This process can take time, and during this time period, activities such as driving are usually restricted. Illness, hormonal changes, sleep deprivation, and changes in medications are common causes of breakthrough seizures. The Foundation's Report to the Nation documents that people with epilepsy have an unemployment rate of 25 percent, providing strong evidence that they are substantially impacted by the condition. It is common for people with epilepsy to go in and out of the workforce because of issues related to their seizure condition. Among people whose seizures are poorly controlled, the unemployment rate approaches 50 percent.
Epilepsy has a significant impact on marriage and reproduction.
People with epilepsy are less likely to marry and have children than the rest of the population. Marriage and procreation is a major life activity. Some individuals may achieve seizure control by medication and suffer no side effects. Still, they may be discriminated against because their employer or others mistakenly believe that they are substantially impaired because of their seizures. Many people with epilepsy do not drive, either because of their own safety concerns, or because they do not meet the state driver licensing requirements.