Great Link Was Here - Look up to his post!
Great link to a previous thread on this topic Bernard. Full of interesting stuff.
There has to be a distinction between organic depression and cognitive depression, that is, between depression resulting from organic dysfunction with neurotransmitters, neurology, etc., and depression that results from the perception of futility, from lack of hope.
I think much of my experience with depression was the latter sort. I knew at a very deep level something was wrong with my head and that life would not go well unless it got fixed. The years of coping and failing to cope yielded their fruit of despair.
After I got the epilepsy diagnosis in 2006, depression cleared up. There was hope. There was action to take. Now it is 2009 and just had another seizure and doubts arise again, but it is nothing like it was. I still perceive hope, though it means less as the years pass by when I might have lived fully.
The "manic" symptoms were I think a consequence of insomnia. Wild-eyed loopiness from lack of sleep. The irritability may be the epilepsy itself. That other thread had references to articles connecting irritability with epilepsy.
When at least one doctor - Dr. John Barry at
http://www.EpilepsyFoundation.org - speaks of these illnesses {sorry the BBS won't let me post the link}, the conclusions they draw from correlations teased out of clinical research do not well discern between cognitive and organic causes (or between causes and effects). That is unfortunate, because the best approach to treatment is likely to differ. Organic illness requires primarily biological intervention. Cognitive illness requires intervention towards resolving perceived/real stressors, such as futility, perceived or genuine .
This BBS is helpful therapy for the cognitive challenges of epilepsy - I feel less futile with the wealth of resources and kind support to be had around here.
It is one of the ironies of our age that when psychologists try to treat organic issues as if they were cognitive deficits, they themselves may be a significant cause clinical depression in their patients, speaking from experience.
Dr. Barry also mentions that patients who are suddenly cured of seizures e.g. with temporal lobectomy experience depression connected with the unexpected challenge of mastering skills and activities from which the epilepsy had previously excluded the patient. The patient and those around him may expect that the patient should immediately act "normal" when in fact there is a time consuming learning curve ahead to master complex and subtle social and other "maturational" skills taken for granted by peers.
E.G. once I beat my seizures I will still have to go get the business experience necessary to function on a par with my peers from B-school in the 90s. I don't really have that expectation, but that is one example of depression-causing side effect of epilepsy, a cognitive dilemma that the luckiest of us epileptics around here are near certain to encounter, and one better treated with counseling than prescription drugs.
:rainbownote: