Susannah Cahalan

Last updated
Susannah Cahalan
Susannah Cahalan.jpg
Cahalan in 2014
Born (1985-01-30) January 30, 1985 (age 39)
CitizenshipUSA
Education Washington University in St. Louis
Occupation(s)journalist, author
Notable work Brain on Fire
Spouse
Stephen Grywalski
(m. 2015)
Children2

Susannah Cahalan (born January 30, 1985) is an American writer and author, known for writing the memoir Brain on Fire: My Month of Madness , about her hospitalization with a rare auto-immune disease, anti-NMDA receptor encephalitis. [1] [2] [3] She published a second book, The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness, in 2019. When she is not writing longer works, she works as a writer for the New York Post . Cahalan's work has raised awareness for her brain disease, making it more well-known and decreasing the likelihood of misdiagnoses.

Contents

Personal life and career

The writing of Brain on Fire: My Month of Madness

As Cahalan was a journalist for the New York Post before she became ill, her editor suggested that she write about her disease and how it impacted her. As she recovered from her brain illness, she decided to bring the same journalistic approach to writing her memoir, using fact and research as the foundation for her story. According to Cahalan, it was a "very dissociative process" to write about her experience with the disease. She had to recreate the timeline of everything that happened, gathering different records from the hospital to keep track of what happened and when. Through interviewing those closest to her, she was able to piece together what that month looked like. [4] Overwhelmingly, what she remembered from her disease was the fear and anger that it created within her. Writing her book, she said, felt like regaining control over the body that had controlled her for so long. [5]

Current affairs

Cahalan still writes for the New York Post with articles published frequently. [6] She gave a lecture at the opening session of the American Psychiatric Association's 2017 meeting. [7] She presents talks for hospitals and universities to raise awareness about her disease. She resides in Brooklyn, New York, sharing a home with her husband, twin boys, and dog. [8]

Anti-NMDA receptor encephalitis

Disease presentation and misdiagnoses

Susannah's disease manifested in 2009 when she was just 24 years old. It began with sensory issues, which she later described in her article "My Mysterious Lost Month of Madness" as experiencing the world “brighter, louder, more painful.” [4] She also began experiencing numbness in the whole left side of her body, and paranoid hallucinations of bed bug bites. Concerned by the numbness, Cahalan sought out a neurologist who ran multiple inconclusive tests, including two normal MRIs. Susannah began experiencing severe insomnia and continued behavioral abnormalities. One night at her boyfriend's apartment, she had a grand mal seizure and woke up in St. Luke's Hospital. Cahalan describes the hospital neurologist as dismissive, and she received her first of multiple misdiagnoses: alcohol withdrawal. Psychiatrists also misdiagnosed her with schizophrenia and bipolar I disorder. Cahalan was released from the hospital, and as her disease worsened, she had another grand mal seizure. [4]

Hospital stay

After her second seizure, Cahalan's parents took her to the hospital for an EEG and demanded that she not be taken to a psychiatric floor. Unlike many anti-NMDA cases, Cahalan was never admitted to a psychiatric ward. While at the hospital, Susannah had her third seizure and was immediately placed on the epilepsy floor of New York University's Medical Center. Susannah's hallucinations and delusions soared during the month she spent in the hospital. Susannah had two lumbar puncture procedures that revealed high white blood cell counts. Because high white blood cells count signify brain swelling, the case was officially passed to neuro-pathologist and epileptologist, Dr. Souhel Najjar at NYU medical center. [4]

Diagnosis (anti-NMDA receptor encephalitis)

Dr. Najjar had Cahalan perform a “clock test", which involves the patient drawing the face of a clock. When Cahalan drew her clock, she was only able to recreate half of it, indicating injury to one side of her brain. After a brain biopsy, it was concluded that Cahalan's issue was not psychiatric, but the result of anti-NMDA encephalitis, a brain-inflammation disease with an unknown cause. She was only the 217th person diagnosed with this illness. [5]

Treatment and recovery

In order to treat her disease, she was given an assortment of different steroids, infusions, and plasmapheresis. She made a full recovery without suffering long-term brain damage. [9]

Film adaptation

Netflix released a feature film based on Brain on Fire. The movie, which shares the title of the book, was directed by Irish filmmaker Gerard Barrett. Chloë Grace Moretz portrays Cahalan in the film, which chronicles the events leading to Cahalan's misdiagnosis, hospitalization, and eventual diagnosis and recovery. [10]

Book about David Rosenhan

In 2019, Cahalan's second book was published, The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness. In the work she accuses psychologist David Rosenhan of fabricating the results of seminal research published in the journal Science . Rosenhan's work demonstrated that staff working at psychiatric hospitals, including psychiatrists, could be easily misled to diagnose schizophrenia when individuals were perfectly sane and reported the mistreatment of patients in these facilities. Cahalan was drawn to this study due to her own experiences with being improperly diagnosed with mental illness, but as she researched Rosenhan and his activity, she began to find contradictions in his work that made her question the validity of his experiment. [9] [11]

Awards

Cahalan has been awarded the Poynter Fellowship in Journalism from Yale University, the Richardson Seminar in the History of Psychiatry from Cornell in 2020, and the Spitzer Memorial lecture from Columbia University in 2020. [12]

Related Research Articles

Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.

