Depression in children with epilepsy

Mental health disorders are on the rise among children and teens. Depression or depressive symptoms are even more common in youth with epilepsy (YWE). There are several factors that likely contribute to symptoms of depression in YWE. Some of these factors may include:

Difficulties with coping and adjusting to the epilepsy diagnosis
Academic stress
Sudden changes in relationships with family or peers
Changes in behavior

If left untreated, depression can negatively impact daily functioning and worsen medical outcomes. For this reason, national epilepsy guidelines strongly recommend pre-teens and teens be screened for depressive symptoms during their neurology appointments.

Depression or depressive symptoms

Parents often find it helpful to know how to identify signs of depression in youth. Below is a list of signs and symptoms that are commonly observed in youth struggling with depression or depressive symptoms. Typically, some of the following symptoms are present for most of the day and persist for two or more weeks.

Irritability
Sadness most of the time
Decline in academic performance
Changes in sleeping patterns (e.g., excessive sleeping or insomnia)
Changes in eating habits (e.g., loss of appetite or overeating)
Negativity (e.g., negative thoughts about themselves or others)
Excessive worry
Low self esteem
Problems with attention, memory or making decisions
Physical complaints (e.g., headaches, stomachache) with no medical cause
Aggression or anger outbursts (often seen in younger children)
Loss of Interest in previously enjoyed activities
Withdrawal from family and friends
Complaints of fatigue, lack of energy or boredom
Refusal or difficulty talking about their feelings
Difficulty completing daily tasks or requests
Engagement in risky behaviors (e.g., drug use, skipping class)
Self-harm (e.g., cutting themselves) or thoughts of suicide*

*If your child or teen expresses thoughts of suicide or is engaging in self-harm behaviors, call 911 or take them to the nearest emergency room for an evaluation.

What can I do if my child has depressive symptoms?

It is important to note that some children and teens can occasionally experience these symptoms for reasons other than depression. For example, side effects of commonly used antiepileptic medications can mimic depression symptoms (e.g., changes in appetite or sleep, problems with concentration, etc.). If your child is experiencing any of the symptoms listed, or others that you may be concerned about, it's always best to contact your neurology provider or pediatrician to discuss your concerns. They will likely refer you to a licensed mental health professional that can assist you in determining whether depression or depressive symptoms are present.

Treatment

Depression is treatable with the right care and support. If depression is detected during a comprehensive intake session with a licensed mental health professional (e.g., psychologist, psychiatrist, licensed professional counselor or social worker), your child will likely be referred for individual psychotherapy. Research studies have shown that cognitive-behavioral therapy (CBT) is the most effective treatment for depression. CBT is an evidence-based strategy that helps youth learn problem solving, relaxation, thought shifting and behavioral activation to manage their mood and improve overall functioning. Based on the severity of depression symptoms, your child might also be referred to a child psychiatrist to determine if psychiatric medication, in combination with psychotherapy, will be effective in managing his or her depressive symptoms. It will be important for your child's psychiatrist to work closely with the neurology team to ensure that medication treatment for their mood does not interfere with their epilepsy treatment.

Resources

The Children's Health℠ Pediatric Epilepsy Center has a psychologist and social worker available to discuss any mental health concerns you might have for your child. Please contact your neurology provider if you'd like to learn more about how to access these services. Additionally, the following resources have information about depression symptoms.

Health & Wellness Library resources:

Websites

Books

Helping Your Depressed Child: A Step-by-Step Guide for Parents, by Martha Barnard
My Feeling Better Workbook: Help for Kids Who Are Sad and Depressed, by Sara Hamil
What to do when you grumble too much: A Child's Guide to Overcoming Negativity, by Dawn Huebner