Epilepsy and Depression

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Anick

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Hi,

I hope that someone can help give me some advice and help better my understanding.

My boyfriend has had Epilepsy for over 6 years. He has never really learnt about his condition as his seizures ordinarily happen at night time, but recently his seizures have increased and have happened during the day. He has been to see a neurologist who has adjusted his meds from 200gm of Sodium Valporate to 1000gm daily. My question is about Depression, he is very depressed at the moment, his condition has been speculated to be temporal lobe epilepsy caused by a tear as he hears robot sounds before a fit, he will be having MRI/CAT scans in the coming weeks to diagnose this properly. It's been over 2 weeks and I have moved out of our home at his request because he is so unhappy.
Can anyone advise me what I can do to support him or has anyone had any similar experiences and can tell me what he is going through because I have very little understanding of what I am suppose to do and I desperately want to help.

Thanks, Anick.
 
Anick,

I am so sorry you and your boyfriend are going through this.

The diagnosis process can be a long road - EEGs, blood tests, MRIs and CT scans, etc. It does take time, so be patient. Some people never do get a firm diagnosis, yet they are put on anti-seizure meds.

One of the many tough things about depression is that some people make such bad choices when they are depressed, and pushing away loved ones is one form of that. He probably doesn't realize the reason he asked you to leave is because of depression and/or anxiety. 25% to 50% of epilepsy patients have depression. It can be separate from their epilepsy, or caused by changes in the brain from the seizures. Temporal lobe siezures can affect the part of the brain that controls/creates emotion. Some people have intense emotions just before or during a seizure. Some people are depressed inbetween their seizures.

http://www.epilepsy.com/epilepsy/interprob_depress
http://www.epilepsyfoundation.org/aboutepilepsy/relatedconditions/depression.cfm
http://professionals.epilepsy.com/page/psysym_depres.html

Nocturnal seizures happen. It's not fun waking up to them. I'm assuming your boyfriend's seizures are partial (focal) seizures that affect just one part of the brain, in his case the temporal lobe? That would mean it's not a tonic-clonic (where he would convulse) or an absence seizure (where he would stop and stare, and then pick up right where he left of unaware that anything has happened)? Another type of partial seizure is a "complex partial" - one where he would lose consciousness, have unusual behavior or speech, and then might be very confused when he wakes up. Here's a list of types of seizures. Click on each kind to see more information:
http://www.epilepsy.com/epilepsy/types_seizures

Here's more info about nighttime seizures and the effect they could have on him:
http://www.pdf-archive.com/timer.php?id=32421
http://www.ncbi.nlm.nih.gov/pubmed/10714662

What can you do? Be there to support him in the ways that he'll let you.

Drive him to appointments if he'll let you. Go in with him to his appointments if he'll let you. There is so much information coming at you during appointments that it really helps to have someone along to help remember everything. It also helps the doctor clearly understand all his symptoms, including the depression. There are drugs that help that and his neurologist will be used to dealing with that additional symptom.

Get educated - just the way you are now. Gentle information where it is needed might be helpful to him if he is open to it.

If he is having altered consciousness seizures (complex partial), help get his house safe - knives off the counter, turn down the water temperature in the water heater to below 120 degrees, keep the floor tidy and remove trip and fall hazards, etc.

Hang in there. As you start to get answers and he gets the right meds, it gets easier.
 
Depression and epilepsy often go hand-in-hand, for reasons that are not yet completely understood. And people with temporal lobe epilepsy seem to be particularly vulnerable. You can help your boyfriend by offering your support and helping him find ways to get treatment -- not just for epilepsy, but for the depression too. His doctors may be able to recommend a counseling therapist for him. Anti-depressants can sometimes help, but adding another brain med to the mix is tricky and can be problematic in terms of interactions with the AED.

You may want to point him towards this site or support groups, where he can find others dealing with similar issues. Encourage his friends and family to reach out and reinforce the activities and interactions that make him feel happier. Make sure he is staying healthy overall in terms of nutrition and exercise. There's a lot of good information here: http://www.coping-with-epilepsy.com/forums/f22/proactive-prescription-epilepsy-1254/

It's wonderful that you are trying to find ways to help him. It can't be easy for you either, so make sure you are taking care of yourself too.

Best,
Nakamova
 
Dear Alfred and Nakamova,
Thank-you for your replies, just reading your words helps greatly and I will now busy myself printing out the information you have kindly supplied.
Alfred, in answer to your question, Yes I think his seizures are called tonic clonic, he screams out at the air comes out of his lungs and then goes into a full fit for approx 2 mins and bites his tongue. He has experienced complex partial seizures too recently where he'll hear robot voices and repeat words that don't make sense.
I'll hang on in there and maybe suggest to him to register on this site so he can also talk to people with Epilepsy, thinking about it I don't think we know anyone else with the condition so he must be struggling to find someone who he can talk to that understands.
 
Your boyfriend sounds a lot like me. I too, had seizures at night, and the frequency of them is getting greater, and happening earlier in the day. I have depression, and for a whole slew of reasons. But, lately since the seizures have gotten worse, so has the depression. I know for me, the depression has worsened because nothing seems the same. You are a lot groggier, run down, and tired. Life has its demands, with work at responsibilities, ad not being able to function the way you would like is very depressing. Also, just living, enjoying the little things are more difficult, because of how exhausted you can become. To have people make a fuss over you, ( and yes, they are only trying to help), makes you feel too dependent and needy, and that causes you to fight it, and become stubborn in some ways. You want so much to do things in a normal fashion, the same as you were, or the same as everyone else. It is very depressing. My son and my husband are going through what you are. I can sit back and look in sometimes, and see how hard it is for them. I don't mean it to be, and I'm sure your boyfriend doesn't either. I am in the process of having my meds changed or adjusted, we haven't decided yet, so I am having a lot more lately, which just makes it harder for them. But, I guess if I were to ask them, I would say, let me talk about it when I'm ready, don't force me. Be there for me when I need you. Have patience with me when I don't feel like going out, or being too active, (sometimes I'm just not up for it), don't treat me like I'm a helpless child, don't panic over ever little thing I do, (it makes me insecure), and just hold me and let me know you are there. Also, I may need their help with errands, dr. appointments, and the like. I guess the only thing you can do, is understand and sympathize with a little distance in the middle, so that he doesn't feel he's nothing but a burden. It is very depressing, to have to wonder if you can even walk through a grocery store without a seizure calling attention to you. Good luck, to you and him both. Asking for help shows that you care, and thats all that you can do really
 
Hi Mandie,

Thank-you for taking the time to reply to me. some thing struck a cord with me that I do all the time. I panic over every little thing he does thinking he's about to have a fit and I know it makes him feel insecure, I'm going to try and work on that as it's my own anxiety not his! I'm glad you think that a little distance is good, I don't want to smother him so all I've been doing is sending him a photo everyday of something he likes or something that I like, so every though we're not communicating he knows I'm thinking of him. Thanks for your support.
 
Good luck, Anick. I'm sure that it will work itself out for him, with a little patience and understanding. He's lucky to have someone who is trying to help him. Some people don't.
 
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