Unpacking: COVID and ‘brain disease’

light blue one use medical protective masks

The headlines are terrifying.

The study behind the headlines was published in the Lancet on April 6, 2021 (yesterday, as of writing this)

I recommend you go read the study, but for a short recap I’m going to break it down here. The main take away point from the study is this:

The largest group of outcomes involving the brain from having COVID-19 are mental health issues.

And really, who could be surprised by that?

I’m in no way attempting to minimize the role of mental health. (Seriously, have you looked at the rest of this blog?) But, I did want to show the data behind those horrid headlines in the media.

Mental health is a serious matter, and the recent study demonstrates that the next wave to follow COVID-19 might be a series of mental health crises. I’m not the first person who has espoused this possibility. Nor, do I think I will be the last.

IF anything, this study has demonstrated that mental health is interwoven with physical health. The first order is to preserve life, but we must not abandon the fundamental human need to live.

The data below is taken from Table 2, of the study.
The table below shows the rates of each outcome for COVID-19 patients at the four levels of severity –
non-hospitalization, hospitalization, ICU admission, and delirium.
Additionally, the data is organized from most common to least common Based on the “No hospital” column.

Outcomeno
Hospital
hospitalICUDelerium
Mood, anxiety, or psychotic disorder (any) 23·59% 24·50% 27·78% 36·25%
Anxiety disorder (any) 17·51% 16·40%19·15%22·43%
Mood disorder (any)13·10% 14·69% 15·43% 22·52%
Mood, anxiety, or psychotic disorder (first)8·15%8·85% 12·68% 12·96%
Anxiety disorder (first)6·81% 6·91% 9·79%9·24%
Substance use disorder (any)5·87%8·56% 10·14% 11·85%
Insomnia (any) 5·16% 5·95% 7·50% 9·82%
Mood disorder (first)3·86% 4·49% 5·82% 8·07%
Nerve, nerve root, or plexus disorders2·69% 3·35% 4·24%4·69%
Insomnia (first)2·23%3·14% 4·24% 5·05%
Substance use disorder (first)1·74% 2·09% 3·15% 2·58%
Ischaemic stroke (any)1·33% 4·38% 6·92% 9·35%
Psychotic disorder (any)0·93%2·89% 2·77%7·00%
Dementia0·35%1·46%1·74%4·72%
Psychotic disorder (first)0·25%0·89%0·70%2·12%
Data are percentage at 6 months (95% CI)

All the other outcomes, which were all physiological, were under 0.50% Those include: Intracranial hemorrhage, Ischaemic stroke, Parkinsonism, Guillain-Barré syndrome, Myoneural junction or muscle disease, and Encephalitis.

If you go read the study, which I recommend you will see that it was well constructed and thorough. I have a small niggle with the combination of outcomes they chose to examine – but in the end the brain is all about chemistry, so I can’t really complain.

A brief ode to 2020

The one thing certain
About all this uncertainty
Is that all our certainty
Is now certainly uncertain.
And that
The only thing certain
Is uncertainty.

That is certainly certain.

Christmas Consumerism – Be Gone!

It’s November. 2020.

Covid. Trump. Systemic racism. Out-right racism. Police brutality.
Did I mention pandemic?

You know, I’m already tired. I was seeing Christmas candy in the grocery store before Halloween. Before. It was like the entire world said – Hey if we can’t go door to door begging candy and tooth rot let’s just fast forward to the most family intense holiday in the US. (You too UK.)

I understand the longing for family. The intense longing for normalcy is afflicting everyone. But, I’ll admit I don’t want to see all the buy, buy, buy ads that come out at Christmas (or midwinter holiday of your choice). Seriously – if anyone is getting a BWM in their driveway with a big red bow I’m going to have to wonder what planet they are living on. Must be nice all that non-this-totally-sucks-reality.

The pressure to buy at this time of every year is insidious, pernicious and permeating. Not to mention ubiquitous. Usually I tune out Christmas until Dec. 20, at least, just to preserve my sanity. But, I just got hit with my first “buy this” ad for the holidays and I’m too tired to even be annoyed. For the record it’s November, 13.

