The mystery of the inflamed brainThe mystery of the inflamed brain
All In The Mind
The Netflix drama ‘Brain on Fire is the story of a young woman in the U.S. who suddenly develops severe psychiatric symptoms. Some clever detective work reveals that she has a rare and mysterious condition causing brain inflammation. We hear from an Australian teenager who’s been through the same ordeal—but once treated has survived and thrived.
29:54•10 Feb 2019
The Mystery Illness That Set a Teenager’s Brain on Fire
Episode Overview
- Severe psychiatric symptoms, including hallucinations and self-harm commands, can be driven by rare autoimmune inflammation of the brain.
- Anti-NMDA receptor encephalitis may be mistaken for conditions like schizophrenia or bipolar disorder, leading to delayed treatment.
- Specialised antibody testing and careful clinical assessment are crucial when usual psychiatric treatments are not improving symptoms.
- Early immune-based treatment, such as plasmapheresis and immunosuppressant medication, is linked with better long-term outcomes.
- Personal determination and support can help someone rebuild education and life goals even after years of illness and misdiagnosis.
“I can give hope to someone that is in that place… and I can use what I've been through and all the struggles that I've been through to help others.”
What emotional and inspiring tales of recovery are out there? This episode of **All In The Mind** zeroes in on a rare autoimmune disease that sets the brain "on fire", blurring the line between psychiatric illness and physical disorder.
You’ll hear 18‑year‑old Sydneysider **Mariana Tana** describe how, as a 15‑year‑old, her life was overtaken by terrifying visual and auditory hallucinations: demonic figures issuing self‑harm commands, voices calling her "fat" and "not worth anything", and scenes tied to the trauma of losing her mum. Her family, ambulance staff and early clinicians often assumed she was attention‑seeking or had conditions like schizophrenia or bipolar, leaving her feeling dismissed and desperately alone.
Professor **David Brown**, a clinician and researcher at Westmead Hospital, shares how careful detective work and a newly developed antibody test led to a diagnosis of **anti‑NMDA receptor encephalitis**, a rare form of encephalitis where the immune system attacks healthy brain cells. He explains that the condition can present almost entirely as psychiatric distress, and that many people may have been mislabelled with mental illness when an inflamed brain was at the root of their symptoms.
Mariana walks through gruelling treatments like plasmapheresis and long‑term immunosuppressant medication, along with the emotional toll of repeated suicide attempts and housing instability. There’s a remarkable turnaround too: despite years out of school and ongoing memory issues, she fought her way back to education and became dux of her school. Her boyfriend **Isaac** adds his perspective on the "insane" contrast between the darkest days and how she is now.
Host **Lynne Malcolm** threads Mariana’s story together with broader questions about misdiagnosis, mind–body connections, and the urgency of asking doctors, "Could this be something else?" if standard psychiatric treatments aren’t helping. By the end, Mariana’s wish is simple: "I can give hope to someone that is in that place." What does her journey say to you about how we understand mental suffering and brain health?
Do you want to link to this podcast?
Get the buttons here!
More From This Show
The latest episodes from the same podcast.