Brain on Fire- Brooke Jewett

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Brain on Fire By: Susannah Cahalan Brooke Jewett Question 1- Progression of Symptoms Susannah had multiple symptoms that made her, and some doctors believe she had different illnesses and disorders. At first, Susannah was excessively worrying, becoming angry at little things, nauseous, numbing of her left hand, etc. This made her doctor worry that her birth control was causing these symptoms. She had an MRI done and on page 19, she tells her coworker “Mono, Angela. Mono” (Cahalan, 2012, p. 19), after talking with her doctor and finding out that she had some larger lymph nodes in her neck. After finding out that she didn’t have mono, she starts to have troubles with her balance, memory, following speech, and she realizes how little she has eaten or slept. She also has extreme moods where one minute she is okay and the next she is in full hysterics. In chapter 8, she has her first known seizure and describes it as “…the most dramatic and recognizable series of seizures I’d been experiencing for days already” (Cahalan, 2012, p. 41). After talking with another coworker, she is convinced she has bipolar disorder. Susannah continues to have extreme thoughts, like whether she needs to break up with her boyfriend Stephen, or tell him that she loves him (Cahalan, 2012, p. 58). She attempts to escape, her attitude gets worse, she becomes accusatory of sabotage, etc. Her mom is told that she is “… exhibiting the classic signs of alcohol withdrawal” (Cahalan, 2012, p. 70). Several disorders were unofficially diagnosed for her within a matter of days from each other.

Question 2- Temporal Lobe Epilepsy “Temporal lobe epilepsy is the most common form of focal epilepsy” (Joshi & Klein, 2019). The amygdala and hippocampus are in the temporal lobes and have to do with emotion processing and memory. Focal aware seizures are either auras or focal impaired awareness seizures (Joshi & Klein, 2019). Auras include symptoms like partial seizures, nausea, deja-vu, panic, anxiety (Joshi & Klein, 2019). Susannah had many similarities with her experiences. She had the feeling of deja- vu but slipped to where she didn’t recognize anything; called jamais-vu (Cahalan, 2012, p. 42). She had many instances of overwhelming and sudden panic and anxiety. Focal impaired awareness seizures have symptoms like numbing of the fingers, lip- smacking, weird arm movement, etc. (Joshi & Klein, 2019). Susannah also had several similarities with these symptoms. Her mom had to keep applying Vaseline to her lips because she kept smacking them together repeatedly, drying them out (Cahalan, 2012, p. 58). 2

Question 3- Cognitive, Emotional, and Behavioral Changes Susannah started the book describing some anxiety she felt over the potential of having bug bites. But after getting it checked out, she wanted her place sprayed even after an inspector said her apartment didn’t show signs of having them (Cahalan, 2012, p. 3). Cognitively, she started to become more anxious after realizing she normally isn’t like that. Susannah describes a few events at the beginning of the book where she can’t control her emotions like crying. After agreeing to get a drink with a coworker, Susannah describes what it was like to try and be around a crowd. “In total, I had to get off the escalator three times to steady myself from sobbing during that eight-floor trip” (Cahalan, 2012, p. 36). Susannah also recalls a movie that she went and saw with her dad that had an emotional father-daughter scene. “…I ran from my seat to the theater’s bathroom, where I hid in a locked stall and allowed myself to weep until the feeling passed” (Cahalan, 2012, p. 21). These emotional outbursts were found to be out of the ordinary by Susannah. Susannah’s behavior was something that changed drastically. A couple of the emotions that led to a behavior change in some moments were anger and confusion. She often mistook someone’s intentions and took advantage of people. She was convinced the MRI nurse did something wrong because the results came back normal, and she took her rage out on her boyfriend by yelling (Cahalan, 2012, p. 43). Susannah describes an incident where she made her stepdad pull the car over so she could get a coffee and some breakfast. In a diner, she remembers feeling powerful for skipping the long line, demanding to get served first, and having her wants met (Cahalan, 2012, p. 62). This behavior relates to the prodromal signs of schizophrenia because there are similarities with her irritability and mood. As well as her sleeping and eating habits. 3

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Question 4- Personality Change A major change for Susannah was how she treated people and how people viewed her. She was outwardly accusatory towards others for what was happening to her. After being told that nothing was wrong with her, she looked at her mom and accused her and her stepdad of hiring all the doctors and nurses to perform tests on her as a punishment (Cahalan, 2012, p. 64). She often treated her dad badly as well. She describes a moment where her dad and stepmom walked into her apartment and started cleaning. “I just walked around them, watching them clean and pretending to gather my things” (Cahalan, 2012, p. 65). After while getting into a taxicab, she accuses them of kidnapping her and saying “I’m calling the police when I get out (Cahalan, 2012, p. 67). She has described her relationship with her mother as better than the one she has with her father, but she has always valued family and wouldn’t normally treat her parents like that. Her irritability towards family members relates to the prodromal symptoms of schizophrenia by it being abnormal to her behavior. It didn’t make me dislike her, I felt bad for her. I knew she didn’t know what was going on and that she couldn’t help but be moody sometimes. It was overwhelming for her. 4

References Cahalan, S. (2012). Brain on fire: My month of madness. Simon & Schuster Paperbacks. Joshi, C., & Klein, H. (2019, August 26). Temporal lobe epilepsy (TLE) . Epilepsy Foundation. https://www.epilepsy.com/what-is-epilepsy/syndromes/temporal-lobe-epilepsy#What-Is- Temporal-Lobe-Epilepsy-(TLE) 5

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