Neuropsychiatrist

[ln1]

Hello everyone.

Have or do any of you currently see a neuropsychiatrist? What is your experience? I think I need to talk to one.

When I was pregnant with my daughter 11 years ago, I had my first episode of depression. When she was born, I believe I went through PPD. Months later, my husband was away on a business trip, and I was experiencing depression once again. Although I didn't go through this when I was pregnant with my first child, my son, I assumed it had something to do with the pregnancy and hormones, and figured it would go away.

Over the years, I had episodes here and there, but was afraid to mention it to my doctor, because honestly, I somehow felt she would deem me mentally unstable and it would go into some "file" that would always come up.

Last year, I finally decided to see a psychiatrist. Literally, all he did was ask questions from his computer screen, input my answers, and told me I have GAD and some depression, then prescribed a medication. The good thing is I had seen my neurologist shortly before seeing the psychiatrist and she told me if he offered any medication to not start taking it right away because we hadn't done my EEG and she didn't want the results to be skewed.

When the E result came back, I started taking Keppra, which has worked wonders for me regarding the anxiety.

A few weeks ago, I had a depression episode...crying, no interest in anything, long naps, feeling worthless...a couple of days later, I had what I think was the stomach bug my kids had. It only lasted for a day, but the next day, I had a headache and was abnormally tired. I also noticed some tingling in my hands and feet, which I hadn't had for a while, but always associated with my seizures.

The overall experience didn't quite feel like the seizures I'm used to...maybe they are changing...I don't know.

Yesterday and today, I've been dealing with my usual depression symptoms.

I don't know if the depression is a part of my seizures or a totally different issue. I just know that I feel like there's nothing I can do to get myself out of it, so I need to talk.

I'm sorry for my rambling, I just feel so desperate. My husband has been very supportive and he's never made me feel like a burden, but I don't want him to have to deal with all of this emotion all the time...

 

[Nakamova]

Epilepsy and depression frequently co-occur. But the Keppra you're taking might also be a factor. It can have serious mood-related side effects -- in addition to "kepprage" it can make the highs higher, and the lows lower. Let your neuro know how you're feeling right away, so she can get a sense of whether the med might be contributing. And ask for a referral to a therapist. The therapist doesn't necessarily need to be neuropsych, but it would be bonus if he/she's familiar w. epilepsy or will consult with your neuro to make sure any treatment is appropriate and safe.

 

[seagull]

Do you feel like just can't be bothered to bother lay in bed watch house go wrack and ruin wake up ache behind eyes dizzy when walk around.I assuming in my case lamc acting like keppra as nakeamova described I don't know if they similar drugs.
yep tough feeling wish I could give you more than empathy

 

[Porkette]

Hi In1,

I've had many times over the yrs. where I felt depressed just like you mentioned I found out it was the medication I was taking and the Epilepsy itself that was causing the depression after having tests done with a neuropsychiatrist. I have temporal lobe epilepsy and it's on the right side, that is the area of the brain that shows a persons emotions. I found keeping myself busy and listening to music a big help. Also I went off the keppra and started vimpat and that made a big difference for me. Depending on your age it could also be premenopause that's causing the depression also. I wish you the best of luck and May God Bless You!

Sue

 

[ln1]

Thank you, everyone!
I have an appointment with my neurologist on the 27th and will definitely discuss this with him. I would be so relieved to find out what could be causing the depression. I just started taking Keppra last year, but I've been dealing with depression for at least 11 years. Wow, Porkette, I never thought about premenopause. I'm 38, but my mother went through menopause in her 40s, so I guess that's something to consider. I'm a lightweight when comes to medicine and nervous about the possibility of having to add an antidepressant or in some way change the Keppra. Just to start thinking about things, do any of you have good/bad/indifferent experiences with antidepressants that you can share? Thanks again!

 

[Nakamova]

I haven't tried antidepressants myself, but I know other members will chime in with good advice on ones that have helped.

Some anti-depressants can potentially make seizures worse, so it's important that any prescriber be aware of those factors. See http://www.epilepsy.com/information...s-their-contribution-seizures/antidepressants for more info.

 

[Cint]

I have TLE and have suffered from severe depression over the years, especially after my 2nd child was born. Hormones DO play a part in Depression for women with E. So after my 2nd child was born and I started getting depressed, my epileptologist referred me to a neuropsychiatrist. I have been taking an ant-depressant along with my AEDs ever since.
My shrink said that for those with E, tricyclics should be taken. But it depends on your type of seizures/E.

