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.