Epilepsy is a neurological issue that affects up to 600,000 people in the UK (Epilepsy Research UK, 2019). The symptoms can range from severe to mild, with different forms of the condition affecting people differently. In this article, we will explore the effects on mental health and the socio-economic trends that accompany, as well as innovative treatments aimed at easing the pain of sufferers.
Epilepsy is characterized by seizures, confusion, and extreme mental fog, and affects millions across the world in a variety of ways (Moshé et al., 2015). Medical research into the more obvious physical symptoms has been carried out for years, but the mental health aspects and the life prospects of those who suffer from epilepsy remain under reported. Epilepsy can increase the incidence of depression and anxiety, to lower rates of attainment and employment, it can affect every facet and outlet of a person’s life.
Epilepsy can have several direct and indirect effects on a person’s wellbeing. Directly, in the sense that those with epilepsy often feel a sense of preictal anxiety in the hours or days before a seizure, and this same sense of dread can often be felt for up to a week postictal of the event (Ramirez-Bermudez, 2008). For those who are diagnosed young, epilepsy can have different effects on a person’s emotional and mental wellbeing based on how the guardians of the individual respond to it. In cases where a parent or guardian has stigmatized the illness or believes that the symptoms are the fault of the child rather than a condition, research shows that many become embarrassed and attempt to hide their condition and the symptoms that often accompany. Consequentially, this often leads to lower levels of self-esteem and confidence, as well as fears of exposure and persistent shame. Conversely, those for whom the condition is treated as normal, and are afforded dignity and understanding in the environment in which they are raised, tended to have better mental wellbeing than their counterparts (Lambert, 1999). According to a 2008 paper, 86% of patients with epilepsy reported ‘anxious mood’, 79% reported ‘tension’, 75% reported issues with their ‘intellectual functioning’ and 78% reported a history of depression (Ramirez-Bermudez, 2008). Thus suggesting there is a direct correlation between these psychological disorders and epilepsy (Ramirez-Bermudez, 2008).
The psychosocial factors can often carry over, with effects including but not limited to; a perception of social stigma, adverse life events, fear, poor self-esteem, learning difficulties, a low marriage rate, and high unemployment rate’ (Piazzini, 2001). In this way, the effects of epilepsy are all-encompassing on a person’s mental as well as physical wellbeing, despite the physical symptoms being better known. Indeed, the picture becomes more concerning as we delve further into the statistics that make up our current body of research on epilepsy and social outcomes. According to a 1991 study, those fortunate enough to be ‘economically active’ the unemployment rate for those with epilepsy stood at 46%, compared to 19% of the general population (Marshall, 1991). When we look at the picture beyond the definition of ‘economically active’ we see that those with epilepsy had an employment rate of 59%. This picture is even more staggering when we consider that people with epilepsy are far more likely to be categorised as ‘unskilled’ and were more likely to be single and live in rented accommodation (Marshall, 1991). Despite the main body of this research being from 1991, the connotations and usefulness it has when discussing outcomes for epilepsy patients is still relevant to this day given that many of these issues remain unresolved at a societal level.
As breakthroughs in neuroscience continue to make lives better across the globe, innovations that may help the 30% of people with treatment-resistant epilepsy are beginning to avail themselves (O’Connell et al., 2017). Use of cannabinoids has been noted as far back as the 1800’s as a traditional folk remedy for easing the physical and some of the mental symptoms of epilepsy, but modern research is limited owing to restrictions on the consumption and research of cannabis and other narcotics. Some studies have indicated that use of CBD may be effective in convulsive and drop seizures, though further research is required on what can be at times a controversial medicine. (O’Connell, 2017).
Despite being fraught with legal issues and mired in public distrust, promising classified substances offer incredible possibility for treating epilepsy and giving patients a far higher and more comfortable standard of living. Innovative treatments and ever expansive research thankfully indicate a bright future for the treatment of epilepsy. Recent developments point to genes responsible for inflammation in the human brain as being responsible for the condition, inflammation that may very well be within our ability to treat with current inflammatory medications. It is our hope that new innovative treatments for epilepsy will ease many health inequalities and make a positive impression on the lives of many affected by epilepsy.
Bibliography
Epilepsy Research UK. (2019). Epilepsy Statistics. Epilepsyresearch.org.uk; Epilepsy Research UK. https://epilepsyresearch.org.uk/about-epilepsy/epilepsy-statistics/#:~:text=There%20are%20over%20600%2C000%20people
Lambert, M. (1999). Depression in Epilepsy: Etiology, Phenomenology, and Treatment. London: Lipincott, Wilkins & Williams.
Marshall, J. (1991). Epilepsy and employment. A community based survey in an area of high unemployment. Journal of Neurology, Neurosurgery, and Psychiatry, 200-203.
Moshé, S. L., Perucca, E., Ryvlin, P., & Tomson, T. (2015). Epilepsy: new advances. The Lancet, 385(9971), 884–898. https://doi.org/10.1016/s0140-6736(14)60456-6
O’Connell, B. K., Gloss, D., & Devinsky, O. (2017). Cannabinoids in treatment-resistant epilepsy: A review. Epilepsy & Behavior, 70(Pt B), 341–348. https://doi.org/10.1016/j.yebeh.2016.11.012
Piazzini, A. (2001). Depression and Anxiety in Patients with Epilepsy. ACADEMIA.
Ramirez-Bermudez, J. (2008). Clinical Presentation of Anxiety in Patients with Epilepsy. Mexico City: National Institute of Neurology and Neurosurgery of Mexico.