Coping with Epilepsy during Adolescence: The War Within
Adolescence is that phase of one’s life that is characterized by rapid physical, psychological and social changes. During this time, a child progresses with personal identity, reaches sexual maturity, and develops new intellectual and social skills. Adolescents having epilepsy often have more to face than others: coping with their disease process, treatment modalities and life style limitations.
The main feature of epilepsy is the unpredictability of when and where a seizure will occur. Nurses are the best suited health professionals to support adolescent patients manage their condition and maximize their quality of life by providing effective time in patient care setting. Epilepsy is the most common neurological disorder in adolescence with a prevalence of six to seven cases per 1,000 adolescents in United Kingdom (Appleton and Gibbs 2007).
Epilepsy is defined as “chronic, yet intermittent disorder characterized by a tendency to experience recurrent, unprovoked seizures” (Appleton and Gibbs 2007). It is important to remember that puberty can result in changes in seizure type and frequency (Sheth 2002). A diagnosis of epilepsy in adolescence can affect education, employment, socializing etc.
Independence, individuality and freedom are critical for all adolescents. Attaining such independence is hampered for epileptic patients, due to limitation of activities, seizures and treatment and their apprehension and embarrassment about the condition. Adolescents may display risk-taking behaviour, defying boundaries set by their family and society as a normal response to growing up, in order to develop independence and establish social autonomy.
Risk-taking behaviour may include not taking their medication on timely basis and alcohol/drug abuse. Adolescents do not understand the long term consequences of adopting risk taking behaviour; rather they are more focused on how it affects their peer relationships and self-image (Leather 2009). This can lead to poor adherence to both treatment regimens and life style recommendations.
Marshall and Crawford (2006) suggested that consuming more than two units of alcohol in a day may increase the risk of seizures in those with epilepsy. Nurses can encourage adolescents to discuss their social needs openly and should advise them to take medication on timely basis before going for any leisure time activities or social events. Marinto (2005) suggested that learning to drive is an important part of an adolescent’s freedom.
However, teenagers with epilepsy can have a disturbed social life as they are not allowed to drive. In the United Kingdom, driving regulations state that an individual with epilepsy can hold a license if they have been free of seizures for one year. Adolescents must be advised to always carry a medical alert bracelet while traveling in public transport as well. Participation in sports has been identified as important in achieving peer acceptance and improving self esteem,(McEwan et al 2004b).
Some sports such as scuba diving, parachuting and sky diving, have specific guidance related to medical conditions. Epileptic patients must be advised against taking part in water sports and should always ensure that there is someone present who knows they have epilepsy. About 3-5% people with epilepsy are photosensitive and can have seizures triggered by flickering lights.
Computers, television and video games are the need of every adolescent but appropriate advice regarding watching television and playing computer games in the dark must be provided. Many adolescents report difficulties in making friends and express feelings of being different. Austin (et al 2002) randomly surveyed teenagers in schools in the United States to look at the familiarity and knowledge of epilepsy among students.
They found that many teenagers held negative views on the condition. Shockingly, of the 19, 441 teenagers surveyed, 49% believed epilepsy was contagious and 69% reported that they would not date anyone with the condition. Epilepsy can have negative effect on adolescent’s education. Academic performance can be affected by increased absenteeism and hospitalization.
This condition enhances anxiety and depression. A school health nurse must arrange session to enhance awareness among staff and other school mates in order to reduce stigma and may positively influence the adolescent experience in school. Unemployment levels have been found to be high among adults with epilepsy (McEwan et al 2004). There are existing restrictions for some occupations such as armed forces and public services. Health care professionals working with adolescents who have epilepsy should provide advice about employment options which may not trigger seizures episodes.
Fourestie V, Douceron H, Brugieres P, Ancelle T, Lejonc JL, Gherardi RK. Neurotrichinosis. A cerebrovascular disease associated with myocardial injury and hypereosinophilia. Brain. Jun 1993;116 (Pt 3):603-616.
McEwan MJ, Espie CA, Metcalfe J (2004b) A systematic review of the contribution of qualitative research to the study of quality of life in children and adolescents with epilepsy. Seizure. 13, 1, 3-14.
Michaud PA, Fombonne E (2005) ABC of adolescence: common mental health problems. British Medical Journal. 330, 7495, 835-838. Morrow J (2007) T
Marin S (2005) The Impact of epilepsy on the adolescent. American Journal of Maternal/Child Nursing. 30, 5, 321-326.
Raty LKA, Wilde-Larsson BM (2007) Quality of life in young adults with uncomplicated epilepsy. Epilepsy & Behavior. 10, 1, 142-147.
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