Influenza and Your Psyche

Where does the flu come from?

The “flu” is the colloquial term that we use for the yearly wanderings of the impressively resilient influenza virus. This germ should not be confused with Haemophilus Influenza, which is a bacterial infection. You can read about Haemophilus Influenza at the CDC website here.

The influenza virus is, in fact, an intrepid little pathogen that saunters around the earth with predictable regularity, changing and mutating to make it less vulnerable to our immune systems in something close to real time. In other words, every influenza cycle is different because the virus is massively adaptable as well as punctually seasonal. When it is winter in the southern hemisphere, the influenza virus makes its home down under. When things get cold for us up here in the States, the virus hops a plane or a boat to our shores.

This has been going on for about as long as history. The constantly changing nature of the influenza virus means that there is a new vaccine every year, and that each new vaccine is based on the best guess as to how the virus will present itself to our immune systems once its new season arrives.

Why in the world is a psychiatrist writing an article about the flu?

Great question. I’d start by noting that a psychiatrist worries about the flu for the same reasons that a pediatrician worries about depression. Feeling lousy from the flu makes the other things that make you feel lousy feel a whole lot more lousy.

There is evidence that children and adolescents with the flu will experience worsening mood and anxiety during the infection, and this is especially the case for young people with pre-existing psychiatric syndromes. Because psychiatric distress is associated with inflammation, and because the flu puts your body in a highly inflammatory state, it is likely that this inflammatory state worsens the body’s psyche. That’s probably why these psychiatric symptoms improve with Tylenol or Ibuprofen or other methods by which the inflammatory system can be cooled.

By the same token, pre-existing depression, anxiety, and other psychiatric syndromes can make it very difficult to recover readily from a bout of the flu. Some of this has to do with the mechanics of self-care. If you’re depressed, you’re less likely to care for yourself well, and this gets even worse when the flu is folded into the mix. Additionally, high-stress states like depression can dampen the immune response to other illnesses, including influenza. That’s why we are more likely to become ill, both medically and psychiatrically, when we are under the influence of highly stressful circumstances.

Moreover, the flu, like all significant illnesses, promotes developmental regression. This means that children will feel and act younger than their actual age. Little kids with the flu will want to snuggle more or might have a much lower frustration or pain tolerance. Older kids will have more tantrums and can become more irritable or nihilistic.

There is even some concern that the flu can awaken previously mild psychiatric vulnerabilities. This is in part related to the fatigue that the flu engenders and in part related to the inflammatory response that the flu and other psychiatric syndromes have in common. There’s no real separation between mind and body—after all, the neck connects the head to the rest of the body. If your feelings suffer, you feel sick. If you feel sick, your feelings suffer. That’s the nature of being human.

At the end of the day, the biggest psychiatric issue that accompanies the flu is the fact that many of the symptoms of the flu mimic many of the symptoms of psychiatric disorders. Loss of interest in previously enjoyable activities, decreased energy, poor concentration, excessive worry… these are all symptoms of flu and also of psychiatric states like depression or anxiety.

As with much of medicine, the extreme cases are easy to tease apart. Fever, aches, and barfing are mostly related to an infectious disease until proven otherwise and then perhaps made worse by a psychiatric syndrome. However, if the fatigue and aches linger after the flu is clear, and if the pediatrician is at a loss to explain the residual symptoms, the epidemiology favors at least entertaining a psychiatric diagnosis.

Read the full article at Psychology Today

Reflection: If you've had the influenza or covid19, have you noticed that it affected your mental health?

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