The Relationship Between Bipolar Disorder and Epilepsy: Challenging the Dichotomy of Mental and Physical Health

Abstract The body of literature associating epilepsy with mood disorders is vast and can be traced as far back as Hippocrates. The comorbidity of the two is notoriously high. The prevalence of depressive symptoms among people with epilepsy has been widely reported for decades, though these symptoms may not be considered or treated as successfully in people with epilepsy as they are in their non-epileptic counterparts. More recently, evidence has been found suggesting that psychiatric symptoms may serve as a precursor to epilepsy. The episodic nature of the illnesses and their congruent model of progression suggest a possible connection. The goal of this literature review is to present evidence of the relationship between the two disorders. Similarities in pathophysiology, structural changes associated with the conditions, and biochemical abnormalities link these two disorders and challenge the distinction between “psychological” and “neurologic” illness. Keywords: bipolar disorder, epilepsy, depression, comorbidity, catamenial epilepsy, antidepressants, anticonvulsant