[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-412016-105":59,"doc-detail-412016-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","im-lonely-an-underrecognized-marker-of-silent-suffering-in-pwe-in-underresourced-settings","“I’m lonely” - An underrecognized marker of silent suffering in PWE in underresourced settings?","","Loneliness is increasingly recognized as a psychosocial determinant of health, yet it remains underexplored in epilepsy, especially where resources are limited. Unlike depression or anxiety, loneliness is less specifically sought or readily disclosed, despite its effects on well-being. Drawing on Jamaica clinical experience and a small observational audit, the article frames loneliness as distinct and pervasive among people with epilepsy (PWE), sometimes co-occurring with depression but also existing independently. It highlights drivers such as stigma, safety-focused restrictions, antiseizure medication effects, and gaps in epilepsy care, arguing loneliness can erode quality of life and treatment adherence. Low-cost, socially focused interventions and routine screening with a simple question are proposed.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/im-lonely-an-underrecognized-marker-of-silent-suffering-in-pwe-in-underresourced-settings/412016/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/im-lonely-an-underrecognized-marker-of-silent-suffering-in-pwe-in-underresourced-settings/412016.png","ImageObject",300,407,{"name":92,"@type":93},"Ben ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is loneliness considered underrecognized in people with epilepsy (PWE)?","Question",{"text":112,"@type":113},"The article notes loneliness is less specifically sought or readily disclosed than depression or anxiety, even though it significantly affects well-being.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What factors contribute to loneliness in PWE in under-resourced settings?",{"text":117,"@type":113},"Contributing factors include societal stigma, physician-advised safety restrictions, side effects of antiseizure medications, and systemic gaps in epilepsy care, which are often intensified in low-resource environments.",{"name":119,"@type":110,"acceptedAnswer":120},"How might loneliness affect quality of life and epilepsy outcomes?",{"text":121,"@type":113},"Loneliness may silently erode quality of life, autonomy, and treatment adherence, including because it can be closely associated with depression.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},412016,1791289502,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Epilepsy & Behavior Reports 33 (2026) 100841  \nContents lists available at ScienceDirect Epilepsy & Behavior Reports  \njournal [homepage:](homepage: www.elsevier.com/locate/ebcr)[ www.elsevier.com/locate/ebcr](homepage: www.elsevier.com/locate/ebcr)  \n| “I’m lonely”: An underrecognized marker of silent suffering in PWE in underresourced settings?\u003Cbr>Amza Ali a,b,c,* \u003Cbr>a Tai Wing, Andrews Memorial Hospital, 27 Hope Rd, Kingston 10, Jamaica b Kingston Public Hospital, North St, Kingston, Jamaica\u003Cbr>c University of the West Indies, Mona Campus, Kingston 7, Jamaica |  |\n| --- | --- |\n| A R T I C L E I N F O\u003Cbr>Keywords: Epilepsy Loneliness\u003Cbr>Psychosocial outcomes Stigma\u003Cbr>Low- and middle-income countries (LMICs) Antiseizure medications (ASMs)\u003Cbr>Health systems | A B S T R A C T |\n|  | Loneliness is increasingly recognized as a significant psychosocial determinant of health, yet it remains comparatively underexplored in the context of epilepsy, and particularly in under-resourced environments. Unlike depression or anxiety, loneliness is less specifically sought, nor readily disclosed, despite its profound impact on well-being. This article draws on clinical experience and a small observational audit in Jamaica to highlight loneliness as a distinct and pervasive issue among people with epilepsy (PWE). While loneliness frequently co-occurs with depression, it may exist independently and may precede diagnosable mood disorders. Contributing factors include societal stigma, physician-advised safety restrictions, antiseizure medication side effects, and systemic gaps in epilepsy care, factors often greatly intensified in low-resource settings. By focusing on the lived experience of patients, this article argues that loneliness may silently erode quality of life, autonomy, and treatment adherence, in part also from its seemingly close association with depression. It proposes low-cost, socially focused interventions as potentially transformative and suggests the need for inclusion of loneliness as a modifiable factor in clinical practice and future research. A simple question,“Do you feel lonely?” could facilitate the identification of loneliness in PWE, and particularly in underserved communities and LMICs with high social stigma, may help improve psychosocial outcomes, and epilepsy control. |\n\n1. Introduction  \nShe had been my patient for decades, someone whose epilepsy defied optimal control, whose life as a professional in civil service bore the scars of lost opportunities, fractured relationships, and public embarrassment from seizures she could not always conceal. One afternoon, unprompted, she simply said: “I’m lonely.” Not depressed, not angry, just lonely. Her quiet admission disturbed me greatly and brought into focus a theme I had often sensed but rarely specifically named in many of my patients: loneliness as a pervasive, yet underrecognized, force in the lives of people with epilepsy (PWE).  \nWhile loneliness affects people across all demographics, certain groups within the epilepsy population may be especially vulnerable. Women with epilepsy may experience compounded effects due to societal roles and expectations. Personal devices like smartphones and the intrusive effects of social media have led to increasing isolation, anxiety and depression among adolescents [1]; young PWE, for reasons discussed below, may be at risk of even greater impacts. With or without  \nepilepsy, young adults, striving for autonomy, and the elderly facing declining health and shrinking social networks, are both disproportionately affected. Although my patient was of high educational status, PWEs in lower and middle-income countries (LMICs) often achieve lower educational status and greater rates of unemployment than even the reduced attainment noted in PWE in high-income countries [2,3].  \nCultural context magnifies the experience of isolation. Epilepsy is sometimes viewed as a spiritual affliction or even a moral failing, driving fear, concealm","cbCaikbSmzOWSmvR","https://ap.wps.com/l/cbCaikbSmzOWSmvR","pdf",353898,"English","# Abstract\n# Introduction\n## Loneliness in people with epilepsy\n## Vulnerable groups and social isolation\n## Cultural stigma and structural barriers\n## Physician advice and safety restrictions\n## Antiseizure medications and social participation","[{\"question\":\"Why is loneliness considered underrecognized in people with epilepsy (PWE)?\",\"answer\":\"The article notes loneliness is less specifically sought or readily disclosed than depression or anxiety, even though it significantly affects well-being.\"},{\"question\":\"What factors contribute to loneliness in PWE in under-resourced settings?\",\"answer\":\"Contributing factors include societal stigma, physician-advised safety restrictions, side effects of antiseizure medications, and systemic gaps in epilepsy care, which are often intensified in low-resource environments.\"},{\"question\":\"How might loneliness affect quality of life and epilepsy outcomes?\",\"answer\":\"Loneliness may silently erode quality of life, autonomy, and treatment adherence, including because it can be closely associated with depression.\"}]","“I’m lonely” - An underrecognized marker of silent suffering in PWE in underresourced settings? | PDF",1790590304]