People with epilepsy may already know that depression can appear as a side effect of recurring seizures. However, research suggests the relationship goes far beyond a simple side effect. Scientists have identified a deep and intertwined connection between epilepsy and depression through years of long-term studies. These findings show that the relationship is not one-directional; instead, it is a complex network where either condition may begin first and influence the other.
This concept was highlighted clearly in a recent press release by the American Epilepsy Society (AES), presenting two new studies discussed at its annual conference in late 2025.
Depression Can Complicate Epilepsy Treatment
One of the key findings revealed by AES is that when a person with epilepsy also suffers from depression, controlling seizures becomes more difficult from the very beginning.
According to the study referenced in the statement, researchers observed that patients with depression were more likely to experience early failure of the first prescribed anti-seizure medication. As a result, doctors may need to adjust treatment sooner than expected, which can complicate disease management.
Importantly, the study emphasized that depression does not cancel the effectiveness of epilepsy medications. Rather, it highlights that mental health is not a secondary concern in epilepsy treatment. Psychological well-being directly affects medication adherence, tolerance of side effects, and the patient’s ability to cope with the condition in daily life.
Depression and Epilepsy: Which Comes First?
Experts draw attention to a previously overlooked point: depression does not always appear after epilepsy. Combined results from multiple studies indicate that individuals with depression may have a higher likelihood of being diagnosed with epilepsy later in life compared to those without depression.
However, researchers stress that this does not mean depression causes epilepsy, nor that most people with depression will inevitably develop epilepsy.
Epilepsy and Depression in Older Adults
Another important aspect of this relationship involves aging. A study published in Epilepsia followed older adults over several years and found that those with epilepsy experienced a worsening course of depressive symptoms over time compared to their peers without epilepsy.
This suggests that depression in older adults with epilepsy may gradually intensify if not detected and treated early. Consequently, researchers recommend that routine and repeated depression screening should become a standard part of follow-up care for elderly epilepsy patients, rather than relying on a one-time or brief assessment.
Possible Causes Behind the Epilepsy–Depression Link
While research has not identified a single definitive cause, several factors may explain this bidirectional relationship, including:
Shared brain networks where seizure pathways overlap with mood regulation circuits
The physiological impact of chronic stress
Inflammatory processes in the body
Sleep disturbances, which may serve as a link between depression and worsening seizures, or vice versa
Additional contributing factors may exist but have yet to be clearly defined. The connection between neurological and psychological mechanisms still requires further scientific clarification.
Three Key Takeaways About Epilepsy and Depression
Based on current research, the relationship between epilepsy and depression can be summarized in three practical messages:
If you have epilepsy, monitoring your mental health is essential. Discussing depressive symptoms with your doctor can improve treatment outcomes and overall quality of life.
If you have depression, there is no need to fear epilepsy, but persistent or unexplained neurological symptoms should not be ignored and should be discussed with a healthcare professional.
Older adults are more vulnerable, making regular mental health follow-ups especially important, as depressive symptoms may change gradually over time.
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