The Link Between Epilepsy and Bipolar Disorder

Though they impact the brain differently, there is likely a correlation between bipolar disorder and epilepsy.

By Sara Novak
May 10, 2023 3:00 PM
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Is epilepsy a mental illness? No, it’s not. But it can place people at a greater risk of having a mood disorder like bipolar disorder. We’re finding more and more that mood disorders and epilepsy co-occur. But there’s still a lot that we don’t understand about the connection between the two.

According to the Centers for Disease Control and Prevention, around 30 percent of those with epilepsy also suffer from serious mental health illnesses, including bipolar disorder, major depression and schizophrenia. The prevalence of depression has been shown to be much higher than bipolar disorder. 

The Connection Between Epilepsy and Bipolar Disorder

Raphael Wald, a neuropsychologist at Marcus Neuroscience Institute, says there is likely a correlation between bipolar disorder and epilepsy. Bipolar disorder is characterized by the lows of depression but also mania “highs,” where a person may become removed from reality. They may have a decreased need for rest or sleep as well as a lack of appetite, lack of focus, racing thoughts, poor judgment and a sense of ego or empowerment.

Wald says that structural differences in the brain are similar between those with mood disorders, including bipolar disorder, and those with epilepsy. “Both illnesses involve known chemical and structural brain differences [that are different] from people who do not suffer from seizures or mood disorders,” says Wald.

The chronic nature of the disease and the hopelessness that goes along with it play a role, but that’s not the whole story. The link between bipolar disorder and epilepsy is complicated.

Epilepsy and Seizures

According to the Epilepsy Foundation, those who have seizures are also impacted by other neurobiological factors like head injuries, strokes associated with the onset of certain types of epilepsy as well as problems with neurotransmitters in the brain associated with both epilepsy and bipolar disorder.

Additionally, medications like phenobarbital, for example, have also been shown in some people to cause depression. There are also some indications that excessive cytokines (a protein associated with immune response) found in the brain may be present in those with epilepsy and bipolar disorder. Dysfunction in the temporal lobe, the part of the brain that processes auditory function and encodes memories, may also play a role in both diseases. 

Treatment of Epilepsy With Bipolar Disorder

It’s also important to note, according to a 2013 study published in the journal Epilepsy Behavior, that there is a genetic component to both diseases. Bipolar disorder is related to family history, as are some types of epilepsy. According to the study, “It’s imperative to conduct an investigation of the patient’s personal history and family psychiatric history to minimize the risk of potential psychiatric symptoms.”

According to a 2016 study published in the journal Focus, researchers found that both conditions respond to similar medications, which could indicate that similar pathologies are going on in the brain. “In some cases, bipolar symptoms and epilepsy may be treated simultaneously by the same anticonvulsant,” write the study authors. The anti-seizure medication levetiracetam, for example, has been shown to treat both conditions. 

Signs of Bipolar Disorder in Patients With Epilepsy

According to Wald, in patients with epilepsy, there’s a one in three chance that they will also have a mood disorder. If the patient has bipolar disorder, look for signs of mania, he says. “Mania involves less need for sleep, increased goal-directed behavior, risky behavior, excessive spending and other similar symptoms,” he says.

Bipolar disorder, like epilepsy, requires treatment. It’s not something that you can live with because it’s a chemical imbalance that requires proper medication. But some treatments have been shown to be effective and allow patients with both diseases to live somewhat normal lives.

Read More: What is Epilepsy and What Should We Know About it?

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