Here is a great link about depression/mood disorders & E:

http://www.epilepsy.com/learn/impact/moods-and-behavior

The most common mood disorders in people with epilepsy are major depression and dysthymia. Some people have milder forms of depression that may also affect quality of life and respond to treatment.

Are There Treatments for Mood Disorders?
Many types of treatment are available for mood disorders. Psychotherapy and medication are the mainstays of treatment, which may be used separately or together. The goal is to completely eliminate your symptoms.
The most common type of medication treatment is called an antidepressant, of which there are several kinds. Your doctor is most likely to prescribe a selective serotonin reuptake inhibitor (SSRI), but there are many other kinds too. It is important to remember that medications for mood disorders may require dose adjustments and may take several weeks before becoming fully effective. Just like AEDs, sometimes more than one antidepressant may need to be tried before getting good results. For most individuals with epilepsy, depressive symptoms usually respond very well to low doses of medication.

Plus, be sure to check this out:

http://www.epilepsy.com/information/women/all-women/hormones-and-epilepsy

Is there a connection between seizures and hormones?
Yes, sex hormones can influence the excitability of nerve cells in the brain and thus influence seizure control. Estrogen can excite brain cells and can make seizures more likely to happen. In contrast, natural progesterone breaks down into a substance that can inhibit or prevent seizures in some women.

 

[Cint]

Wow, Porkette, I never thought about premenopause. I'm 38, but my mother went through menopause in her 40s, so I guess that's something to consider. I'm a lightweight when comes to medicine and nervous about the possibility of having to add an antidepressant or in some way change the Keppra. Just to start thinking about things, do any of you have good/bad/indifferent experiences with antidepressants that you can share? Thanks again!

I started going thru perimenopause in my early 40's. My ob/gyn kept telling me I was "too young" to be starting menopause. But for women with E, hormones CAN and often do go ballistic! Check out my previous post.

Right now I take Zoloft because that is what works. We tried many anti-depressants and like the AEDs, nothing else worked. I also take the Keppra for seizures.

 

[Porkette]

Hi Cint,

Thanks for the help. I've gone through my change and the depression is finally gone it was a little hard for awhile but I got by once I realized what was causing the depression.
My Epileptologist told me that often women that have temporal lobe epilepsy may go through their change earlier than most women. I found using natural progesterone cream
the best thing for me. Here's wishing you well and May God Bless You!

Sue

 

[Cint]

I've gone through my change and the depression is finally gone it was a little hard for awhile but I got by once I realized what was causing the depression.
My Epileptologist told me that often women that have temporal lobe epilepsy may go through their change earlier than most women. I found using natural progesterone cream
the best thing for me.

Hormones aren't/weren't the only cause of MY depression. They just made it much worse. Often times, TLE and depression go hand in hand. The depression didn't get better until nature took over. Once I got thru menopause, the depression was much better. But it's still there. It runs in my family.

 

[ln1]

This is a lot of EXCELLENT information. Thank you so much. I too have TLE and the more I research it, the more I see the connection between it and depression. This is TMI I'm about to share, but I must ask. Have you ever noticed a connection between depression and gastro issues? I previously mentioned that I had a bout of depression for a couple of days, followed by what I thought was a stomach bug, which only consisted of one day of diarrhea. My most recent episode of depression lasted a couple of days, and the following day, I had another whole day of diarrhea. I typically don't experience diarrhea and wonder if maybe the two could be connected somehow?

 

[Nakamova]

Depression can cause gut issues and vice versa, through the mechanisms of physiological stress. But there's a lot of interesting research coming out (still mostly in animals) that suggests that the specific makeup of bacteria in your gut can influence your emotional health. On a practical level, it may mean that down the road, very specific diets or probiotics will be prescribed on an individual basis to target issues of neurological health.

If you feel like delving into the science, check out the links below (all from articles published in the last few years):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662178/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370913/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214654/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228144/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788166/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/
http://www.ncbi.nlm.nih.gov/pubmed/11916191

Many of the studies about the gut-brain connection are still in their infancy in terms of providing concrete data in human subjects, but it's becoming pretty clear that a connection exists, as with co-occurring celiac/IBS and seizures.

