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Every day, in every hospital, people are being admitted with neurological symptoms like seizures, paralysis, inability to speak or walk. Other patients suffer from psychiatric symptoms such as bizarre delusions or life-shattering hallucinations. Yet not all is as it first seems. Some of those with physical problems will not have identifiable physical causes, and some with apparent psychiatric disorders will have a specific and potentially treatable physical cause.

In this 4-part series, neurologist, Professor Guy Leschziner, explores the nature of the complex interactions between physical and mental health, and how the division between the two may ultimately make little sense.

We meet Hannah, a student, who's only 20 when her behaviour suddenly changes. Almost overnight, she goes from tidy to messy, becomes erratic, unable to hold a conversation; she seems lost in herself. Her family recognises she is having a mental breakdown and Hannah is admitted to a psychiatric ward. And yet, she is not just mentally ill. Her psychiatric symptoms are later found to have a very physical cause. She has encephalitis - her brain is ‘on fire’, attacked by an autoimmune disease. We follow Hannah’s progress through diagnosis to treatment and to a dramatic outcome that takes everyone by surprise.

We also hear from Kat, who’s in her twenties, with a high-powered job in the City. Out of the blue, she starts having seizures and episodes of déjà vu. Her memory, usually very sharp, is letting her down. And she is extremely anxious. At the same time, Kat’s sister is diagnosed with cancer and Kat spends every weekend caring for her young niece and nephew. Kat’s GP thinks it’s a classic case of stress and trauma and refers her to a psychologist and a psychiatrist. But, after months of talking therapy, Kat sees a neurologist who discovers that her anxiety and seizures are driven by antibodies attacking her brain. It is her body, as well as her mind, that is unwell.

We’ll hear from psychiatrists and neurologists about the challenges of diagnosing such rare autoimmune diseases and about the pioneering immunotherapy that’s helping Kat and other patients like her.

Presenter: Professor Guy Leschziner
Producer: Sally Abrahams
Sound: Neil Churchill

Production co-ordinators: Maria Ogundele and Helena Warwick-Cross
Editor: Clare Fordham

Image: Amy Hiley amyhileyart.com