<span class="mw-page-title-main">Psychiatric hospital</span> Hospital specializing in the treatment of serious mental disorders

Psychiatric hospitals, also known as mental health hospitals, or behavioral health hospitals are hospitals or wards specializing in the treatment of severe mental disorders, including schizophrenia, bipolar disorder, eating disorders, dissociative identity disorder, major depressive disorder, and others.

<span class="mw-page-title-main">Martha Mitchell effect</span> Labelling real experiences as delusional

The Martha Mitchell effect occurs when a medical professional labels a patient's accurate perception of real events as delusional, resulting in misdiagnosis.

Encephalopathy means any disorder or disease of the brain, especially chronic degenerative conditions. In modern usage, encephalopathy does not refer to a single disease, but rather to a syndrome of overall brain dysfunction; this syndrome has many possible organic and inorganic causes.

<span class="mw-page-title-main">Rosenhan experiment</span> Experiment to determine the validity of psychiatric diagnosis

The Rosenhan experiment or Thud experiment was an experiment conducted to determine the validity of psychiatric diagnosis. Participants submitted themselves for evaluation at various psychiatric institutions and feigned hallucinations in order to be accepted, but acted normally from then onward. Each was diagnosed with psychiatric disorders and were given antipsychotic medication. The study was conducted by psychologist David Rosenhan, a Stanford University professor, and published by the journal Science in 1973 under the title "On Being Sane in Insane Places".

<span class="mw-page-title-main">David Rosenhan</span> American psychologist

David L. Rosenhan was an American psychologist. He is best known for the Rosenhan experiment, a study challenging the validity of psychiatry diagnoses.

Rasmussen's encephalitis is a rare inflammatory neurological disease, characterized by frequent and severe seizures, loss of motor skills and speech, hemiparesis, encephalitis, and dementia. The illness affects a single cerebral hemisphere and generally occurs in children under the age of 15.

California encephalitis orthobunyavirus type strain California encephalitis virus was discovered in Kern County, California, and causes encephalitis in humans. Encephalitis is an acute inflammation of the brain that can cause minor symptoms, such as headaches, to more severe symptoms such as seizures. Mosquitoes serve as its carrier and for this reason this virus is known as an arbovirus.

<span class="mw-page-title-main">Viral encephalitis</span> Medical condition

Viral encephalitis is inflammation of the brain parenchyma, called encephalitis, by a virus. The different forms of viral encephalitis are called viral encephalitides. It is the most common type of encephalitis and often occurs with viral meningitis. Encephalitic viruses first cause infection and replicate outside of the central nervous system (CNS), most reaching the CNS through the circulatory system and a minority from nerve endings toward the CNS. Once in the brain, the virus and the host's inflammatory response disrupt neural function, leading to illness and complications, many of which frequently are neurological in nature, such as impaired motor skills and altered behavior.

Lauren Slater is an American psychotherapist and writer. She is the author of nine books, including Welcome To My Country (1996), Prozac Diary (1998), and Lying: A Metaphorical Memoir (2000). Her 2004 book Opening Skinner's Box: Great Psychological Experiments of the Twentieth Century, a description of psychology experiments "narrated as stories," has drawn both praise and criticism. Criticism has focused on Slater's research methods and on the extent to which some of the experiences she describes may have been fictionalized.

<span class="mw-page-title-main">Meningoencephalitis</span> Medical condition

Meningoencephalitis, also known as herpes meningoencephalitis, is a medical condition that simultaneously resembles both meningitis, which is an infection or inflammation of the meninges, and encephalitis, which is an infection or inflammation of the brain tissue.

<span class="mw-page-title-main">Limbic encephalitis</span> Inflammation involving the limbic system in the brain

Limbic encephalitis is a form of encephalitis, a disease characterized by inflammation of the brain. Limbic encephalitis is caused by autoimmunity: an abnormal state where the body produces antibodies against itself. Some cases are associated with cancer and some are not. Although the disease is known as "limbic" encephalitis, it is seldom limited to the limbic system and post-mortem studies usually show involvement of other parts of the brain. The disease was first described by Brierley and others in 1960 as a series of three cases. The link to cancer was first noted in 1968 and confirmed by later investigators.