 

[ln1]

Nakamova, you are so right! Last year, I noticed my personal connection between eating certain foods and the development of migraines, neuropathy, increased seizures, etc. So it only makes sense that it could go the other way - brain issues causing gastro issues. In fact, I've been taking a daily probiotic for several years for stomach pain that no doctor could figure out. When I coupled the probiotic with going gluten-free, dairy-free, soy-free, and egg-free, that stomach pain never resurfaced.

Also, my sister was diagnosed with Celiac Disease, and then within months, also diagnosed with E.

I spoke with both my maternal and paternal grandmothers and learned that "stomach issues" and E are common on both sides.

I'm so happy to be learning all of this for myself and for my children, so they don't have to start from scratch to figure out things.

Thanks so much for the article links!

 

[Porkette]

Hi In1,

A few yrs. ago I had gastro problems along with diarrhea and I had to see a gastro specialist. The Dr.found out it was my seizure med (mysoline) that I had been taking for so many yrs. and it ate up the lining of my intestines. I was put on a low fat diet and wasn't allowed any coffee, soda or sweets. I had to drink tea and eat a lot of yogurt. I
also couldn't have anything with milk in it. I lost a lot of weight but I needed to.
If you continue to have problems see a gastro specialist. I wish you only the best and May God Bless You!

Sue

 

[ln1]

Update...

So, I saw my new neurologist today. I like the fact that he was knowledgeable yet down to earth.

We discussed my current Keppra usage as well as the depression issue.

In talking things through, we came to the conclusion that the depression is likely not a result of the Keppra. It may be because of the E itself or a co-morbidity. He asked if I had considered an anti-depressant but left it completely up to me on whether or not I'd like to go that route. He even mentioned possibly going the therapy route. He also talked about AEDs that have an anti-depressant component.

As much as I despise the idea of taking an additional medicine, I think I will keep my Keppra the same and add an anti-depressant, especially because of some of the thoughts I've been having while going through my depression episodes.

He recommended Lexapro and said that's the only one he feels comfortable recommending for his E patients.

Here's hoping for the best...

 

[Nakamova]

Thanks for the update In1. It sounds like your neuro was helpful. It might be a good idea to see a therapist while taking the Lexapro -- especially so that you can have their perspective on whether the med is doing the trick for you.

 

[ln1]

Thanks for the update In1. It sounds like your neuro was helpful. It might be a good idea to see a therapist while taking the Lexapro -- especially so that you can have their perspective on whether the med is doing the trick for you.

Great idea!

 

[resaebiunne]

My $.02, go see a psychiatrist. A neurologist isn't the best choice when it comes to these issues. Finding a neuropsychiatrist would be even better. Your pdoc will get hold of the records for your epilepsy and they typically understand what is going on because of the E. Many medications used for treating depression are also anticonvulsants. In my case, my pdoc put me on Lamictal as a mood stabilizer (I have schizoaffective disorder bipolar type). Then in turn, my epileptologist increased the dose to see if that would help with my seizures (turns out it made them worse).

A psychiatrist will better understand the medications that can be used which I think is why your neurologist said he only feels comfortable recommending Lexapro.

 

[ln1]

My $.02, go see a psychiatrist. A neurologist isn't the best choice when it comes to these issues. Finding a neuropsychiatrist would be even better. Your pdoc will get hold of the records for your epilepsy and they typically understand what is going on because of the E. Many medications used for treating depression are also anticonvulsants. In my case, my pdoc put me on Lamictal as a mood stabilizer (I have schizoaffective disorder bipolar type). Then in turn, my epileptologist increased the dose to see if that would help with my seizures (turns out it made them worse).

A psychiatrist will better understand the medications that can be used which I think is why your neurologist said he only feels comfortable recommending Lexapro.

Thanks so much for your input!

I agree a neuropsychiatrist is a great choice.

I saw a psychiatrist last year and he diagnosed me as having generalized anxiety disorder and in his words "a little depression". He recommended Buspar, which I think addresses the anxiety, but I never took it because my neuro didn't want me to take anything until we completed the EEG. When the EEG came back abnormal, I was started on Keppra, which actually has kept the anxiety at bay.

My family and I recently moved to CO, and in talking to the neurologist today, it seems that my best bet for a neuropsychiatrist or even just a psychiatrist is going to be in Denver, which is about an hour from where we are. Once I get a little more settled down, I'll do some research into options.

Thanks again for your feedback.