How Sickness Affects Your Brain
It goes without saying that anything that weakens your body can also have a negative effect on your mind. One of the biggest struggles that people who live with mental health problems have with illness is the depressive/anxious thoughts that occur more frequently when the body is feeling weak. Everyone knows the general symptoms the common cold and flu; congestion, fever, hot and cold sweats, aching muscles, headaches and fatigue, but what doctors and articles don’t always mention is how this physical illness can produce mental symptoms that mimic depression. Now this isn’t something that is ‘all in your mind’ as people like to pretend, there actually scientific evidence that shows why illness creates or exacerbates depression and anxiety in those who are susceptible to it, people like me.
I have been ill now for about a month. It started off with low-level cold symptoms and then progressed this last week into major fatigue, complete congestion to the point of pain, fever and cold sweats, sore throat and a cough. I went to my doctor the other day and he told me I have a virus. The problem with a virus is you can’t prevent it happening and you can’t cure it, it just has to take it course. Unfortunately all you can really do is treat the symptoms with painkillers etc as and when necessary. Now to be honest, I’m a 31 year old adult so this is not the first time I’ve had a virus or cold and flu type symptoms. The physical aspect of this sickness I can cope with; I can take painkillers for the pain and I can rest when I need to. What really hit me like a ton of bricks, however, is the psychological weakness that happened simultaneously. I am lucky that though I am living with bipolar, I am high-functioning and my episodes normally come years apart. My acute generalised anxiety is under control 99% of the time and I haven’t had a panic attack in over a year… until the other day. Just to set the scene, I was feeling really physically weak, I had just been to the walk-in centre as my medical practice was closed on Sundays and the nurse at the walk-in centre had just told me that there was nothing wrong with me. By this point, I was feeling the full physical effects of this virus that I didn’t know I had but what I didn’t expect was the extreme mental fatigue and heightened anxiety. Now I have lived with anxiety my entire life, so I’m always aware of it and there are a lot of things in my lifestyle I do to mitigate it. For example, going to the gym and other physical activities that help control what I call the ‘blue energy ball’ that sits in my core. I eat well, I sleep well and I try and live in a way that optimises my chances of not having the anxiety or my bipolar control my life.
So to put this in a nutshell, I was sick from the virus, I hadn’t managed to exercise or even eat well for around two weeks and then the added stress of feeling like death warmed up and having to go to the walk-in centre and be told that I’d just have to deal with it from a rather dismissive senior practice nurse all culminated in me having a panic attack in my car as I was trying to exit the carpark. I couldn’t seem to get the ticket into the machine, it started beeping, I lost my cool and I spent the next 20mins getting beeped at by other cars because I turned off my engine and concentrated on trying to control my breathing and regulate my body. Now as anyone knows when you’re experiencing a panic attack, your body is flooded with adrenaline and endorphin, you can’t think straight because your essentially in fight or flight mode, you can’t see properly as you get tunnel vision and your heart rate is really elevated. It’s not my first panic attack nor will it be my last, I imagine, but I’ve got to a stage now where I can feel it coming and I can usually prevent it but ultimately sometimes I just have to sit through it. I just want to mention here that my faith in humanity has been rocked because hundreds of people either walked or drove past me, looked me in the eye on some occasions, saw I was struggling to control my breathing and I had tears but not one person even asked if I was alright. I would always stop and ask if I thought someone was struggling in anyway. I hope you would too.