<span class="mw-page-title-main">Anti-NMDA receptor encephalitis</span> Rare disease which results in brain inflammation

Anti-NMDA receptor encephalitis is a type of brain inflammation caused by antibodies. Early symptoms may include fever, headache, and feeling tired. This is then typically followed by psychosis which presents with false beliefs (delusions) and seeing or hearing things that others do not see or hear (hallucinations). People are also often agitated or confused. Over time, seizures, decreased breathing, and blood pressure and heart rate variability typically occur. In some cases, patients may develop catatonia.

<span class="mw-page-title-main">Differential diagnoses of depression</span> Differential diagnoses

Depression, one of the most commonly diagnosed psychiatric disorders, is being diagnosed in increasing numbers in various segments of the population worldwide. Depression in the United States alone affects 17.6 million Americans each year or 1 in 6 people. Depressed patients are at increased risk of type 2 diabetes, cardiovascular disease and suicide. Within the next twenty years depression is expected to become the second leading cause of disability worldwide and the leading cause in high-income nations, including the United States. In approximately 75% of suicides, the individuals had seen a physician within the prior year before their death, 45–66% within the prior month. About a third of those who died by suicide had contact with mental health services in the prior year, a fifth within the preceding month.

<i>Brain on Fire</i> 2012 autobiography by Susannah Cahalan

Brain on Fire: My Month of Madness is a 2012 New York Times best-selling autobiography by New York Post writer Susannah Cahalan. The book details Cahalan's struggle with a rare form of encephalitis and her recovery. It was first published on November 13, 2012, through Free Press in hardback, and was later reprinted in paperback by Simon & Schuster after the two companies merged.

<i>Brain on Fire</i> (film) 2016 film

Brain on Fire is a 2016 biographical drama film directed and written by Irish filmmaker Gerard Barrett. The film is based on Susannah Cahalan's memoir Brain on Fire: My Month of Madness and stars Chloë Grace Moretz, Jenny Slate, Thomas Mann, Tyler Perry, Carrie-Anne Moss, and Richard Armitage.

Anti-Hu associated encephalitis, also known as Anti-ANNA1 associated encephalitis, is an uncommon form of brain inflammation that is associated with an underlying cancer. It can cause psychiatric symptoms such as depression, anxiety, and hallucinations. It can also produce neurological symptoms such as confusion, memory loss, weakness, sensory loss, pain, seizures, and problems coordinating the movement of the body.

Souhel Najjar is a Syrian-American neurologist whose story with Susannah Cahalan turned into an American drama film. He is considered an expert in the field of encephalopathy, specifically the treatment of encephalitis.

Winston Harvey Price was an American scientist and professor of epidemiology with a special interest in infectious diseases, who made media headlines in 1957, when he reported details of a vaccine for the common cold after isolating the first rhinovirus. He was acknowledged by the director of the Public Health Research Institute at the time. However, other specialists in the field of vaccine research have disputed his methods and data.

References

  1. "'Brain on Fire' by Susannah Cahalan". AAMCNews. Retrieved 4 September 2016.
  2. Kahn, Jennifer. "Under Attack: One Woman's Terrifying Battle With an Auto-Immune Disease". oprah.com . Retrieved July 30, 2015.
  3. Cadwalladr, Carole (January 13, 2013). "Susannah Cahalan: 'What I remember most vividly is, the fear and anger'". The Guardian . Retrieved 30 July 2015.
  4. 1 2 3 4 Cahalan, Susannah (October 4, 2009). "My Mysterious Lost Month of Madness". New York Post. Retrieved 31 July 2022.
  5. 1 2 Cadwalladr, Carole (12 January 2013). "Susannah Cahalan: 'What I remember most vividly are the fear and anger'". The Guardian. Retrieved 31 July 2022.
  6. "Susannah Cahalan". New York Post. Retrieved 31 July 2022.
  7. Aftab, Aftab (18 February 2020). "50 Shades of Misdiagnosis". Psychiatric Times. Retrieved 31 July 2022.
  8. "Susannah Cahalan – Ex Officio Member". Autoimmune Encephalitis Alliance. Retrieved 31 July 2022.
  9. 1 2 Eakin, Emily (November 2, 2019). "Her Illness Was Misdiagnosed as Madness. Now Susannah Cahalan Takes On Madness in Medicine". The New York Times. Retrieved November 17, 2019.
  10. Rooney, David (16 September 2016). "'Brain on Fire': Film Review". Hollywood Reporter. Retrieved 31 July 2022.
  11. Rowe, Elizabeth (November 5, 2019). "Susannah Cahalan on The Great Pretender, Brain on Fire, and the Changing Field of Psychiatry". BOOKish. Archived from the original on December 19, 2019. Retrieved November 17, 2019.
  12. "Susannah Cahalan". Keppler Speakers. Retrieved 31 July 2022.
External videos
Nuvola apps kaboodle.svg Q&A interview with Cahalan on The Great Pretender, November 10, 2019, C-SPAN