Epilepsy

Mim was walking for a designer at Dhaka Fashion Week when she had her first seizure, backstage, at nineteen. Her family told everyone she had fainted from the heat of the lights. Her agency was told the same. She is twenty-two now, booked every season, and her mother worries more about marriage proposals than about the seizures.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding epilepsy

Epilepsy is a long-term condition of the brain in which bursts of abnormal electrical activity cause repeated seizures. Seizures can look like shaking, staring spells, sudden falls or brief confusion. It is a medical condition, not possession, not madness and not contagious. People with epilepsy also have higher rates of anxiety and depression, often made worse by stigma and secrecy.

How common is epilepsy?

Around 50 million people in the world have epilepsy, WHO estimates. And up to 70% of them could live without seizures if properly diagnosed and treated.

Signs and symptoms of epilepsy

• Episodes of shaking, stiffening, staring, or loss of awareness
• Sudden unexplained falls, or confusion afterwards
• Low mood, anxiety or isolation in someone living with epilepsy

Treatment for epilepsy

Diagnosis and seizure treatment are led by a neurologist, usually with anti-seizure medicines. A psychiatrist’s part is to treat the depression and anxiety that so often come with epilepsy, to help families talk about it openly, and to tell epilepsy apart from other conditions that can look like it.

For anyone who witnesses a seizure: stay calm, move hard objects away, cushion their head, put nothing in their mouth, turn them on their side once the shaking stops, and call 999 if it is a first seizure, lasts more than five minutes, causes an injury, or leaves them struggling to breathe or slow to wake.

What getting better can look like

Good care, for Mim, might mean a year without a seizure, an agency that knows what to do if one comes, and a family that no longer needs a story about the lights.

Common questions about epilepsy

Is epilepsy curable, or will the seizures last for life?

Epilepsy is a long-term condition of the brain, and for many people it can be well controlled. WHO estimates that up to 70% of people with epilepsy could live without seizures if properly diagnosed and treated, usually with anti-seizure medicines prescribed by a neurologist. Any change to those medicines should be planned with the treating doctor.

What should I do if someone is having a seizure?

Stay calm, move hard objects away and cushion the person’s head. Put nothing in their mouth, and once the shaking stops, turn them on their side. Call 999 if it is a first seizure, if it lasts more than five minutes, if the person is injured, or if they have trouble breathing or do not wake fully afterwards.

When to see a psychiatrist

Any first seizure needs medical assessment. If epilepsy is affecting mood, confidence or family life, that deserves care too.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• World Health Organization, “Epilepsy” fact sheet
• NHS, What to do if someone has a seizure (fit), page last reviewed 19 December 2023