The diagnosis of epilepsy represents a broad spectrum, both medically and socially.  The onset of epilepsy is traumatic at any age but especially so in adolescence.  Adolescence is a time of significant individual growth and change.  Physical changes occur, intellectual capacities increase and emotions intensify.  It is a time of "angst", a time of individual self testing, experimentation and self definition.

The major tasks of this period include establishing independence, realizing one’s identity and preparing for adult self-reliance.  The psychological development of the adolescent can be fully understood only in the context of the teenagers previous experiences and the uniqueness with which he had moved through earlier developmental stages.

The impact of major restrictions on lifestyle imposed by seizures in adolescence stands at odds with the increasing independence that characterizes adolescence for  children with epilepsy.  In particular, issues of disclosure, stigma, self-esteem, driving, social relationships including dating and work become fundamental issues during the adolescent years.  The factors that lead to successful adjustment versus maladjustment in adolescents with epilepsy are still being sorted out.

Many factors play a role in how this disorder is perceived and coped with by the adolescent.  The family and their attitudes, social environment and the cognitive deficits of the adolescent are just a few of many factors to be considered.  Little research has been conducted as how best to intervene in assisting the adolescent with the psychosocial burden of epilepsy.   In my work with adolescents and their families over the past 20 years, I find that understanding the issues of adolescents with epilepsy requires listening to them carefully.  We must never forget that one of our most powerful tools in the treatment and care of patients is that of a careful and respectful extended conversation with them.  It should be a conversation in which we come to fully understand the concerns of our patients, as well as one in which we impart our understanding of both their epilepsy and the ways in which we can reinforce, clarify or suggest new ways of coping with it and their life experiences.  Of key importance in the prevention of social problems so often associated with epilepsy is early intervention to assure the teenager gets appropriate medical care, patient and family education in regard to epilepsy, l and an opportunity for individual and peer group support in regard to his/her seizures.  The following are of key importance in the prevention of social problems associated with epilepsy:  1) early intervention to assure appropriate medical care, 2) patient and family education in regard to epilepsy, and 3) an opportunity for individual and peer group support in regard to his/her seizures.  With prompt  intervention, many of the common psychosocial problems can be prevented.

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Please note:  The above article was reviewed by the author and corrected in August, 2005.

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