Many people living with epilepsy also experience mental health challenges, and bipolar disorder is a common coexisting condition. Bipolar disorder is characterized by mood swings, which can range from depressive episodes to manic periods. For individuals with epilepsy, managing both conditions can be complex, with one condition sometimes affecting the other.

More than 1,400 members of MyEpilepsyTeam report living with both bipolar disorder and epilepsy. This overlap raises many questions: How are the two conditions linked? Can epilepsy increase your risk of developing bipolar disorder? In this article, we’ll explore the connection between these two conditions and how they affect one another.

Is Bipolar Disorder More Common Among People With Epilepsy?

Yes, research shows that bipolar disorder is more common in people with epilepsy than in the general population. Studies indicate that people with epilepsy have a higher risk of developing a mood disorder, and people with a mood disorder have a higher risk of developing epilepsy.

According to a 2021 review, mood disorders and anxiety disorders were the most common mental health conditions that affect people who live with epilepsy. Bipolar disorder affected 6.2 percent of study participants, especially those with temporal lobe epilepsy (TLE). By contrast, about 2.8 percent of the general population is estimated to have bipolar disorder.

Does Epilepsy Cause Bipolar Disorder?

While epilepsy itself doesn’t directly cause bipolar disorder, brain activity from recurrent seizures may contribute to its development. A 2020 study showed that participants who had possible seizure-related brain activity tended to have more hypomanic episodes (periods when energy and mood are elevated, but not as elevated as they are in a manic episode) each year. This connection suggests that there may be shared neurological factors at play, possibly due to disruptions in brain regions that control both mood and seizure activity.

Some MyEpilepsyTeam members have shared stories about developing bipolar symptoms after years of seizures: “I went through a tragic accident and fractured my skull,” one MyEpilepsyTeam member shared. “Although I already had epilepsy, I later learned that it caused my bipolar disorder.”

While more research is needed to fully understand the exact relationship between bipolar disorder and epilepsy, there’s some evidence that seizure activity can affect mental health over time.

Other MyEpilepsyTeam members have commented on the difficulty of simultaneously managing their epilepsy symptoms and the complications of bipolar disorder.

“The mental health aspect makes it harder,” another MyEpilepsyTeam member shared. “I have a tendency to push people away and stay in my own world … unless it’s my kids, dog, or horses.”

Shared Risk Factors Between Bipolar Disorder and Epilepsy

Several factors may increase the likelihood of having both bipolar disorder and epilepsy.

Genetics

Both epilepsy and bipolar disorder can run in families, suggesting there might be a genetic or hereditary link between the two. A gene called ANK3, which is associated with bipolar disorder, has also been linked to epilepsy.

Neurochemical Imbalances

Both bipolar disorder and epilepsy are associated with abnormalities in neurotransmitters (chemicals the brain uses for communication) like serotonin, dopamine, and GABA. These chemicals regulate both mood and brain excitability, so issues with their production or regulation in the brain can lead to a higher risk of bipolar episodes as well as seizures.

Brain Injuries

Repeated seizures or injuries to brain areas that control emotions, like the temporal lobe, can increase the risk of developing bipolar disorder. These brain regions play a big role in regulating mood, so when the brain is damaged, it can make emotional control harder.

Studies show that people with temporal lobe epilepsy are more likely to experience mood disorders, including mania and depression. This connection between brain injury and mood regulation may help explain why bipolar disorder is more common in people with epilepsy.

Can Bipolar Symptoms Trigger Seizures?

Manic episodes in bipolar disorder are characterized by heightened energy, mood swings, and sometimes impulsive behavior. In some cases, these periods of emotional stress may trigger seizures in individuals with epilepsy.

Sleep deprivation is a common trigger for both mood episodes and seizures, and it’s crucial for those with epilepsy to get adequate rest. Managing both conditions can require a careful balance of medications and lifestyle changes to avoid triggers like stress and lack of sleep, which can worsen both mood and seizure control.

Can Bipolar Medications Trigger Seizures?

While some bipolar disorder medications, such as antidepressants, can increase the risk of seizures, it is generally rare. One 2021 study showed that selective serotonin reuptake inhibitors (SSRIs) may provoke epileptic seizures in 0.1 percent of people who take them.

However, several medications used to treat bipolar disorder, such as mood stabilizers and antipsychotics, can make seizures less likely and help you manage them. For example, lamotrigine and valproate are commonly prescribed for both epilepsy and bipolar disorder, making them potentially effective for people managing both conditions.

Can Antiepileptic Drugs Complicate Bipolar Disorder?

Some anticonvulsant drugs used to treat epilepsy, including gabapentin (Neurontin), lamotrigine (Lamictal), topiramate (Topamax), and divalproex sodium (Depakote), have been found to improve mood and help manage both epilepsy and bipolar disorder.

However, everyone can react differently to drugs and may experience different side effects. Some antiepileptic drugs (AEDs) can affect mood and potentially complicate bipolar disorder in certain people.

Here’s a table showing which AEDs are associated with different mood-related side effects.

Given the wide range of potential side effects, it’s important to work closely with your health care provider to find a treatment plan that works for both conditions.

Tips From MyEpilepsyTeam Members

Living with both bipolar disorder and epilepsy can be challenging, but many members of MyEpilepsyTeam have shared advice for managing both conditions.

Stick To a Routine

Regular sleep and medication schedules can help stabilize both mood and seizure control.

“What helps with taking medication is developing a routine and sticking with it … My mom took me aside and said, ‘This is your disease. You can handle this,’” a MyEpilepsyTeam member shared. “Just set up your routine and go for it. Stay on the path.”

Talk to Your Doctor

Always report new or worsening symptoms to your neurologist, regardless of whether they’re related to your mood or seizures. Although speaking to your doctor can be intimidating, it’s an important part of managing both bipolar disorder and epilepsy.

“I have a difficult time talking to my doctor, odd as it sounds,” another member shared. “I go to the VA and still have that way of thinking that I shouldn’t talk to doctors. I’m just figuring it out. I have to get up and face the world every day for my kids.”

Seek Support

Whether you go to therapy, join peer support groups, or find community on MyEpilepsyTeam, talking to others who understand what you’re going through can be a vital part of managing your health. Make sure to speak with people closest to you, like family, your partner, or other loved ones, about the support you need.

“Feel free to post either to vent, ask for support, or give others support,” a member urged others. “We would also like to know some of your feelings and opinions on various questions so we can help you learn more, as well as give you support!”

Other Mood Disorders Associated With Epilepsy

While bipolar disorder is commonly associated with epilepsy, other mood disorders can also coexist with seizures, including:

• Major depressive disorder
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)

The Bottom Line

If you’re living with both bipolar disorder and epilepsy, you’re not alone. These conditions often overlap, and managing them together requires a careful, individualized approach. Speak with your health care provider about the best treatment plan for your unique situation. Medication, therapy, and lifestyle changes can all work together to improve your quality of life.

Talk With Others Who Understand

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. On MyEpilepsyTeam, more than 122,000 members come together to ask questions, give advice, and share stories with others who understand life with epilepsy.

Do you live with a mood disorder in addition to epilepsy? Have you found effective ways to nurture your mental health? Share your experiences in a comment below or on your Activities page.