What is the relationship between epilepsy and bipolar disorder?

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People with epilepsy may be more likely to have psychiatric conditions, including bipolar disorder. However, researchers currently do not fully understand the reasons for this.

Some suggest those with epilepsy may also have other conditions, such as bipolar disorder, due to:

• genetics
• environmental factors that cause epilepsy and bipolar disorder
• neurobiological factors, such as differences in the brain
• combinations of the above

Researchers also believe that having epilepsy at the same time as other psychiatric conditions could be due to bidirectional relationships. This is where psychiatric conditions increase the risk of epilepsy, or having epilepsy increases a person’s risk of developing psychiatric conditions.

According to 2024 research, genetics may also play a part in whether a person develops epilepsy and other conditions.

Some evidence indicates having focal epilepsy may make a person more likely to develop psychiatric conditions such as bipolar disorder. Focal epilepsy is where a person’s epilepsy mainly affects one side of their brain and body.

However, this research concluded that genetics can only partially explain why people with epilepsy also have other conditions.

Epilepsy is a chronic brain condition. If a person has epilepsy, groups of nerve cells called neurons in the brain sometimes send the wrong signals. These signals then cause seizures.

Seizures are short, unusual changes in brain activity. Some seizures can appear to be staring spells. Others may cause a person to:

• fall
• shake
• be unaware of what is going on around them

A person must have experienced two or more seizures for a healthcare professional to diagnose epilepsy.

Learn more about epilepsy.

Bipolar disorder is a mental health condition that causes periods of unusually high and low mood.

These are called manic and depressive episodes. They differ from the typical ups or downs most people experience. During these episodes, people experience:

• atypical shifts in:
  • energy
  • activity levels
  • concentration
• unusually intense emotions
• changes in sleep patterns and activity levels

They may also engage in out-of-character behaviors, often without recognizing potentially harmful or undesirable effects these may have on their life.

These mood shifts can affect how people carry out daily tasks.

The condition’s symptoms and severity can vary from person to person. People can experience extended periods without symptoms.

During a severe episode, a person may experience psychosis, including hallucinations or delusions.

Learn more about bipolar disorder.

Several studies have estimated how many people with epilepsy also have bipolar disorder.

In 2021, scientists reviewed research into mental health conditions people with epilepsy have. They estimated the prevalence of bipolar in people with epilepsy to be 6.2%.

However, they noted that the studies they analyzed varied in sample size, which may have affected their results. The individual studies also reported the prevalence of bipolar disorder in epilepsy to vary from 0.5% to 11.9%.

In 2022, researchers analyzed bipolar disorder and its symptoms in people with epilepsy. They estimated the prevalence among people with epilepsy as 4.5%.

Treatment plans for these conditions may involve the following methods:

Treatments for bipolar disorder

These aim to help people manage mood changes and other symptoms. Healthcare professionals will tailor treatments for each person, including:

• medication, such as:
  • mood stabilizers
  • antidepressants
  • antipsychotics
• psychotherapy, such as cognitive behavioral therapy (CBT)
• self-management strategies and habits, such as:
  • consistent sleeping schedules
  • regular physical activity
  • avoiding alcohol or other drugs
  • limiting caffeine
• external support, such as family, friends, and support groups

Learn more about treatment for bipolar disorder.

Treatments for epilepsy

Epilepsy treatments can help stop or lessen seizures. They include:

• medications, such as antiseizure drugs
• surgery to stop seizures or to make them easier to manage
• sleep management strategies
• other treatments, including vagus nerve stimulation, which involves using an electrical device to send signals to a large nerve in the neck
• a ketogenic diet, which features a limited caloric intake and high fat and low carbohydrate foods

People may be able to prevent epilepsy by:

• preventing brain injuries
• lowering their chance of stroke and heart disease
• following a prenatal care plan with a healthcare professional to avoid problems during pregnancy
• washing their hands and preparing food safely to prevent infections such as cysticercosis
• keeping their vaccinations up to date

Read about the outlook for people with epilepsy.

The following are answers to some questions people commonly ask about bipolar disorder and epilepsy.

What mental illness is associated with epilepsy?

People with epilepsy commonly also have depression, anxiety, or episodes of psychosis.

Why do seizure meds help bipolar disorder?

Seizure medications such as carbamazepine, valproic acid, and lamotrigine have mood-stabilizing properties. Healthcare professionals may use them to treat bipolar disorder in people without epilepsy. However, other seizure medications may make a person’s bipolar symptoms worse.

Bipolar disorder can cause a person to have varying episodes of shifts in their mood, concentration, and energy. Epilepsy is a condition that causes people to have seizures.

People with epilepsy may be more likely to have bipolar disorder. Scientists are still investigating the reasons for this. However, some factors can make a person more likely to have bipolar disorder if they have epilepsy.

Treatments for bipolar disorder can help a person manage their mood changes and symptoms. Epilepsy treatments can help stop or lessen seizures.