Why can't I have a grand mal seizure without everybody making it a big deal?

You can take my anti-depressants from my cold dead hands

The holidays are a stressful time for everybody. And every body reacts to stress in complex, unique ways. To celebrate the new year, this body expertly repressed and navigated two weeks worth of abandonment triggers stemming from an abusive upbringing and the resulting anxious attachment style, letting everything out in one overwhelming burst of electrical activity called a “big fucking seizure.” 

Chill, I'm fine. The CAT scan came back clear so there’s nothing in or on my brain. But they say that means it was probably caused by my medication. Bupropion, brand name Wellbutrin, lowers people’s threshold for seizures by releasing catecholamines, which can stimulate abnormal activity in the hypothalamus—your brain’s “control centre,” responsible for keeping homeostasis. Bupropion is also the only pill that has ever helped my Borderline Personality Disorder and ADHD, and was giving me the most hopeful months of my life right up until it spilled a full can of Monster Energy Drink all over the control panel for my cerebellum. I didn’t realize at the time that seeking care for this would strip me of my medication, and my autonomy.

The last thing I remember is lying blissfully on a mattress on the floor, watching Too Hot to Handle with my partner and friends. All threats were gone: Christmas was over, my parents were back in Winnipeg, my partner was back from their hometown, and the new year’s party pressure had passed. In this moment, finally able to relax, my brain let out the scream it had been holding in for weeks.

Everyone thought I was laughing. They looked back to laugh with me and instead saw my muscles contracting violently, jerking my body into a rigid state while I struggled to breathe. I made gurgling choking sounds as my wrists curled, my legs locked, my chest tightened, and my eyes rolled back in my head.  

My partner ran over to push me on my side and got someone to call 911. My muscles kept spasming, but my chest wouldn’t budge. She counted the seconds as I went over a full minute without breathing. It takes roughly 3-4 minutes of no oxygen to incur permanent brain damage, a couple more means almost certain death. After 90 seconds I inhaled, and my muscle contractions became more rhythmic and fluid until I opened my eyes (apparently to tell my partner I loved them, which is adorable). 

I have no memory of this, or the minutes before and after. The phase before is called an Aura—during this time I apparently mentioned I was feeling inexplicably ‘weird’—and the minutes afterwards, which I spent pacing around the room agitated and only vaguely aware of my surroundings, are called the Postictal Phase. Even with paramedics standing over me, it took some convincing to accept that I’d had a seizure. But the look on my friends’ faces was enough to get me into the ambulance. After a night in the ER I was cleared to go home, told to follow up with the psychiatrist prescribing me. 

This was a huge mistake. The psych was dead clear: all medical literature said to take me off Bupropion immediately. But I fought like a bitch and, given my mental health history, they very reluctantly allowed me to take the informed risk of continuing Bupropion at half the dosage knowing I could have another seizure at any time. Maybe while alone they said, standing up or on the stairs. Maybe I’d stop breathing for longer, or vomit and asphyxiate on my back. 

Whatever. I’m not convinced it was necessarily Bupe’s fault to begin with. Seizures happen when our sensory input reaches a tipping point that surpasses our brain’s ability to process. While this is commonly misunderstood to mean flashing lights or loud noises, emotions like fear and worry are also major contributors to overload.

This past Christmas saw me reunite with my estranged family after five years, my first time ever meeting them post-transition. I was deadnamed and misgendered more times in those three days than I had been in the previous two years combined. Despite this reunion, I spent Christmas Day alone because of latent family drama that made dinner unsafe for me. The loving partner I would usually turn to for support was out of town, visiting their very much not-estranged family and spending Christmas with their long-distance partner. 

To cope, I leaned a little too hard on benzodiazepines, a class of medication famous for contributing to seizures during both abuse and withdrawal. This is especially true when mixed with alcohol, which I almost never drink but had several shots of on New Year’s Eve. And in the middle of all this, I took the very significant step of meeting said partner’s partner, which forced me to confront the raw reality of my abandonment trauma while simultaneously receiving it from my family. 

But psychiatrists don’t care about that, because acknowledging the role of environmental and non-medical factors takes away their power. In the psychiatrist’s office, only brain chemistry exists—engaging with anything but pharmacokinetics makes a patient devastatingly human, far too complex and chaotic to explain let alone manipulate effectively through medication. 

Would I have had a grand mal seizure if I hadn't been taking Bupropion? Honestly, no. But I also wouldn’t have had a seizure from Bupropion alone if I’d had a safe, happy, Cali sober holiday. Maybe just a single much-needed expensive session with my therapist would have been enough to divert neurological disaster. 

Many patients would tell you this is actually the most likely case–but doctors aren’t patients. Doctors are able to become doctors specifically because they’ve never had to be patients. They’re selected and empowered by capitalist healthcare, and the only factors that matter are ones that can be labelled, measured, and monetized. 

That’s why I’ve accepted my role in psychiatry as a fleshy, noisy, inconveniently sentient bundle of neurotransmitters. My deadname sits at the top of a document somewhere in the database of a mental hospital, followed by a list of ways that capitalism has tried to ruin me and then blamed me for it. The people writing this document are not only ripping away my psychological lifeline on the incalculable probability that it contributed to a medical event with myriad complex causes—they have the power to lock any of us up indefinitely without trial or charges, something even the most crooked cops and judges can’t pull off in this system.  

So fine, I accept that I could very well be in line for another, more serious grand mal seizure. But that probability is unknowable. And I won’t be conscious to feel it anyway. 

What I will feel is waking up every morning with my self worth cowering in the corner of a brain that resembles a trashed motel room. I will feel the endless beatdown of cis-normativity, and I will feel the repeated stabbing pains of abandonment every time I try to love someone. Or I could go back on atypical antipsychotics and become an emotional terminator, functionally alive with no urge to eat or sleep or cry, riding out muscle contractions so strong I wake up in the middle of the night from hitting my own face. 

I wish I had time to care about another seizure, but I have rent to pay. If I stop now I will die a death far slower and more painful than any seizure, and I will be conscious for every second of it. The lesson I learned from this terrifying and potentially lethal ordeal is that I should lie to my doctors if I want to preserve what minuscule agency I have left over my central nervous system as a trans autistic in the carceral psych-industrial complex. If exercising that agency means playing Russian roulette with my brain chemistry, then the least these fascists can do is prescribe me the bullet.

Cassandra Kislenko is an autistic genderless angel writing in Tkaronto.
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