Prevention
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COVID-19 may be causing psychosis in a small number of patients.
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Most of these patients have no personal or family history of mental illness.
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Post-COVID psychosis appears to be temporary and is being treated with normal antipsychotic medication.
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 began, doctors are discovering the mental side effects of the new coronavirus.
In addition to neurological complications like brain fog, dizziness and headaches, doctors are reporting psychosis in a small number of COVID-19 patients who have had the virus, according to The New York Times. The cases are happening in people in their 30s, 40s and 50s, most of whom have no history of mental illness. Here’s what the experts know so far.
What is psychosis and how is it associated with COVID-19?
Psychosis refers to a state of mind in which a person separates from reality; they can no longer distinguish between what is real and what is not. Although there is no official research linking COVID-19 and psychosis (yet), the known case studies are alarming.
A 36-year-old woman tried to pass her children through the drive-through window of a fast food restaurant to prevent them from being kidnapped. A 52-year-old man was convinced that he had caused the pandemic and attempted suicide out of guilt. A 55-year-old woman hallucinated monkeys and lions, and later became convinced that a family member had been replaced by an imposter.
In the most distressing case, described in The New York Times story, a 42-year-old woman had persistent visions of her two young children being murdered – and had planned to kill them.
None of these patients had a history of mental illness, but all tested positive for COVID-19 or antibodies were found. 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, said Brittany Busse, MD, associate medical director at WorkCare. But that theory is changing as more evidence emerges. “Many of the current case studies are revealing psychotic symptoms in people with mild illness and without an underlying psychiatric condition,” she explains.
Now, doctors hypothesize that psychotic symptoms are the result of inflammation. Specifically, a SARS-CoV-2 infection triggers a “cytokine storm” immune response in some patients, causing potentially deadly inflammation. “It is suspected that this inflammation of the blood vessels also includes inflammation of the brain and nervous system,” says Dr. Busse. This ability to cross the blood-brain barrier may be the culprit behind symptoms such as loss of smell or taste, brain fog and even psychosis.
“The current notion 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 on Mount Sinai, New York. “COVID brings home the mind-body connection, showing that psychiatric disorders are biologically motivated as much as physical disorders.”
COVID-19 is not the only viral disease with the potential to cause psychosis. Researchers have discovered reports of post-viral psychosis since the 18th century, and the Spanish flu pandemic of 1918 was the first time it was documented in significant numbers. In other words, COVID-19 is not the only one – any number of diseases has the potential to cause psychosis. (“Viruses were actively underestimated before COVID” in relation to neurological conditions, explains Dr. Malaspina.)
Which patients suffer from post-COVID psychosis?
The New York Times The report notes that the majority of patients suffering from psychosis had only mild symptoms of COVID-19, with some showing neurological symptoms such as “tingling in the hands, dizziness, headaches or decreased smell”. Two weeks to a few months later, psychosis set in. In addition, most patients are also in their 30s, 40s and 50s, which is a strange age group – these symptoms are usually present in younger patients like schizophrenia or in older patients like dementia.
For now, there is no way to say who, exactly, may be at risk for post-COVID psychosis, says Dr. Malaspina. There are few reports and little research on the neurological impacts emerging from the virus.
“If you or a loved one starts showing signs of not being able to 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 thoughts of suicide or murder, go immediately to a hospital or call 911 ”, advises Dr. Busse. Early action is the key to treatment – and it can protect you and the people around you.
The best way to prevent post-COVID psychosis is to simply avoid contracting COVID-19 in the first place, says Dr. Busse. Talk to your doctor to see if you can qualify for the vaccine and continue practicing safety measures like washing your hands, wearing a mask and staying at least two meters away from people who are not part of your home.
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 correct at the time of publication. However, as the COVID-19 pandemic evolves rapidly and the scientific community’s understanding of the new coronavirus develops, some of the information may have changed since the last update. While our goal is to keep all of our stories up to date, visit the online resources provided by CDC, WHOit’s yours local department of public health to stay informed about the latest news. Always speak to your doctor for professional medical advice.
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