When I finally got home that day, I was thoroughly exhausted from the virus and from the panic attack. The whole time I was driving home I could feel this sense of tiredness descending on me like a heavy blanket and I remember just saying to myself out loud ‘just get home, you’re almost there’. The minute I got in, I lay on the sofa and for the next few hours I dozed before going to bed. So, the next day I was thinking about this accursed, unexpected panic attack and I was getting a little bit annoyed with myself. I manage my mental health very strictly and to suddenly have a panic attack now after so long made me feel like I’d failed myself, like I was weak minded and like I’d taken a massive step backwards. Now I know that its not about being weak, I know that these things happen and it doesn’t mean I’m any less of a strong person so after I’d got over the initial self loathing I started to actually use my brain. Why was it that all of a sudden after so long, I felt completely overwhelmed by anxiety, like I had no control and that ended in this panic attack. I’d been feeling heightened anxiety for about two days and I accept that I am physically weaker from having this virus. I know that not being able to do my usual routines such as going to the gym definitely had an effect on my anxiety levels but it shouldn’t have made me so overly anxious in such a small space of time. Feeling that out of control with my emotions frightened me, to be honest. I’ve fought so hard to get to where I am today, to create the life that I have and to be able to cope with all the things that have been thrown at me thus far. Feeling so randomly out of control took me back to a place in my mind that I didn’t ever want to experience again, a place back where I didn’t understand my mental health issues and I didn’t know how to prepare or to work with them. This anxiety seemed to come from nowhere and completely blindsided me.
What I found out was that there has been a lot of research on mental health and how depression/anxiety is affected by physical sickness. When the immune system is activated by a pathogen (the virus in this case), it produces pro-inflammatory cytokines that signal the brain to cause ‘sickness behaviour’. A cytokine (cyto, from Greek“κύτταρο” kyttaro“cell” + kines, from Greek “κίνηση” kinisi “movement”) is a category of proteins that are important for cell signalling and induce sickness behaviour which can be described as “…Nearly universal behavioural changes [which] are a manifestation of a central motivational state that is designed to promote recovery” (Reference). What this means is when you immune system is fighting off the sickness, these cells tell your brain to make you behave in certain ways to help you get well again. Now the mental symptoms that you develop are annoyingly a mirror of depression and heightened anxiety, which actually makes perfect sense.
“Illnesses like the flu or the common cold can closely mimic and cause depressive symptoms by activating your immune response and inflammation in your body” (Hall 1996, Smith 1999, Capuron 1999).
To fight off the virus, I need to rest, conserve my energy and do as little physical exertion as possible. Evolutionary logic would said that I should stay away from social activity, so as not to spread the illness to others and by heightening my anxiety I’m less likely to put myself in situations that will require me to use bursts of energy or get me hurt. This is the mental response to the physical fighting of the immune system and as this happens to all of us, including animals and “physically ill patients with no previous history of mental disorders” (Reference), then those of us with already diagnosed mental health issues or those of us vulnerable to them are, logically, going to be worse affected.
We know that “cytokines have powerful effects on neurotransmitter activities, including those linked with depression, bipolar, schizophrenia etc; such as norepinephrine, serotonin and dopamine (Reference). It makes sense then that as my immune system is activated to try and fight off this virus, the heightened anxiety and low mood that I am feeling is produced by the cytokines messing with my already sensitive system. That makes me feel a little better for having a melt down in a car park. I couldn’t work out for two days why I felt so overly anxious and emotional, I even considered PMT/PMS but I was sure that wasn’t the case as I log everything and I know exactly how that feels. At least now I can confidently say I wasn’t just being weaker than normal, it was a chemical reaction in my body that I had no control over. I subsequently went to my own GP the day afterwards and explained what happened and how ill I was feeling physically, he reaffirmed that it was indeed a virus, or in his words ‘it’s a virus until proved otherwise’ and he prescribed me Propranolol to take as and when I feel like I’m losing the fight to control my anxiety for the duration of this virus. Propranolol, for those of you who have not come across it before is a beta-blocker normally used to treat irregular heart beats and heart related problems, in this case used to lower my heart rate during anxiety attacks. While I am reluctant to ever take more meds than absolutely necessary, it did actually help me the day after the panic attack when I was still feeling the heightened anxiety.
If you want to know more about the medications used such as Quetiapine, Promazine, Propranolol, Citalopram, Paroxitine and Venlafaxine – Check out my downloadable ebook ‘The Helpful Drug Review’ (coming soon).
So I leave you with this; if you are sick or someone you know is sick, don’t just disregard the emotional and mental affects of the illness. Even a common cold/flu can have a significant impact on mental health, especially if you are someone who lives with a mental health issue to start with, like me.
For more information on this topic, I found the following blog from Psychology Today very helpful.