I can’t describe how unwelcome this message is this year. Buy. BUy. BUY! Shouting at us from every corner and screen. Please, just this once. Stop.

If ever there was a need for a season about the renewal of hope this is the year. Families are looking at foreclosure, homelessness, hunger and death. Added to all that is the reality of an invisible something ‘out there’ that kills.

Just among my friends there is a lot of pain. Some are telling me that mortgage payments are becoming a serious concern. Credit cards are maxed. Health insurance is vanishing. Some of them are living in deathly fear of becoming sick, and not just with COVID. They have no savings and no insurance. Their ability to remain financially afloat depends on their future good health. I have friends that are looking at the continued closure of the industry that they work in until June or September of 2021.

People are hurting. To me the added expectation of the rampant consumerism of the holiday season is just adding salt to a wound. So, please, this year, can we just wish each other peace and good health.

Coming Alive Amidst a Pandemic.

Gabby Petito

Oh, the irony.
Thirty plus years of
Being various degrees of suicidal
And now we have a pandemic
Upending the world
I want to live.

Strangely, that’s about average for me.
Let me take a moment to unpack this one.

My depression started somewhere in seventh or eighth grade.
It’s possible it started earlier, but
I have no memories earlier
Except for a very few, so let’s say – around 12.

At age 12 I started to self-harm.
‘Escape’ was the word always in my thoughts.
I didn’t know much as a pre-teen
but, trust me, I knew I wanted out.

At this tender age
Out was still a fantasy
Of rescue or of running away.

Other people, with other issues,
Might have managed to escape on their own.
I couldn’t.

Where would I escape to?
Was escape even possible?
Did I even deserve better?
Who did I think I was?
This was where God put me.
This was my lot.
Suck it up.
Manage.

As a teenager, my resources changed.
I had access to a car and endless mountain roads.
I was always safe in my car.
I felt ‘in control’ of something.
That was where I started to think
Maybe, at least, I could control my death.

My fantasies of escape became fantasies of dying.
I wore black constantly.
I was erasing myself from my life.
(Not that there was much to erase.)
Vanishing before my own eyes.
I was content with that.

I was content with
The process of unbecoming
Because I had a way out.
Sitting in the driveway was
A 1980s bright orange mustang.
Ugly as sin, but the straight six was a beast.

Having that door made staying easier.
Because I knew I didn’t have to stay.
I had a choice.
Of all the things in my life that were broken,
Out of my control,
Dangerous, or terrifying.
I had control over one thing.
One choice.

How does all of this relate to today?
For better than 30 years
I managed to face tomorrow
Because I knew that if I didn’t want to,
If it was too hard, I didn’t have to.
I could stop.

In my 20s,
I saw all my friends growing and flying,
Becoming these spectacular people.
While I was sheathed in lead.
The learned helplessness,
The ‘shoulds’ of my family
Ruled every aspect of my life.

I slept a lot.
hoping I wouldn’t wake.
And when I was awake
I prayed to die.

Dear God,
Fix me.
Or finish me.

I actively debated suicide.
And came close to death a couple of times.

I was so depressed
I had my first hallucination.
Thankfully, it was also my last.

My 30s were calmer,
At least, on the surface.
I finally found help for the depression,
But not for the problem at the root of all of it.
Ideation moved back and forth
Between passive and active.

As my 30s wore on
I found the pendulum
Spent more time towards the passive side.
That was good.
I was able to function.

Although I went through the motions
I did not understand
This ‘joi de vivre’ that others expected

I’m not saying I was never happy.
I am saying every day was a trudge.
An exercise in existing.

So, where I slept through most of my 20s,
My 40s were marked by
A type of emotional numbness.
On occasion, the ice beneath my feet would break.
Plunging me into terror.

Two years ago,
Perhaps three
I finally made the connection with cptsd
I found a good therapist to work through it.
I’m still working on it.
Likely, I will for the rest of my life.

Now, I’m over 50 and discovering how to live.
I grieve so much of the life I missed.

