From prevention
-
COVID-19 can cause psychosis in a small number of patients.
-
Most of these patients have no personal or family history of mental illness.
-
Post-COVID psychosis appears to be temporary and is treated with normal antipsychotic medication.
By now you know the physical symptoms of COVID-19: fever, cough, shortness of breath, new loss of taste or smell – the list goes on. But now, almost a year after the pandemic, doctors are discovering the mental side effects of the new coronavirus.
In addition to neurological complications such as brain fog, dizziness and headaches, doctors report psychosis in a small number of COVID-19 patients who have previously had the virus, according to The New York Times. The cases occur in people in their thirties, forties and fifties, most of whom have no history of mental illness. Here’s what experts know so far.
What is psychosis and how is it linked to COVID-19?
Psychosis refers to a mental state in which a person detaches from reality; they can no longer distinguish between what is real and what is not. Although there is as yet no official research linking COVID-19 and psychosis, the known case studies are of concern.
A 36-year-old woman tried to pass her children through a fast food restaurant’s driveway to prevent them from being abducted. A 52-year-old man was convinced he had caused the pandemic and had attempted suicide out of guilt. A 55-year-old woman hallucinated monkeys and lions and later convinced a family member had been replaced by a fraudster.
In the most disturbing case, described in The New York Times story, a 42-year-old woman experienced persistent visions of her two young children being murdered – and devised plans to kill them both.
None of these patients had a history of mental illness, but all tested positive for COVID-19 or were found to have antibodies. With hospitalization and treatment, everyone recovered.
How can COVID-19 lead to psychosis?
Initially, doctors believed that psychiatric symptoms were the result of long ICU stays and large doses of steroids, says Brittany Busse, MD, co-director at WorkCare. But the theory changes as more evidence emerges. “Many of the current case studies reveal psychotic symptoms in people with a mild illness and no underlying psychiatric condition,” she explains.
Now doctors assume that psychotic symptoms are the result of inflammation. Specifically, a SARS-CoV-2 infection elicits an immune response from a “cytokine storm” in some patients that causes potentially fatal inflammation. “It is suspected that this inflammation in the blood vessels also includes inflammation in the brain and nervous system,” says Dr. Buses. This ability to cross the blood-brain barrier can be the culprit behind symptoms such as loss of smell or taste, brain fog and even psychosis.
“The current idea is that a number of psychiatric conditions are inflammation of brain cells,” agrees Dolores Malaspina, MD, MS, professor of psychiatry and director of the psychosis program at the Icahn School of Medicine at Mount Sinai in New York. “COVID brings home the body-and-body connection, showing that psychiatric disorders are just as much driven as biological disorders.”
COVID-19 is not the only viral disease that could possibly cause psychosis. Researchers discovered reports of post-viral psychosis as early as the 18th century, and the Spanish flu pandemic of 1918 was the first time it had been documented in large numbers. In other words, COVID-19 is not unique – any number of diseases can cause the psychosis. (“Viruses have been actively scrutinized before COVID” regarding neurological conditions, explains Dr. Malaspina.)
Which patients suffer from psychosis after COVID?
The New York Times the report notes that most patients suffering from psychosis had only mild symptoms of COVID-19, and some experienced neurological symptoms such as “hand tingling, vertigo, headache, or decreased odor.” Two weeks to a few months later, psychosis began. In addition, most patients are also in their thirties, forties and fifties, which is a strange age group – such symptoms usually occur in younger patients such as schizophrenia or older patients such as dementia.
For now, there is no way to say who exactly may be at risk for post-COVID psychosis, says Dr Malaspina. There are simply too few reports and too little research on the emerging neurological consequences of the virus.
‘When you or a loved one begins to show signs that you cannot distinguish reality from unreality [including hearing voices, smelling or seeing things that aren’t there, and believing that you are being followed] or if you have suicidal or murderous thoughts, go to a hospital immediately or call 911, “Dr. Busse recommends. Early action is the key to treatment – and it can protect you as well as the people around you.
The best way to prevent psychosis after COVID is simply to avoid COVID-19 in the first place, says Dr. Buses. Talk to your medical provider to see if you might be eligible for the vaccine, and keep taking safety precautions, such as washing your hands, wearing a mask, and staying at least six feet apart as humans. which is not part of your household.
If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.
This article is accurate from press time. As the COVID-19 pandemic develops rapidly and the scientific community’s understanding of the new coronavirus develops, some information may have changed since it was last updated. As we strive to keep all our stories up to date, please visit the online resources provided by the CDC, WHO, and yours local department of public health to stay up to date with the latest news. Always talk to your doctor for professional medical advice.
Go here to join Prevention Premium (our best value, complete access plan), subscribe to the magazine or get digital access only.
FOLLOW PREVENTION ON INSTAGRAM
You may also like