Forbes India 15th Anniversary Special

Quality of Life Issues in Epilepsy

Dr. M M Arun Shivaraman, MD (Gen Medicine), DM (Neurology), DNB (Neurology), FEBN

Published: Feb 3, 2022 05:13:27 PM IST
Updated: Mar 9, 2022 07:38:21 PM IST

Quality of Life Issues in EpilepsyEpilepsy is a chronic condition with various social and psychological consequences. People with epilepsy tackle a range of challenges in their day-to-day life, because its not only about recurrent seizures, but it can be so much more and can include a very wide range of difficulties in cognition, psychiatric status, and social adaptive functioning.

Social bonds are core of our daily living and are an essential determinant of our Quality of Life (QoL). In people with epilepsy, numerous factors can slow down cognitive and affective functions necessary for smooth social interactions. Not only biological factors impact the QoL but cultural, social and religious beliefs also influence it.

People with Epilepsy Disproportionately Affect the Quality of Life Quality Due to:

Stigma and Misconception

Even with advances in education, myths and misconceptions about epilepsy still dominate today's society. Historical conceptions of epilepsy and misrepresentation in the media made more complex and negative image of epilepsy in the public eye. Media portrayals are often misguided by ancient myths that see the person with epilepsy as being possessed by demons, frothing at the mouth, violent and in need of urgent medical care. The stigma of epilepsy can regularly be more crippling for patients with epilepsy than introducing side effects. Hence people with epilepsy try to hide their condition.

Family overprotection and lack of social support may have a negative impact on self-esteem and prevents individuals from developing independence. The perceived stigma that accompanies epilepsy resultant negative self-image; and general personal dissatisfaction.

Impact of Anxiety and Depression

People with epilepsy have a higher rate of depression and anxiety disorders than the general population. Person with anxiety and depression are more likely to experience epilepsy and those with epilepsy are more likely to experience anxiety and depression. Patient may fear having a seizure which will in turn raise anxiety thresholds as will the associated stigma of having a seizure in public.

Dispositional Factors: Self-esteem and Sense of Mastery

Unpredictability is very often when someone is living with epilepsy because they may not know when a seizure will occur. Most importantly, social support was a mediator between disease severity and mastery, defined as patients' general belief that they can control the course of life despite their epilepsy. As social support increases, the sense of mastery increases, and the person's ability to cope with the limitations of their disease improves, influencing directly health.

Social factors: Social Isolation and Relationships

Epilepsy has been appeared to decrease open doors for social collaboration. Patient may have been over protective in early life which has obstructed important independent living skills and confidence in social life. A decrease in social life has many perplexing outcomes regarding social help. Social help can be a defensive factor in supporting patients with epilepsy to adapt to living with a chronic condition.

Education & Employment

Children with epilepsy have been shown to underachieve at school in comparison to their peers and are more prone to educational difficulties. These difficulties may arise as a consequence of a number of factors. Drug therapy and post ictal confusion may slow cognitive functioning and impact on children's capacity to learn. Patients with epilepsy and those who have a history of epilepsy are prohibited by law from a variety of occupations. Practices that discriminate against people with epilepsy are another major contributing factor to unemployment.

Strategies to Enhance Quality of Life

Enhancements in medical interventions and diagnostic procedures will have significant effect for the management, anticipation and psychosocial result of epilepsy and also in  improve quality of life.

In order to live a happy and full life it's important to learn how epilepsy can affect any individual, their rights and responsibilities are and how to find support and resources. Supportive friend, friendly neighbor and supportive co- workers could help in enhancing self esteem and lowering sadness and loneliness and problem associated with drug, eating and sleeping. In fact, this 'social capital' has been found to impact positively on health, morbidity and mortality.

Individual and family counseling may also work to enhance self-esteem in patient with epilepsy. Support groups for both the individual and their family can increase social support and facilitate coping strategies. Educating families and patient will enable better self-management of the condition and reduce seizure.

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