So here’s the irony:
I’m writing. I adore my husband.
Finally, I am discovering who I am.
I have put most of my desire for death aside.
I want to live. I have something to live for.

Here, at a very scary moment,
In a world that I have always shunned
Because of my twisted roots,
At the moment when
Life seems most precarious,
My life is most precious.
Now – I want to live.

Guest Post: from Carrie About Anxiety and Masks

Linen Facemask

I keep seeing people complaining that they can’t breathe in face masks. They describe feeling light headed, they fear that they’re not getting enough oxygen. They describe feeling tightness in their chests, tingling in their extremities. They feel confused and claustrophobic.

Baby, that’s not oxygen shortage, you’re just having an anxiety response. Welcome to the club. We have a handshake… you just hold out your hand… and it shakes.

You’re not going to die. It feels like it. It’s scary. You don’t like it. There are actual scientifically proven ways to deal with and overcome these feelings.

When you see someone who is going off on an anti-mask rant, slip them a DM with this link.

Don’t mock them in public, or show them the proof about why they’re not dying of oxygen deprivation.

They’re just experiencing a new mental health challenge and since they’ve never had any patience for any mental health stuff, they’re totally not equipped to deal with it.

Why Protective Face Masks Make You Feel Anxious and What You Can Do to Cope

A good friend posted this on FB and with her permission, I’m passing it along.

Covid: I was waiting for someone to point this out.

I wish I had said this, but this is perhaps the most comprehensive and cogent information I have seen.
If you have a link to this person’s blog entry, please share it. I want to link directly to the blog.

On Viruses
From J.Wade via FaceBook

Depiction of the Covid 19 virus

Chicken pox is a virus. Lots of people have had it, and probably don’t think about it much once the initial illness has passed. But it stays in your body and lives there forever, and maybe when you’re older, you have debilitatingly painful outbreaks of shingles. You don’t just get over this virus in a few weeks, never to have another health effect. We know this because it’s been around for years, and has been studied medically for years.

Herpes is also a virus. And once someone has it, it stays in your body and lives there forever, and anytime they get a little run down or stressed-out they’re going to have an outbreak. Maybe every time you have a big event coming up (school pictures, job interview, big date) you’re going to get a cold sore. For the rest of your life. You don’t just get over it in a few weeks. We know this because it’s been around for years, and been studied medically for years.

HIV is a virus. It attacks the immune system, and makes the carrier far more vulnerable to other illnesses. It has a list of symptoms and negative health impacts that goes on and on. It was decades before viable treatments were developed that allowed people to live with a reasonable quality of life. Once you have it, it lives in your body forever and there is no cure. Over time, that takes a toll on the body, putting people living with HIV at greater risk for health conditions such as cardiovascular disease, kidney disease, diabetes, bone disease, liver disease, cognitive disorders, and some types of cancer. We know this because it has been around for years, and had been studied medically for years.

Now with COVID-19, we have a novel virus that spreads rapidly and easily. The full spectrum of symptoms and health effects is only just beginning to be cataloged, much less understood.
So far the symptoms may include:
Fever
Fatigue
Coughing
Pneumonia
Chills/Trembling
Acute respiratory distress
Lung damage (potentially permanent)
Loss of taste (a neurological symptom)
Sore throat
Headaches
Difficulty breathing
Mental confusion
Diarrhea
Nausea or vomiting
Loss of appetite
Strokes have also been reported in some people who have COVID-19 (even in the relatively young)
Swollen eyes
Blood clots
Seizures
Liver damage
Kidney damage
Rash
COVID toes (weird, right?)

People testing positive for COVID-19 have been documented to be sick even after 60 days. Many people are sick for weeks, get better, and then experience a rapid and sudden flare up and get sick all over again. A man in Seattle was hospitalized for 62 days, and while well enough to be released, still has a long road of recovery ahead of him. Not to mention a $1.1 million medical bill.

Then there is MIS-C. Multisystem inflammatory syndrome in children is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. While rare, it has caused deaths.

This disease has not been around for years. It has basically been 6 months. No one knows yet the long-term health effects, or how it may present itself years down the road for people who have been exposed. We literally *do not know* what we do not know.

