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  • I have a very vivid memory

  • of my GP saying to me:

  • "You are mentally sick

  • and you have to accept help to get better."

  • Hannah was a healthy 20-year-old psychology student

  • living at home with her family

  • when she started experiencing flu-like symptoms.

  • I went to my GP and I was kind of told

  • that viruses will just generally go,

  • you just need to go home and rest, take it easy.

  • Her GP thought she had glandular fever.

  • Hannah was feeling very tired, so the symptoms fitted.

  • But then she started to develop changes

  • in her personality.

  • Soon after, Hannah lost her ability to speak.

  • I had to ask my mum to come in,

  • sit with me and talk for me to the GP.

  • I would kind of write down to my mum

  • what needed to be said.

  • Hannah was sent home with antidepressants

  • and a referral to a psychologist.

  • Her symptoms deteriorated, and she was soon admitted

  • to a psychiatric hospital,

  • where she was given antipsychotic medication.

  • She was seen by a psychiatrist,

  • who ordered an MRI scan.

  • During the scan, doctors found a cyst on her brain

  • and sent her to A&E for investigation.

  • When I got to A&E,

  • they reviewed the cyst

  • and said I was probably born with it,

  • it probably had nothing to do with the symptoms.

  • But what they did notice was

  • that my blood test showed I was fighting

  • some sort of virus.

  • More tests followed,

  • and after three weeks, the results came back,

  • and Hannah finally got her diagnosis:

  • Anti-NMDA receptor encephalitis.

  • It's an autoimmune form of encephalitis,

  • which is the inflammation of the brain.

  • According to Professor Guy Leschziner,

  • having your physical symptoms mistaken for a mental illness

  • is not uncommon.

  • We do occasionally see individuals

  • with very severe psychosis and behavioural change

  • in whom the initial diagnosis

  • is of a psychotic illness like schizophrenia.

  • But actually,

  • over the course of days or weeks

  • whilst they're in hospital,

  • it begins to be obvious that actually

  • what is underlying their condition

  • is one of these autoimmune conditions.

  • It's been known for more than a century

  • that damage to particular parts of the brain

  • and things like tumours can result in changes

  • in personality or behaviour.

  • But over the last 20 years or so,

  • we've begun to recognise

  • that there are a number of conditions

  • that have an immune basis,

  • whereby the immune system attacks the brain

  • and causes changes

  • to the functioning of that brain.

  • In Hannah's case,

  • it took several weeks for doctors to recognise

  • that this was a serious autoimmune condition

  • that required treatment with very heavy-duty drugs.

  • I was moved to neurology ward.

  • I was completely mute

  • and I had lost the ability to dress myself,

  • wash myself, feed myself.

  • So I really was trapped in my own body at this stage.

  • Hannah underwent immunotherapy treatment

  • and had 13 plasma exchanges

  • a process of filtering blood

  • before pumping it back into her body.

  • Although the treatment didn't work initially,

  • and her parents were told by doctors

  • she probably didn't have long to live,

  • after two weeks, Hannah woke up.

  • Hannah, say "Dad".

  • Dad.

  • Over subsequent weeks,

  • she learnt to speak again and walk again.

  • She says it was like learning how to live again.

  • I look back at the person

  • before I got encephalitis,

  • and I don't really know her.

  • I just can't connect with that person.

  • Five years on, Hannah has mostly recovered,

  • though she is still on immunotherapy treatment,

  • and that makes her more vulnerable to infections

  • and could impact her fertility.

  • I wish GPs would know more about encephalitis,

  • because they're the first point of contact

  • for a lot of patients.

  • I wish my GP knew more about it,

  • so she could direct me to the right pathway.

  • If I was to think about all the people who had encephalitis

  • and died in psychiatric hospitals

  • or care homes,

  • I wouldn't be able to sleep at night.

  • In Hannah's case,

  • a physical illness, encephalitis, was mistaken

  • for mental illness.

  • But sometimes it's the other way around.

  • We know that the connection

  • between body and mind goes both ways.

  • Physical problems can result in psychiatric symptoms,

  • but also psychological issues

  • can contribute to physical disease.

  • Professor Leschziner says he sees patients

  • who have symptoms like seizures, paralysis

  • and numbness with no obvious physical cause.

  • Some are eventually diagnosed

  • as having functional neurological disorder,

  • or FND,

  • which is a problem with how the brain receives

  • and sends information to the rest of the body.

  • We don't fully understand

  • what causes these conditions.

  • It seems that anybody can be vulnerable to changes

  • within the software that defines

  • how our nervous systems work.

  • We know that there are some risk factors.

  • So stress, anxiety, depression,

  • previous psychological trauma in particular.

  • But ultimately,

  • anybody can develop

  • these functional neurological disorders.

  • Globally, hundreds of thousands of people

  • develop FND every year.

  • Conditions like FND

  • and the experiences of people like Hannah

  • have led some doctors to believe that we need

  • to stop thinking of mental and physical health

  • as separate.

  • I think we need to move away

  • from defining diseases or disorders

  • as of the body and of the mind.

  • We know that actually, in almost all cases,

  • there are contributions from both.

  • Even in conditions that are thought to have

  • a pure physical basis,

  • we know that how people interpret their symptoms

  • is important in terms of defining their quality of life

  • and how severe they perceive their symptoms to be.

  • So actually understanding that,

  • making sure that everybody has access

  • to both physical and psychological treatments

  • is really of utmost importance

  • for pretty much every condition that is seen

  • by our healthcare systems,

  • and is important for everyone.

I have a very vivid memory

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