Epilepsy and mental health

Musa is an undergraduate student who is on his way back to school, after spending the inter-semester break with his parents here in Ibadan. While waiting at the motor park for the bus to fill up, he suddenly fell down and started convulsing on the floor. His hands and entire body were jerking violently.

Commotion ensued, and a crowd quickly gathered around him. Several people were barking different instructions: ‘bring a spoon, let’s put it in his mouth’. ‘Nooo, someone get us olive oil to put in his mouth’. ‘A spoon is not good, bring a piece of wood’. ‘Sprinkle water on his head’. ‘Hold his head, try and open his mouth’. ‘Let’s pray for him – against every spirit of demonic possession, the devil is a liar’. ‘Be careful oooo, his saliva must not touch you, otherwise you will contact the disease too’. ‘So better don’t move too close to him’. ‘Pour some palm oil on his head’. Pandemonium and confusion reigned supreme as no one appeared to have a clear idea of what to do.

The crowd could therefore be grouped into three different categories: a). Curious onlookers who were afraid to move close or touch the person (perhaps for fear that it may be contagious via the saliva; b). Active participants who had an idea of what they assumed would be helpful and were busy running around to get such items; c). The prayer warriors, who were convinced that it was a demonic possession or spiritual attack and therefore resorted to fervent prayers to break the spell.

After a few minutes, the convulsion ended, and Musa fell asleep peacefully. The prayers changed to thanksgiving on the ‘victory’ over the spirit of demonic possession. Others started discussing in whispers, about what they have just witnessed. The consensus was that it was a result of spiritual attack by ‘enemies’ or possession by evil spirits.

What is epilepsy?

Epilepsy is a brain disorder which occurs as a result of abnormal electrical activity of the nerves of the brain. Because the brain controls our movement (and our thoughts, behaviour and so on); when the nerves of the brain are firing abnormally, it manifests as abnormal muscle contractions and jerky movements. This is what we see as the convulsion and the person falls to the ground. This is the commonest type of epilepsy, but there are several other types.

Some of the other types, especially the complex partial seizures which manifests as abnormal behaviour that lasts for just a few minutes, before they come back to their senses, is often considered to be a form of spiritual possession that is mysterious. Or, it is seen as a mental disorder.

What should we do when we witness someone having a fit?

The first thing is to appreciate that epilepsy is not contagious and cannot be contacted from the saliva of the patient.

DOs:

• Be calm
• If there are harmful objects such as chairs or metal around the person, move them away.
• If the person is wearing tight clothes around the neck, such as a neck tie, loosen it.
• Allow the person free room until the seizure is over.
• After the person recovers, someone should help the person to sit up for some time and then help to contact family or friends to help them home. This is important, as they may still be slightly confused.

DON’Ts

• Please, do not put anything in the person’s mouth – no spoon, wood, oil or any such thing.
• Do not attempt to hold the person’s head or force the mouth open.
• Afford the person some privacy, a few individuals can be on hand to offer assistance but forming a crowd of onlookers is not helpful.

Can it be cured?

Epilepsy is usually a chronic condition and we don’t talk about cure for chronic conditions such as hypertension or diabetes. Rather, we talk about controlling the condition with medications. So, hypertension, diabetes and epilepsy can be well controlled with medications, and the affected individuals will live their normal lives without problems.

What are the mental health consequences?

In the scenario described above with Musa, when he recovers and looks up to see a crowd gathered all around him, with his head and body covered in palm oil, olive oil and so on, he is unlikely to be happy. They may be sent away from school, refused permission to marry, and denied job opportunities. Thus, depression, anxiety and sometimes suicidal thoughts may occur among persons with epilepsy. These are often worsened by stigmatisation and discrimination, leading to a feeling of isolation from society. We should therefore show empathy and support for affected persons, while encouraging them to seek adequate treatment.