'Documentary Analysis: Brain on fire'

The film is about the experience of a writer named ‘Susannah’ who Is living her life as normal as one can live. She is happy with her life and at her 21, she gets her dream job and is living her best possible life. She's a New York Post cub reporter, loves to write. Her family is very supportive of whatever she wants to do and Stephen, her lover, is a budding musician. However, there were unusual series of symptoms reported like she begins to zone out at inopportune times. Few episodes can be taken into consideration, “it was her birthday when her parents came and she started feeling lost and vague.” Another episode where “her boss was narrating the work that is to be done, she was completely zoned out.” She was further suffering from migraines, missing deadlines and meetings, and seeing things that no one else can see or hear, such as bedbug bites or dripping faucets which can be seen in the movie when she was alone and the water was dripping. She yelled at the tap and asked it to shut. While when her dad came in there was nothing like it but she insists that there was. Frequent episodes of forgetting were also seen where she wasn’t able to keep track of days and not being able to complete the work assigned.   

Stephen takes her to the hospital when she has a seizure, where the physicians' theories about stress, lack of sleep, and excessive partying fail to explain the real cause rather saying it is because of her trance condition.  Later Susannah goes to stay with her divorced mother Rhona after she can no longer function in the office or at home alone, bouncing between high highs and low lows despite taking meds that don't seem to help. She there started to make external attributions to the state she was in. “she blamed it on Stephen, on the posts, editor and later on  New York primarily the reason of being unhappy.

 A panel of doctors would spend a month - and a huge amount of money - desperately attempting to discover what had gone wrong medically. Anti seizure and psychotic pills were medicated.  An electroencephalogram (EEG) was used by the doctors to look at the pattern where the neurons are firing and not in synchronizations with other neurons in the brain which came out to be normal. All neurological test including magnetic resonance imaging (MRI) came to be normal. Meanwhile, as her family, lover, and friends stood helplessly by her bedside, she began to progress inexorably from psychosis to catatonia.   

Despite the fact that this period nearly tore her family apart, it served as remarkable monument to her parent's faith in susannah and their detremination to not let her go.               

 There were a series of progressive symptoms where she diagnosed herself on Google and said to the doctor that I am a bipolar, I am creative and this happens to creative people. Later misdiagnoses of bipolar disorder or schizophrenia don't help either. She suddenly screams in her office saying no one loves me then suddenly laughs, firstly she was unhappy and then suddenly becomes happy. When she was with her father at the dining, “she smashes the crockery, throwing things on the floor, had a thought that her father would kidnap her and later asks not to touch her.” While she was in the hospital, she asked the doctor to get her out saying that people in the television are saying bad things about her, later she had a talk with Stephen where she expresses that “I am scared and I have multiple personality disorder” and further reported to the therapist that “nurses are talking about her” they think I cannot hear them but I can. She also tried to escape from hospital but failed. As seen In the movie she was referred to one doctor and then to another and at the end right diagnosis happened and right intervention was given. It is shown that Despite enormous breakthroughs in treatment, complex autoimmune disorders affecting several organ systems remain one of the greatest medical problems. The widespread symptoms of complex autoimmune disorders, in particular, make it difficult to diagnose the disease early on, which delays therapy. A group of experts has recently proved that treating autoimmune disorders as early as possible, even before the first clinical symptoms appear, can be exceedingly effective.(Werner and Albert, 2021).

Then, at the last minute, renowned neurologist Souhel Najjar joined her team and saved her life. He identified the signs of a recently found autoimmune sickness in which the body assaults the brain, a condition often linked to schizophrenia and autism, and maybe the source of "supernatural happenings" throughout history. The tools used were Finger Nose Proprioceptive test where the doctor asked her to touch her nose from the right hand, Tandem Gait (Heel-to-Toe) which is a physical exam where he asked her to walk in a straight line one foot infront of the other and lastly clock draw test was used where she was instructed to draw a clock on a piece of paper from 1 to 12 and which came out to be a turning point in the movie as She compressed all 12 digits on the right side of the clock, indicating a problem with the right side of the brain, which is accountable for viewing the left half of the clock. This demonstrated a more focalized lesion in her brain, rather than the more diffuse damage that would be expected in a psychiatric disorder. The clinical signs are difficult to understand. Patients usually have significant symptoms, and healing takes a long time. The ability of uxiliary examination to determine prognosis has gradually been demonstrated. The importance of EEG in predicting a patient's long-term prognosis is gradually becoming recognised. Immunotherapy started early has always been the right treatment plan for a confirmed diagnosis, but for some patients with low restorative effects, more and more effective treatment methods, such as magnetic resonance imaging (MRI), 18F fluorodeoxyglucose positron emission tomography (FDG-PET), and antibody measurement, need to be explored to shorten the clinical course of patients, reduce disease complications and sequelae, and obtain a better prognosis.(Wang and xiao,2020). 

Just because of her boyfriend and parent’s dedication and the faith they had in their daughter made her so lucky in the end as She ended up in the hands of a neurological team instead of being admitted to a psychiatric institution as a result of that one seizure. Without the support of her family and loved ones it wouldn’t have been possible for her to be at the stage where she is now. They never left her alone, were there with her throughout her journey. The positive regard and social support that was being provided by her boss, boyfriend, friends and parents played a very important role in her recovery.  The positive impact of social support on health habits and adherence, as well as greater relationship quality, has been demonstrated. Recent research has revealed a strong link between social and emotional support from others and improved health. In disease populations, social support has an impact on mortality, and good quality of life and it also aids in the study of the mechanisms that cause the behavior occurring, (Reblin and Uchnio, 2009). Social support can truly save ones ife. People who have deep ties with friends, family, or coworkers, as well as other support networks, are less vulnerable to illness. Individuals with autoimmune diseases who have a lot of social support have a better chance of surviving. There's also a strong link between social support and well-being indicators. Those with intimate personal relationships are better able to cope with a variety of pressures, (Salovey,2000).

Research References 

References

Anja Werner, A, Schafer, S, Albert, H., & Winkler, T. (2021). Targeting B cells in the phase of systematic autoimmunity globally interferes with autoimmune pathology, 24(9).DOI: 10.1016/j.isci.2021.103076

Barry, H, Byrne, S., Barrett, E., Murphy, K.C., & Cotter, D. R. (2015). Anti- N-methyl-d-aspartate receptor encephalitis: review of clinical presentation, diagnosis and treatment, 39(1), 19-23. https://doi.org/10.1192/pb.bp.113.045518

Reblin, M., & Uchino, B. N. (2008). SOocial and emotional support and its implication for health, current opinion in psychiatry, 21(2), 201-205.  https://doi.org/10.1097/YCO.0b013e3282f3ad89

Salovey. P., Rothman, A., Detweiler, J., & Steward, W. (2000). Emotional states and physical health. American Psychologist, 55(1).

Wang, H., & Xiao, Z. (2020). Current Progress on Assessing the Prognosis for Anti-N-Methyl-D-Aspartate Receptor Encephalitis, 2314-6133, https://doi.org/10.1155/2020/7506590