Chapter 1: What are the key themes discussed by Dr. Suzanne O'Sullivan?
I have epilepsy. Oh, do you?
Well, let's find out. Let's find out. The first book is All in Your Head, True Stories of Imaginary Illnesses. So let's just start with some actual data, which is your guesstimation, and you acknowledge it's an estimate. But of all the people that come in that have had seizures, a symptom of epilepsy... 30% of them are not epileptic.
Correct.
And then you found also that's largely true for cardiologists when people come in with chest pains. It's common for people with heart palpitations that about a third of people that are experiencing symptoms, often it doesn't align with the actual underlying disease.
Yeah, so I run seizure clinics and most people who are referred to me, they've been having a variety of different kind of convulsions or other types of seizures. Usually they come to me with a pre-existing diagnosis of epilepsy. And in the best week or the best year, a fifth of those do not have epilepsy. The seizures they're having have a purely psychological cause.
So their brains are shutting down for a purely psychological reason. And that's something that we as neurologists see all the time. That is so common. As I always explain to patients, our brains shut down in certain overwhelming situations all the time. You know that sort of you're really overloaded with information. You're listening to the radio.
You're trying to hear a sports result or a particular thing and you miss it like 10 times. And you keep rewinding and rewinding and rewinding and missing the same thing multiple times.
Yeah.
That's dissociation. That's what our brains do to protect us in moments of being overwhelmed. It's like everything in the body. Some people have too much hair. People have too little hair. Everything goes a bit wrong in some way. And this thing called dissociation, which is designed to just help us to control the overwhelming amount of information in our environments. sometimes goes wrong.
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Chapter 2: How does Dr. O'Sullivan distinguish between epileptic and psychosomatic seizures?
Well, listen, we all have some of the traits of these things, but we do not have a medical problem unless we are impaired. And it's the impairment that makes it a medical diagnosis. And that's what everyone in TikTok is really failing to appreciate. Also, I can't remember whether it was ADHD or autism, but there was something like 11 billion TikTok videos about, I think, autism.
And when they scrutinized top 133, 27% of them provided accurate information and the other 73% were just full of inaccuracies. But that's interesting, too, because those inaccuracies are seeding themselves into medical culture as well.
Well, it's funny when I see the ADHD clips, which I see all the time, it triggers something that happens a lot in AA, which is I'll be listening to someone share in AA and they'll say like this, this and this, my alcoholism. And I often go like, no, that's your humanism. You're being a human right now. And similarly with ADHD, I'll go, that's just being a human in a highly stimulating world.
Yes, you have that. I don't deny that, but that's normal and natural. And we all have some degree of that.
Exactly. And I think we're just getting worse and worse at drawing the line between what's a normal amount of it and what is an abnormal amount of it.
Do you think part of the problem is with social media? I feel like people want a thing that makes them specific. They want a thing that makes them special. They want something to be able to talk about, be an expert in. I think they want to excuse some of their shitty behavior.
unappealing behavior. Like, yeah, I always am interrupting, but I have ADHD. Don't you also think they want an excuse for some stuff?
Yeah, I'm sure that's part of it. But I also think there is this like inclination to have a thing now to present to the world. Like you don't even have a personality if you don't have a thing.
Exactly. I struggle a little bit with that because I'm seeing people who are, I'm the 15th doctor they've seen and they've got 10 different diagnoses and I'm seeing a slightly different population than the TikTok population.
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