Does it really matter?
The New York Times runs a great podcast called The Daily. You should listen to the episode from March 22, 2021.
It deals with Long Covid, something about which I am sadly too familiar. But I’ve had it “easy,” only suffering with chronic headaches and sore throats for the past year. The Daily interviewed a poor guy named Ivan whose Long Covid triggered acute psychosis. For anyone who has read my book, you know the unfortunate familiarity I have with this, too.
Since contracting the virus, Ivan suffers recurring bouts of paranoid delusions: people are after him, tracking his movements, secretly recording him. The fear in his voice is palpable. At times, he can recognize that his thoughts are out-of-touch with reality, and this is even more terrorizing. Of course, his wife and kids have no idea what to do. Wisely, they seek support from the local psychiatric treatment center.
As I listened, my heart went out to this family. I hoped that in time they could find the right medication to prevent Ivan from suffering. I felt an immense amount of sympathy, and I was sure that others would feel the same. But the more I thought about this, the more frustrated I became.
Would everyone feel the same if his psychosis wasn’t linked to Covid? Did the fact that the delusions were caused by the virus make a difference to people listening? What if Ivan was genetically predisposed to suffer from delusions, or had a chronic under- or overproduction of a particular neurotransmitter that caused his recurring breaks from reality? Would people still feel the same level of sympathy?
The cause of his psychosis shouldn’t matter. It shouldn’t matter but it does. Ivan’s story perfectly illustrates the flaw in the logic. If doctors can find some “organic” cause—a virus, a thyroid problem, a tumor—it’s okay to talk about it. Others will sympathize and offer their support. But if nothing organic can be found, then it’s a “mental” problem, and, well, that’s totally different in society’s eyes.
But it’s not different. We don’t know much about Covid yet. We don’t know if the virus affects the brain directly or messes with the body’s ability to regulate neurotransmitters. But when my doctor ordered a neurotransmitter check for Long Covid, it was the only test that came back irregular. In my case, the imbalance might cause headaches; in Ivan’s case, perhaps it causes psychosis.
It’s not different because research has shown that chemical imbalance is at the root of many mental illnesses. If you have read Jessie Close’s book Resilience, you know that she and her son were involved in research at McLean Hospital. It showed that a genetic mutation was causing the illness in her family. It’s a fascinating story; the mutation caused certain individuals to process a specific amino acid too rapidly. Things improved once they augmented their daily intake of that compound.
If someone has inflammation of the heart, we don’t care what caused the swelling. If they have a tumor, we don't ask if it was genetically instigated or the result of an environmental factor. Why do we care when it comes to an imbalance of neurotransmitters in the brain? A former contributor to Forbes, Robert J. Szczerba, captured it well when he wrote: