. I can’t keep fighting myself like this. It is exhausting and extremely difficult.

I suspect that a lot of this comes from my teen years. I never really had that fun high school experience, and I’m missing out on the college experience. I never went to prom and I really only dated one girl — and that relationship was unhealthy. It feels like I’m “broken” or “defective.” While in high school I was hospitalized for a week because my epilepsy was out of hand. I felt like an experiment. My mother tells me that as a kid I had a vibrant and fun-loving personality. Now that side of me is long gone. I’m cynical and say things like “god is dead.”

I’m such a mess. Now I’m dating a really great girl who is about 3.5 years younger than I am. She listens to me and offers good advice, but I feel that if I don’t “man up” I’m going to end up losing her.

I don’t know why I’m depressed. I don’t know why I can’t be self-motivated like so many people I know. I have dreams and aspirations that seem unreachable.

Psychologist’s Reply

You do not say whether your epilepsy is currently under control, or what medications you are on, but people with epilepsy are commonly depressed (estimates vary widely, but run as high as 60%) and this is more of an issue with uncontrolled seizures and certain medications. Motivation is one of the first things to go when people become depressed. Negative thinking (e.g., your cynicism) both results from and exacerbates depression. Your personality is not destroyed, therefore, but more likely severely damped down by your depression. There are four things you can do about this.

  1. If you are not on an antidepressant, it would be well worth your while to consult your neurologist or a psychiatrist knowledgeable about epilepsy and who will coordinate with your neurologist to see if a trial of antidepressants might help. I emphasize the bit about “knowledgeable” and “coordinate” because some psychotropic medications lower the seizure threshold, and so you want to be absolutely certain of what you are taking.
  2. It is difficult for researchers to tease out what portion of the depression that people with epilepsy experience stems from the effects on the brain of seizures, the sedating effects of some seizure medications, and the lifestyle issues. Certainly not being able to drive, having accidents while seizing, negative reactions from family, friends, and the public to seizures, missing out on fun activities due to fear of seizing, job discrimination, and so forth certainly must play a part. Therapy with a practitioner who is familiar with the biological as well as the social and psychological issues can be tremendously helpful. A therapist can also help you determine which of your dreams and aspirations may not be realistic, and which are. Continuing to chase after unrealistic hopes can contribute to your depression, while focusing your energy on the achievable ones can increase your sense of efficacy and reduce your depression long term.
  3. You may be eligible for support services at school which will help you improve your performance there, as well. If you are not already working with them, check with your school’s version of Student Support Services. Counseling may be offered free of charge to students through the school’s psychology department or counseling office.
  4. There are any number of national and international organizations devoted to educating the public about epilepsy. Some of these organize local support meetings or offer them online. Availing yourself of group support in whatever form you can find it will help a great deal both with your moods and with your coping on a daily basis. Other people with epilepsy have been where you are and can offer a wealth of support and information to keep you from having to reinvent the wheel, as well as forming your own personal cheering squad to help keep you going when things get tough.

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And finally, for your girlfriend to hold your depression against you would be about like her thinking less of you for not being able to run road races after a spinal cord injury. This is not about your character! If she is half the woman you think she is, she will take it all in stride as part and parcel of your disability. However, for any of us who are disabled, leaning too hard on our partners can put a strain on the relationship. Getting the services we need from the appropriate sources helps us be partners rather than patients in our relationships. That frees up our partners to be partners rather than Red Cross nurses at home. It does not make you less of a man to avail yourself of these services: fighting depression by yourself is not only exhausting, as you have experienced, it is also unnecessary when there is help available.

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