‘’There was a lot of stuff that you were constantly having to think about and take into consideration in your life that other people just don’t have to deal with. At times it can be overbearing and just weigh on you, stress on you. You know, you can feel depressed and you just don’t feel like maybe you have the same opportunities as other people,’’ (1) was what a Swedish patient of epilepsy, Derek Erickson, said during an interview. Only at six months old, did his parents observe odd behaviour, diagnosing him with epilepsy as an infant.
Epilepsy is a neurological disorder that causes abnormalities in how the brain functions (2). These abnormalities can be observed during periods of unusual behaviour, such as sensations and seizures, which comes with a variety of symptoms alone. While some seizures cause the body to ‘jerk and shake’, also called a ‘fit’ (3), some cause loss of awareness, a staring spell where one stares blankly for a few seconds, stiff muscles, temporary confusion or feelings of anxiety, fear or deja vu. They are the result of neurons being synchronously active when they are not supposed to be (4). The active neurons continuously send out electric signals. If these electric signals are sent towards our motor neurons, which are responsible for communicating with our muscles about when to contract and when to relax, our body will react with the ‘jerk and shake’ movement.
Seizures fall under two main categories; focal, meaning that seizures seem to result from abnormal activity in a particular part of the brain, or generalised, meaning that the seizures involve all parts of the brain. In addition to varying in category and location in the brain, they can also differ in frequency; while one can experience a seizure as little as once a year, another individual may experience several seizures every day.
As Derek Erickson has shared, patients of epilepsy often face psychological challenges which are mostly unknown to their outside world. There are numerous physical consequences including patients falling down during a seizure, often injuring the head. These impacts are the visible and predictable results of epilepsy. However, the disorder is not simply confined to the physical impacts but also involves the psychology of an individual. The physical and mental impact of epilepsy coexists, often being intertwined with how patients have to react to their symptoms.
A study by Kerr et al. has confirmed that people suffering from epileptic seizures are more at risk of injuries. While assessing the risks of accidents, they found that 12 months after the beginning of the seizures, the cumulative probability of accidents was 17%; at 24 months after the beginning of the seizures, this value became 27% (5). The natural knowledge of this causes the patients to live in a state of anxiety, as it is unknown to them when they will have the seizure. “When will it happen?”, “Where will it happen?”, “Will I be alone?”, “Will I hit my head and become unconscious and no one will be there to help me?” are just a few of the many questions that are storming in their head constantly. The burden of this eventually becomes unbearable and can lead to social isolation.
In research conducted with participants who were 18 years and older, it was found that epilepsy patients were twice as likely to be diagnosed with depression when compared to adults that were not suffering from epilepsy (6). The cause of depression also has its roots in the biology of epilepsy, where some brain areas that are localised for the regulation of mood may be targeted for focal seizures and can cause the misregulation of the individual’s moods. This, when coupled with the continuous fear caused by the uncertainty of when the seizures will take place, individuals have been observed to withdraw into themselves, isolating themselves from the outside world, and eventually becoming alienated.
Swedish. (2013, September 12). A patient's experience with epilepsy. YouTube. Retrieved June 30, 2022, from https://youtu.be/cQn3Kh9OlIg
Mayo Foundation for Medical Education and Research. (2021, October 7). Epilepsy. Mayo Clinic. Retrieved June 30, 2022, from https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093
NHS. (2020). Epilepsy Symptoms. NHS choices. Retrieved June 30, 2022, from https://www.nhs.uk/conditions/epilepsy/symptoms/
“Epilepsy.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/epilepsy.
Kerr, M. P. “The Impact of Epilepsy on Patients' Lives.” Acta Neurologica Scandinavica, vol. 126, 2012, pp. 1–9., doi:10.1111/ane.12014.
Kobau, Rosemarie, et al. “Prevalence of Self-Reported Epilepsy or Seizure Disorder and Its Associations with Self-Reported Depression and Anxiety: Results from the 2004 Healthstyles Survey.” Epilepsia, vol. 47, no. 11, 2006, pp. 1915–1921., doi:10.1111/j.1528-1167.2006.00612.x.