For those in our society who suggest that people being cautious are cowards, for people who refuse to take even the simplest of precautions to protect themselves and those around them, I want to ask, without hyperbole and in all sincerity:

How dare you?

How dare you risk the lives of others so cavalierly. How dare you decide for others that they should welcome exposure as “getting it over with”, when literally no one knows who will be the lucky “mild symptoms” case, and who may fall ill and die. Because while we know that some people are more susceptible to suffering a more serious case, we also know that 20 and 30 year olds have died, marathon runners and fitness nuts have died, children and infants have died.

How dare you behave as though you know more than medical experts, when those same experts acknowledge that there is so much we don’t yet know, but with what we DO know, are smart enough to be scared of how easily this is spread, and recommend baseline precautions such as:

Frequent hand-washing
Physical distancing
Reduced social/public contact or interaction
Mask wearing
Covering your cough or sneeze
Avoiding touching your face
Sanitizing frequently touched surfaces

The more things we can all do to mitigate our risk of exposure, the better off we all are, in my opinion. Not only does it flatten the curve and allow health care providers to maintain levels of service that aren’t immediately and catastrophically overwhelmed; it also reduces unnecessary suffering and deaths, and buys time for the scientific community to study the virus in order to come to a more full understanding of the breadth of its impacts in both the short and long term.

I reject the notion that it’s “just a virus” and we’ll all get it eventually. What a careless, lazy, heartless stance.

CPTSD: Coronavirus and Mental health

To all my extrovert friends. I’m sorry you are suffering from this prolonged visit to my kind of world. But, in all honesty, if it were not for your discomfort. I would wish the world like this always.

I like quiet. I like silence. To me, these things are good.
They are safe. They are peaceful and without violence.

Related article:
What is Complex PTSD?

As you feel uncomfortable in a world that is moving a bit too slowly for you, the “normal” world feels a bit too fast and crowded for me. The lights are too bright, too harsh.

This slower world, with its breezes and the patter of rain on the roof, I’m happy with it and I will be sorry to see it go.

cottage near bank of lake
Photo by Martin Edholm on Pexels.com

Something I haven’t told my readers before is that at one point in my life I lived alone for nearly two years. There is a little house, by a creek, on a road that leads nowhere, in Meat Camp, NC where I spent 2 years healing.

I was removed from the world for a little while in my 20s. In a time of life that most people equate with experimentation and adventure, this tiny house became one of the most important shelters of my life.

I have so many stories from that time of my life. The house was near the bend in the creek, and stories were caught daily in the thickets along the banks. There was always something new to see or learn.

I think the reason that haven is in my thoughts today is that I learned so much in the silence. I learned how to sit with myself again on the steps at the kitchen door. I found my laughter caught in the tangle near the footbridge.

I found so many of the pieces that I had surrendered or cut away to please someone else. A toxic person that even though they were hundreds of miles away – I still feared, because of what they had shaped me into. But, those tales are for another day.

Today I wish all my extrovert friends could see the world as I do.

To me, this isn’t a dull boring place. I’m not lonely. What I see is a sky that is so clear and blue that it makes my heart ache. I see people walking. Not hurried steps desperate to “be there” – but slow steps of people who “are here”.

The colors are more intense, the green of the maple leaves against the sky is a shocking clash of color. The silence lets me hear the trees sigh in the breeze. I can hear the birds overhead and the squirrels chittering as they race around the bottom of the trees.

I wish all my extrovert friends could see what I see.”

And, more than that, I wish that it could be as great a balm for them.

But, I know that many, perhaps most, people want to resume “normal”. This quietude makes them restless and irritable. The world on pause feels so much more welcoming to me. Without clashing noise of the constant burble of voices, I find the world welcoming. I might even say “better”.

I know this condition won’t stay.

But I hope that all my extrovert friends will remember these days when all the noise of life is resumed. Perhaps they can then understand a bit, what it is like for me to live in their world

Like the wildlife, I am enjoying the respite from the persistent human pace of normalcy. Until the world breaks out again in progress and activity I’ll just be over here. Enjoying the quiet.