Is Influenza Depression a Real Thing?

Sick with influenza depression.

Is that even a real thing? Can the flu cause depression?

We are in the midst of flu season once again and that made me think of something that happened to me nearly 10 years ago. I wasn’t aware of its significance back then, but the more research I did, the more it peaked my interest.

In 2009 and throughout 2010 we saw a deadly outbreak of the H1N1 virus, also known as the Swine Flu. It was the first flu pandemic in four decades and only the second outbreak of the H1N1 flu virus since just after WWI. The 2009 virus was a different version of the previous H1N1 virus, and as you might remember, it spread around the globe incredibly fast.

I was working at a small office in 2009. I lived in a small town and I had never considered getting the flu shot. Usually a few people at the office would get sick. I would get sick too, spend a few days resting in bed, and then I would be good again until the next year’s flu season. It was normally just a cough, stuffy nose, and feeling tired, nothing too bad.

2010 was different. The first thing out of the ordinary was that it hit me outside my usual “flu time”. Previously, I had gotten sick in October, November, or December, but was always fit again for the holidays. In 2010 it happened in March. The second thing out of the ordinary was the symptoms. 

How my influenza depression started

I had spent the night at my boyfriend’s house. During the night I woke up a few times and just felt “off”. I couldn’t put my finger on it. By the time morning rolled around, I had trouble moving my legs and I had cramps all over my body. It felt like I was burning from the inside out. I was hot and cold at the same time and my skin felt clammy. Even the blanket touching my body hurt.

I called my parents, who were also my work bosses at the time. Feeling dizzy and sick I remember saying to my mom that I thought I was being poisoned. She said that I was being completely ridiculous, but after realizing how sick I was, she came to the house right away. In a short time I developed a fever and it became clear that I wasn’t going to work that day.

Since it was easier to care for me at home, my parents decided to move me from my boyfriend’s house back to my room at their house. By the evening, I had deteriorated even more. Pillows propped me up because I felt like I was drowning in my own lungs. I could hardly breathe and my whole body was burning and cramping all over. My mom decided to give me some Ibuprofen to help with the fever and the pains.

That was only the beginning

Shortly after, I started throwing up blood and my parents were in a real panic. My mom wanted to call the ambulance. Somewhere in my delirium I heard hospital and ambulance and I freaked out. The hospital is one place I never wanted to go. In my opinion, people went to the hospital to die. So I kept saying that I just wanted to die at home in my own bed.

I don’t remember the following days. From what I have been told my family took turns staying home and caring for me. Strangely enough, nobody else got sick. I was in and out for several days.

It took three weeks before I was able to get out of bed again on my own. I had no appetite and I still felt weak and tired all the time. After a month, I went back to work for the first time. Since I just had to sit at a computer, I decided to give it a try. Laying around in bed for all that time was driving me crazy.

Another 5 months passed before I was able to fully function again. During that time I kept having bouts of extreme exhaustion. Sometimes I had to nap at lunch because I was so tired. And that was just from sitting at my desk! Exercise was completely out of the question. I ate healthy and took every antiviral supplement I could find. Later on, my doctor asked if she should test me for the Swine Flu virus. She was pretty certain that’s what had happened to me.

Toward the end of 2010 I started feeling better again and I was so happy the flu was done with. In October I got very nervous because the possibility of picking up the flu again scared me. But, that year I did not get sick again at all. Instead, I slid into a very bad bout of depression.

This fact did not stand out to me at the time. I battled depression and the “how and why” of it was extremely difficult to understand. But, as I began doing more research on depression later on, I found depression and influenza mentioned together more and more often. Influenza depression is not a specific condition; however, the two popping up together made me think about my Swine Flu.

Apparently Daniel Hack Tuke, a British physician, already explored the link between influenza and depression in the 19th century. In 1892 he wrote a series of articles about his observation that influenza patients seemed to get depression more frequently than patients who had not contracted influenza.

Dr. Hack Tuke had great interest in psychology and was an asylum reformer. He traveled throughout Europe and North America, visiting asylums in different countries and gathering knowledge about mental health. He also wrote and edited many books, putting his vast knowledge to paper.

In more recent times, Dr. Steven Schlozman, a psychiatrist at Massachusetts General Hospital, has made the same connection. In a blog post he explains the concern about influenza and depression, as each condition seems to worsen the other condition.

For example, children who suffer from depression have a much harder time recovering from influenza. And children who have a severe case of influenza can develop a sort of influenza depression, which makes it difficult to recover.

Another interesting thing Dr. Schlozman mentions is inflammation. When we contract the flu, our body mounts a full immune response in an effort to kill off the virus. This response puts our bodies into an inflammatory state.

Psychiatric distress, such as depression, is also associated with an inflammatory state. It is possible that inflammation plays a big role in influenza depression. 

Influenza damage and the foundation for influenza depression

Studies suggest that severe cases of the flu leave behind some type of small, permanent damage in the nervous system. This might explain why people who have battled the flu could be more prone to becoming depressed later on.

I think this is especially of concern in elderly people. When I volunteered at the extended care unit, for instance, it happened very often that elderly patients did not recover from the flu with the same mental presence they had before they became ill.

In my case, I was already battling depression before I ever had the flu. But, the flu could be another piece as to why depression stayed with me for so long and was so difficult to break through. I imagine that could be the case for people who have had severe cases of influenza, maybe even more than once. Or for people who had influenza as a child and then battled depression in their teenage years.

Another thing to consider is the psychological effect the flu left behind. I was so scared of getting sick again that for several years after 2010 I developed anxiety during the end of the year. I was always anticipating getting sick.

At the sign of the smallest tickle in my throat I would break out sanitizers, face masks, antivirals, supplements, and essential oils. A complete pharmacy sat on my desk, just in case. As a depressed person I can tell you that kind of anxiety did not help my situation.

The reality of influenza depression

I am not a doctor, so there is no medical opinion here. Undeniably, a connection between depression and influenza exists and becoming aware of that is another piece in the depression puzzle.

Of course, we cannot shield ourselves and our families from ever becoming sick. But, knowing that influenza depression exists might help us make decisions after the flu that can better prevent a possible onset of depression.

If we know someone who is recovering from influenza, we can check in on them frequently and look for signs of depression.

We might also understand better that if we were sick with the flu multiple times, it could be part of the explanation of why we are battling depression that seems to just cling to us permanently.

Time to panic?

Having said that there is no reason to break out surgical masks, pack up the family, move to remote Northern Canada, and live off the grid.

It might be a little more difficult, but knowing the link between the two is already one more step closer to healing.

Stay healthy this flu season and practice lots of self-care.
And if you are curious now, you can explore even more about influenza depression online!