This Personality Change Could Actually Be a Sign of Infection, According to Doctors
Woman experiencing a mood change as a sign of infection
It's essentially impossible to go through life without getting an infection. We've come to expect and accept the fact that we'll probably get one at least once a year when the upper-respiratory virus season rears its ugly head and leaves us leaning into unplanned bed rotting. However, "common" doesn't mean "benign," as some viruses can have more severe outcomes and affect people differently. Knowing various signs can help you help yourself (or loved ones).
"Understanding early symptoms of potential infection increases the ability for earlier intervention and reduces the risk of severe complications and permanent disability," says Dr. Sakeitha Crowder, MD, who specializes in internal and geriatric Medicine with Novant Health Adult Primary Care Harper Hill in North Carolina.
You likely know all about upper-respiratory symptoms like coughing and sneezing and ones for stomach viruses like cramping and diarrhea. However, doctors share one surprising infection sign that drives home the idea that mental health is physical health.
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The Unexpected Mood Change That Could Be a Sign of Infection
Anger or, more generally, new and sudden mood changes, can be a sign of infection. "Abrupt, unprovoked changes in mood and generalized awareness are a few of a myriad of potential signs and symptoms which develop in the body as indicators of active infection," Dr. Crowder says.
Surprising? Maybe. Is it important to flag these changes in you or a loved one? Absolutely. "Sometimes, an infection can also cause changes in other organs, such as the brain," says Dr. Nikhil Palekar, MD, the director of the Stony Brook Center of Excellence for Alzheimer's Disease. "When that happens, it can affect a person's mood behavior."
Dr. Palekar explains that this change is often triggered by increased inflammation. "Our bodies are geared towards fighting infection by producing certain chemicals, called cytokines, which then trigger an immune response in the body," he says.
Additionally, infections can cause inflammation. "The state of inflammation can impact the brain as well and cause increased inflammation in the brain, or activation of inflammatory cells in the brain called microglia," Dr. Palekar says. "This can cause changes in the mood."
Hence, you may feel rather low before realizing you have a cold. Additionally, older adults may be at an increased risk for infection-related anger and mood changes. Dr. Palekar says the natural process of aging, vascular changes (reduced blood supply to the brain) and diseases (like dementia) can play a role.
"Even a small or minor infection like a urinary tract infection can have a significant impact," he says. "They seem much more agitated...The term we typically use for that is delirium."
In addition to agitation, Dr. Palekar says patients may have mood swings or become paranoid. "This is different than the progression of a dementia illness," Dr. Palekar says. "This is directly as a result of an infection."
How do you know if the change is a result of an infection, typical dementia progression or exclusively a mental health condition?
"People should always seek medical advice from a health professional regarding potential mood changes," Dr. Crowder says. Typically, Dr. Crowder says a primary care physician can do a workup or refer you to the appropriate specialist. Emergency room providers handle more urgent issues.
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What Types of Infections May Cause Mood Changes?
Several viruses can cause mood changes, such as sudden irritability or increased anger, explains Dr. Christopher C. Butler, BA MBChB, a professor at the University of Oxford and advisor to Lindus Health.
"Viral infections are the most common causes among infection-associated mood problems, and these include influenza, respiratory syncytial virus, COVID-19, Epstein bar virus (glandular fever) and herpes viruses," Dr. Butler says.
However, people with bacterial infections aren't immune. "Bacterial infections like streptococcal infections, and infectious syndromes like pyelonephritis, sepsis and pneumonia, have all been associated with short- and longer-term debilitating symptoms including low mood, exhaustion, headaches, brain fog and anhedonia," Dr. Butler says.
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How to Treat Infection-Related Mood Changes
1. Treat the infection
Dr. Crowder advises people to start directly at the source: the infection itself. Depending on the infection, you may be able to take a round of antivirals or need to emphasize non-medical remedies like rest and plenty of fluids.
2. Prevent recurring infections
The adage about prevention being the best medicine rings true when treating mood changes related to infections. "Collaborate with your healthcare provider on ways to reduce risk for recurrent infection(s)," Dr. Crowder says.
For instance, Dr. Crowder suggests reviewing CDC recommendations for Pneumococcal vaccines, which you may qualify for.
"Pneumococcal vaccines reduce risk of bacteremia and sepsis, thus reducing the risk of long-term mood changes post-infection," Dr. Crowder says.
3. Communicate with your provider about your mental health
Mood changes that result from infection can outlast the acute phase of the illness.
"Have open and honest discussions with your health care provider regarding mood changes that persist after an infection for selection of appropriate medications, such as SSRI inhibitors to improve mood, referral to counselors or psychologists for cognitive behavior therapy to manage mood changes or resource of local support groups," Dr. Crowder says.
Sources
Dr. Sakeitha Crowder, MD, who specializes in internal and geriatric Medicine with Novant Health Adult Primary Care Harper Hill in North Carolina
Dr. Nikhil Palekar, MD, the director of the Stony Brook Center of Excellence for Alzheimer's Disease
Dr. Christopher C. Butler, BA MBChB, a professor at the University of Oxford and advisor to Lindus Health
