Epilepsy and Suicide - the Increased Risk
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Suicide in people with epilepsy
The Diagnostic and Statistical Manual of mental disorders, fifth edition (DSM-5) defines suicidal ideation as “thoughts about self-harm with deliberate consideration or planning of possible techniques of causing one's own death, while suicide is the act of intentionally causing one’s own death and a suicide attempt is an attempt to end one’s own life, which may lead to one's death.10 &11 Every year, close to 800,000 people around the world die as the result of suicide: equating to one person every 40 seconds.12
Epilepsy13 is one of the most common neurological diseases and affects about 70 million people14 worldwide. Living with epilepsy often negatively affects people’s relationships with their family and friends, limits their activities at school, college, and/or the workplace, which in turn contribute to the high levels of psychiatric illness amongst people with epilepsy.
Studies of those with epilepsy in the US have shown that about a third of people with focal seizures suffer from anxiety disorders and that depression is 4-7 times more common in those with epilepsy.15 Another US study showed that people with epilepsy are at a 22% higher risk of suicide than the general population16 and another from Canada showed that people with epilepsy have a lifetime prevalence of suicidal ideation of 25% (compared to 13%17 in those without epilepsy).17*
There are studies showing that epilepsy and suicidality share common neurological pathways, which could increase the risk of suicide in people with epilepsy18 and that the incidence rate ratio for psychosis, depression and anxiety is significantly increased in all of the years prior to the diagnosis of epilepsy.19
The prevalence of suicidal ideation, suicide attempts and completed suicide among people living with epilepsy is found to be significantly higher than in those of the general population.
Whether it be National Epilepsy Awareness Month20 (November), National Suicide Prevention Month21 (September), Mental Health Awareness Week22 (in May) or any other day; people with epilepsy should be regularly screened for psychiatric illnesses, emotional imbalance, and suicidal ideation; for early diagnosis and treatment.
* It is worth noting that statistics can vary significantly from country to country, for instance, the percentage of those with epilepsy dying from suicide in Sweden accounts for significantly more than in rural China, and the percentage of those with epilepsy dying from drowning in rural China account for significantly more deaths than in Sweden.23 It is also worth considering the differences in overall suicide between countries. E.g.in Sweden 11.7 people per 100K die of suicide and in China: 8 people per 100K die of suicide.24 This leads us to the question: ‘How is suicide rate is affected by medication, wealth, and culture?’
International Public Speaker, CEO of Epilepsy Sparks
2. Military Institute of Aviation Medicine: http://www.wiml.waw.pl/?q=en
3. Warsaw Tour: https://warsawtour.pl/en/main-page/
4. Wikipedia: https://en.wikipedia.org/wiki/Poland
6. Depeche Mode: http://www.depechemode.com/
7. ABBA: https://abbasite.com/
10. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; (2013): https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
11. SpringerLink: https://link.springer.com/article/10.1186/s12991-018-0174-6
World Health Organization. Preventing suicide. A global imperative. Geneva: World Health Organization; (2019): https://www.who.int/mental_health/prevention/suicide/suicideprevent/en/
ILAE official report: a practical clinical definition of epilepsy. Epilepsia. Fisher RS, Acevedo C, Arzimanoglou A, et al. (2014); 55: 475–482. https://onlinelibrary.wiley.com/doi/full/10.1111/epi.12550
14. Epilepsy Sparks: https://www.epilepsysparks.com/
15. Harvard Health Publishing (2016): https://www.health.harvard.edu/newsletter_article/Epilepsy_and_psychiatric_disorders
I think anyone with epilepsy will agree with this and it is not unknown. I would like to see what research is being done in order to help people diagnosed with epilepsy and coping day to day with epilepsy. There is a very significant lack of support for people with epilepsy. This needs to change.