If you or someone you know may be struggling with suicidal thoughts, you can call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) any time day or night, or chat online.
Ben Price always was the biggest presence in any room. Loud and funny, his smile was captivating, said his wife, Jennifer.
The couple owned a small business and two farms in an Illinois suburb west of Chicago, where they lived with their two teenage children. She said her husband was the hardest working man she had ever met.
“He was the epitome of unconditional love and loved his kids with all his heart,” she said.
Price tells herself it wasn’t her husband who died by suicide on one of their farms the morning of Feb. 28. She believes he was taken over by what some health care professionals call “COVID psychosis.” The thought keeps the grief from swallowing her whole.
“It was shocking and devastating and so completely out of his character,” she said.
Neurological and psychiatric experts are seeing more reports of COVID-19 sufferers developing psychotic symptoms, even when they have no prior history of mental illness. While rare, the condition can be severe enough to require hospitalization.
Symptoms may include hallucinations, unusual agitation, restlessness preoccupation, paranoid beliefs, decreased need for sleep and impulsive behavior, said Dr. Jonathan Alpert, a professor of psychiatry, neuroscience and pediatrics at Montefiore Medical Center and Albert Einstein College of Medicine in New York City.
Alpert did not treat Ben Price, who was never officially diagnosed with a COVID-related neurological condition before his death. But he recognizes the signs, and urges people to seek immediate medical attention if they think someone is beginning to show symptoms of COVID psychosis.
“When people are psychotic, they aren’t in touch with reality and may do things that harm themselves and other things that are very dangerous,” he said. “It looks like COVID-19 has a somewhat higher risk of causing it than other viral infections that we’ve seen.”
Ben, 48, came down with COVID-19 two weeks before his death. When his oxygen levels were low, he was taken to the hospital and received treatments including steroids, antiviral medication and an antibody infusion, his wife said.
The COVID unit was anxiety-inducing, Price said, but her husband didn’t show signs of psychosis until he was home from the hospital. His anxiousness and paranoia skyrocketed, she said, and he became obsessed with working on the farm even though in February there was no work to be done.
He went from being boisterous and animated to subdued and “child-like.” After days of trying alone to help him, Price took him to a primary care doctor who prescribed him anxiety medication.
“It just wasn’t working. He was pacing and upset and worried,” Price said. “I was watching my daughter watch him and being worried … she saw it was not her dad.”
Although data is scarce, experts say “COVID psychosis” may be caused by brain inflammation triggered by the body’s immune response to the virus, said Alpert. Other contributing factors may include the side effects of high-dose steroids, low oxygen levels or the emotional trauma of being severely ill. Some COVID-19 patients also suffer from small strokes that could lead to psychiatric disorders, he said.
A first episode of psychosis normally occurs in late adolescence or early adulthood, Alpert said. However, a study he co-authored in November featured a 49-year-old man and 34-year-old woman who had COVID-19 and no prior history of mental illness.
After going public with her story, Price said she’s heard from dozens families who fear their loved ones were or are suffering from the same condition.
“You can’t imagine the stories, the devastation and the things that people are doing out of character – thriving wonderful people with zero prior (mental health) history,” she said. “It’s happening more than we realize.”
A massive study, involving more than 230,000 COVID-19 survivors and published April 6 in The Lancet Psychiatry, found .4%, or nearly 1,000, had developed a psychotic disorder.
“There’s probably over 50-plus individual case reports where people are describing very specific instances of psychosis in the setting of someone having COVID-19,” said Dr. Colin Smith, a resident physician in internal medicine-psychiatry at Duke Medical Center, who also co-authored a case report studying COVID psychosis.
Patients with temporary or permanent psychosis are at an increased risk of suicidality, said Dr. Mason Chacko, clinical assistant professor of psychiatry at Stony Brook University Hospital, who also authored a case report that detailed a patient who developed COVID-19-associated psychosis and died by suicide.
“Depression psychosis, being internally preoccupied, or hearing voices or thoughts of self-harm could be triggers as well,” he said.
If she had known about COVID-induced psychosis, Jennifer Price said, she would have been better prepared to help her husband. That’s why she’s petitioning for the Biden administration to add a neurology expert to the White House Coronavirus Task Force.
Alpert agrees more focus should be placed on the possible mental health and neurological outcomes of COVID-19.
“Society itself, whether people have COVID or not, are experiencing significant mental health impacts,” he said. “Any COVID task force that doesn’t have mental health or neurological expertise on it is not really a full task force.”
The medical community itself is just learning about the possible psychotic manifestations associated with COVID-19 recovery, Alpert says, which is why it’s important for doctors to screen for psychiatric distress.
So far, Price has been successful in her own state, convincing Illinois Gov. J.B. Pritzker to add neurology experts to the Illinois COVID Task Force. And she’s been in touch with Eduardo Cisneros, Intergovernmental Affairs Director for the COVID-19 Response Team at the White House.
She hopes a mental health question can be added to the Centers for Disease Control and Prevention’s V-safe survey, a smartphone-based tool that uses text messaging to provide personalized health check-ins after people receive the COVID-19 vaccine.
“Sharing my story is one thing but really what is important is action,” Price said. “My Ben has his hand on my back and he’s with me every step of the way.”
For pandemic-specific mental health resources, head to covidmentalhealthsupport.org.
Crisis Text Line also provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.