SINGAPORE — Five years ago, life took a terrifying turn for Hazwady Nazran, a 38-year-old music teacher and songwriter, when he began experiencing severe and inexplicable symptoms.

Hospitalized under distressing circumstances, he faced violent episodes, paranoid delusions, profound confusion, memory loss, and seizures that threatened to spiral out of control.

Without the insistence of his wife, Dr. Miria Hastuti Soedarsono, a 34-year-old medical professional, Hazwady might have found himself confined to a mental health facility. “Hazwady went through three months of bizarre behavior,” Dr. Soedarsono recalled. “He complained of vision problems, endured sleepless nights, and exhibited volatile emotions—shouting at our son Almizan, despite his loving nature.”

Describing his struggle, Hazwady reflected,

“This disease was a silent thief. It came in quietly, leaving a trail of anxiety, confusion, and memory loss, accompanied by emotional turmoil, hallucinations, and a fractured sense of reality.”

The onset of the disease occurred in late 2018 during a period when the family was enjoying life to its fullest.

Hazwady had recently launched a successful start-up while balancing a thriving career in the shipping industry. The deterioration in his health was heartbreaking, leading him to abandon his professional aspirations as his body weakened.

The alarming escalation of Hazwady's symptoms led to a harrowing episode where he was restrained in a psychiatric ward after enduring seizures and losing bladder control.

“It was beyond frustrating,” Dr. Soedarsono recounted. “Doctors attributed it to mental health issues, but as a doctor myself, I knew something else was wrong. I pushed for a lumbar puncture and an MRI scan.

In a twist of fate, Hazwady was diagnosed with anti-NMDA receptor encephalitis in 2019,

an autoimmune disorder wherein the body produces antibodies that attack NMDA receptors in the brain, causing swelling and disrupting normal brain functions. Fortunately, colleagues of Dr. Soedarsono at Sengkang General Hospital initiated treatment with steroids and intravenous immunoglobulin, which temporarily improved his condition.

However, a relapse soon followed, and the same treatment proved less effective.

Dr. Yeo Tianrong, a neuroimmunologist from the National Neuroscience Institute at Tan Tock Seng Hospital, explained how anti-NMDA receptor encephalitis operates. The immune system's antibodies erroneously target the NMDA receptors, which are crucial for communication between nerve cells. Such disruption can manifest through symptoms resembling viral fevers followed by severe neuropsychiatric disturbances, including depression, mania, anxiety, and, at times, severe psychosis.

Dr. Yeo highlighted the misconception surrounding this condition,

as many patients are initially misdiagnosed with psychiatric disorders due to their symptoms. Autoimmune diseases like anti-NMDA receptor encephalitis are exceedingly rare, affecting one to two people per million each year, and predominantly impact young women with a history of ovarian teratoma—persistent tumors that can evoke an immune response.

A fascinating insight from Dr. Yeo suggested a historical perspective:

“In the late 1600s in Salem, Massachusetts, women accused of witchcraft may have suffered from similar symptoms due to this condition. Their behaviors—ranging from fits to mutism—bear striking resemblances to today’s understanding of anti-NMDA receptor encephalitis.”

For Hazwady, his journey through misdiagnoses ended when he sought a third opinion from Dr. Yeo after seeing two other doctors.

The assault on his brain's limbic system—a region crucial for emotion and memory—led to significant gaps in his recollection and emotional regulation.

While Dr. Yeo prescribed a series of oral immunosuppressants,

Hazwady struggled with compliance and faced minor relapses that required continuous monitoring. Yet, today, with effective treatment and unwavering support, Hazwady has embraced his life’s passion again—teaching music to children at an international school and actively songwriting for a talent management company.

He now shares his story of resilience:

“I’m not defined by my condition anymore. I’ve gone from chaos to clarity, rediscovering my love for music and my family. My son is now seven and my daughter two, and I’m proud of the life I’m building.”

His journey is a testament not just to personal strength but to the importance of accurate diagnoses and compassionate support—reminding us that even in the darkest times, hope and healing are always within reach.