Do We Really “Get Over” Viruses?
The Longer-Term Effects of Viruses on Mental and Physical Health
Inspiration can strike in the most unassuming places. As a third-year doctoral student in psychology, I was not expecting the dentist’s office to inspire the topic of my dissertation. The dentist asked about my medical history, including my history of having had Infectious Mononucleosis (IM), or “mono” as it is commonly referred to. This common but serious illness often occurs during a person’s teen or young adult years with symptoms that include fever, swollen lymph nodes, extreme fatigue (like your head is permanently glued to the pillow-type fatigue), and nausea. The symptoms can last anywhere from 6 weeks to months on end.
This dentist cited increasingly common research that “mono” may affect the likelihood of developing Chronic Fatigue Syndrome later in life. She discussed how the Epstein-Barr virus (responsible for “mono”) may spontaneously reactivate, causing susceptibility to other infections. I shared with her that I had been feeling unusually fatigued lately and in a constant state of operating at 70% -what she said could not have been more timely. I called my advisor Lynn O’ Connor, Ph.D., the next day and said, “there is something here.”
This led to my deep dive into the study of the longer-term mental and physical effects of common viral infections or autoimmune diseases on the lives of young adults. There is growing evidence on the detrimental impact of chronic, dormant infections on mental and physical health. The effects are sometimes immediate, as in the case of sudden-onset pediatric obsessive-compulsive disorder (OCD) referred to as (PANDAS/PANS), while others are years down the road, as in the case of viral exposure in utero being implicated in the risk of schizophrenia. As for autoimmune diseases, the Herpesvirus family (8 known viruses so far) has been implicated in multiple sclerosis, gastrointestinal disorders, thyroid conditions, fibromyalgia, lupus, and more.
For decades, researchers have suspected that viruses have a detrimental impact on overall health, even when symptoms have long passed. There are many factors that might contribute to deteriorating health, including, but not limited to, stress, genetic predispositions, poor diet, lack of sleep, trauma, systems of oppression, contaminated water and air, and chronic viral infections.
Particularly in the 1970s and 1980s, chronic viral infections became a trending topic among medical and psychiatric researchers (L. O’Connor, personal communication, September 21, 2020). Many studies during this time found associations between viral infections and depression, anxiety, bipolar disorder, OCD, schizophrenia, and other psychotic disorders (Cadie, Nye, & Storey, 1976; Yolken & Torrey, 1995). More recently, Romm (2020), interviewed for Goop.com, is specifically concerned with the “low-level chronic alarm” state viruses put on the stress response system.
Another way in which the link between viruses and mental illness has been supported is in the study of sudden onset pediatric OCD following a strep or other infection, referred to as PANDAS/PANS (Swedo et al., 1998; Swedo, Leckman, & Rose, 2012; Swedo et al., 2015). The result is a debilitating “overnight” case of OCD in children that one father described as “unfamiliar territories of terror, confusion, anguish, anger, blame, guilt, helplessness and even hopelessness” (PANDAS Network, 2018). The classification of this disease and subsequent research has led to further understanding of viruses’ attack on neurons and what neuroinflammation might present as behaviorally. However, much is still to be determined.
In research, case examples, blog communities, and personal communication, people have often reported experiencing mental health symptoms (e.g., depression, anxiety, obsessive thoughts) that seemingly have no precipitating stressor and/or event and come on suddenly. Anecdotally, many adolescents and young adults have described obsessive behavior and compulsive thoughts after recovering from mono.
One blogger described his experience post-mono as “stuck in a living hell” with obsessive thoughts (anonymous, 2018).
Stories like this deserve further research. There is some evidence to support the biological etiology of major mental disorders yet to be determined.
There is one virus in particular that has been at the forefront of America’s mind since February 2020: COVID-19. Recent research suggests COVID-19 is no exception; its impact on physical and mental health is showing to last long after a negative swab for many individuals. Because the effects of COVID-19 are unfolding on an ongoing basis, the longer-term effects of this infection are yet to be fully understood. However, there is evidence of devastating neurological and psychological ramifications in confirmed cases.
Researchers in Great Britain examined 125 completed case reports and found that 62% of patients had suffered a “cerebrovascular event,” the majority of which are classified as an ischemic stroke (Varatharaj et al., 2020). The second-highest occurrence of neurological changes was “altered mental state,” most from psychiatric diseases and a smaller number from encephalopathy and encephalitis. Of all reported cases of psychiatric disorders, 92% were first-time diagnoses in the person’s lifetime (Varatharaj et al., 2020).
A podcast episode by the New York Times highlighted the experience of a man who experienced psychosis following testing positive for COVID-19 (Barbaro, 2021). Ivan Agerton, a 50-year-old male, described his experience with debilitating paranoia, delusions, hallucinations, and lack of sleep with no history of a psychiatric illness before that day. After two admissions to the psychiatric ward, a referral to a psychiatrist, and medication, he was better but still recovering at the time the podcast was recorded. During his first visit to the hospital, three weeks after first exhibiting COVID-19 symptoms, he tested positive, a phenomenon currently being referred to as “Long COVID.”
Pam Belluck, a health and science reporter also interviewed during the episode, cited dozens of cases in the world similar to Ivan’s (Barbaro, 2021).
The body is miraculous and mysterious at the same time. More and more, scientists and practitioners alike are beginning to integrate research about the mind and body rather than cylo medicine and psychology as separate categories. When people become sick, depressed, anxious, or a combination of the three, it is rarely considered how hard the human body must work to keep latent viruses in check (Romm, 2020). Much is still unknown about the exact mechanisms by which latent viruses influence the immune response and genetic sequences.
More research is needed on the psychosocial experience of people with overnight changes in mood and functioning or who are living with chronic disorders. While viruses are here to stay, their negative impact could be mitigated by research that informs collective health in the form of preventative measures and treatment (e.g., vaccines).
