Post Viral Psychosis is a complex mental health and physical health disorder that can suddenly appear in healthy individuals exposed to viruses such as West Nile Virus (now in Arizona) or Influenza. High fever and/or lack of oxygen to the brain can cause the patient to hallucinate and see or hear things that don’t exist in reality as well as act confused, incoherent, catatonic, unable to speak, interact, poor memory, sudden amnesia or inability to remember or recall.
Rachel was a long time patient of my women’s health and hormone clinic, was in perfect health and ran regularly. One day her husband came home and her car was running in the driveway and almost out of gas with the driver’s side door left ajar. When he went into the house Rachel was not making sense with her speech and was seeing imaginary bugs all over the house she was swatting with a fly swatter and screaming about how the house needed to be fumigated for bugs. Rachel’s husband promptly took her to the ER where they admitted her into their psych ward and diagnosed her with schizophrenia and bipolar disorder. The psychiatrists had Rachel on five antipsychotic, bipolar and anxiety medications to no avail. Instead of talking about bugs and swatting imaginary bugs, Rachel just sat and stared into space and did not talk when her husband came to visit. After two weeks and no improvement, Rachel’s husband asked to discharge her to get a second opinion. The hospital said that he would be doing that against medical advice or AMA as we call it in the medical field.
Frightened upon how much worse Rachel had become her husband called me and scheduled an appointment to talk to me about what was going on with Rachel since I was the only doctor that knew what her personality was like, that she never had an previous anxiety, depression or mental health issues and the only thing we were treating her for at my clinic was her heavy periods.
Upon moving to Arizona from Seattle I noticed there was a big difference in taking histories on my cold and flu patients. When I worked as as a nurse at the hospital nobody ever complained of cold and flu symptoms that caused viral symptoms or “zappy feelings throughout my body” as one patient with West Nile Virus described it.
Fortunately by taking a solid history of events we realized that they had recently been camping in an area where a lot of mosquitoes were, and Rachel had had many bug bites the few weeks prior to the psychotic hallucinating event.
I wrote a referral for Rachel’s husband to take her to a different ER and ask she has a spinal tap for West Nile Virus. The spinal tap was positive and suddenly Rachel had a team of experts working on her to restore her back to normal. We were so grateful that immediately Rachel had a team that included a neurologist, infectious disease doctor, psychiatrist, and ICU doctor. Rachel recovered in the hospital but still continued to have brain fog, pain, and headaches which we addressed with Naturopathy and Herbal Medicine until she was back to 100% normal.
The picture of Post Viral Psychosis is a rare mental health condition I see occasionally in my Holistic Psychology practice. Viral Psychosis generally presents “Out of the blue” with no previous mental health issues reported and can be very confusing to family members. Family may assume the patient is on drugs or alcohol as they appear to be hallucinating. Instead their brains are infected and starved of oxygen. Lack of oxygen to the brain causes hallucinations similar to people hallucinating on mushrooms. The patient behaves child like as they struggle to function in reality. Frustrated family members that are yelling at them or expecting them to function while their brain and nervous system are severely infected are just going to traumatize them and make them worse.
Do Post Viral Psychosis Patients Have PTSD?
The brain is under attack and inflamed somewhat like a traumatic brain injury with Post Viral Psychosis. Furthermore, traumatic experiences such as car accidents, falls, and physical fights patients start with other people from Psychotic rage can cause patients with Viral Psychosis to then develop PTSD. Patients with psychosis can end up in the emergency room, psych hospital, or even jail cell and feel further traumatized by these experiences. Especially without a loved one present. Treatment of the adrenal glands is then imperative to help this type of mental health patient recover as I discuss futher on my PTSD and Adrenal Gland blogs.
What is happening with Post Viral Psychosis?
A severe viral infection causes the brain to become inflamed and/or starved of oxygen such as when people take hallucinatory mushrooms and the patient begins to see and hear things that are not part of reality. The brain not receiving oxygen because it is clogged with viral particles, immune cells, cytokines, and other biological warfare the immune system is throwing at the virus yet failing the battle.
What Viruses Cause Post Viral Psychosis?
West Nile Virus, Influenza and other neuroinvasive viruses are known to invade the nervous system and brain and may be the triggering event for post viral psychosis. Especially for patients without a family history of schizophrenia or mental health disorder. During the Spanish Flu in 1911, doctors first began to document this phenomena of patients becoming so sick their brains became infected with inflammation and went crazy right before their eyes. As the Spanish Flu went away, and the doctors reported most cases resolving around the five year or less mark, less was talked about Viral Psychosis until West Nile Virus permanently moved to the United States.
Looking back on the odd flu cases with neurological symptoms I have seen as a doctor the years prior to their announcement of West Nile Virus it became clear to me that I have been seeing patients with Post Viral Psychosis and nervous system destruction the years prior to the US announcing it is a new issue that is now here to stay.
After twenty six years of interviewing flu patients, I only started to note these weird neurological flus in 2016 which began to increase in rate of reports from my patients in Arizona. Especially those that own horses and live on a ranch.
I state this because West Nile Virus appears like a travel flu and my #1 question for these odd “neuro flu” cases I was suddenly seeing had not traveled at all. However, the most of them all lived in Rio Verde aka “Horse Country” in Arizona where mosquito bites are much more common.
Am I Schizophrenic if I have Post Viral Psychosis?
The classic difference between patients with standard schizophrenia vs those with post viral psychosis is that the patient with the viral syndrome is generally more aware that their behavior is abnormal and may have breaks in and out with their ability to see reason and that there is something “off” with their mental health or perception of reality. They may also go in and out of states of psychosis and appear completely normal at times.
Of further distinction, most patients with Post Viral Psychosis will recover and not have another episode unless they are re-exposed to West Nile Virus unlike Schizophrenia that generally just does not go away and will continue to be episodic and require antipsychotic drugs.
Patients that are made worse on antipsychotic drugs are a red flag for Post Viral Psychosis in my mind. Schizophrenic patients will rapidly improve on antipsychotics or through a process of trying different anti-psychotics whereas the Post Viral Infected brain will either get worse from the harsh side effects of these drugs or fail to improve.
Post viral psychosis begins either suddenly or mild symptoms like brain fog, fatigue, lethargy, depression, anxiety, and insomnia.
Triggers for Post Viral Psychosis:
Patients under heightened stress, abusing drugs, drinking excess alcohol, experiencing socioeconomic hardship and access to proper medical care are at greater risk for developing Post Viral Psychosis.
Treatment for Post Viral Psychosis:
Most patients I have worked with already have been to the ER/hospital and need my help for rehabilitation. Sometimes I have caught this diagnosis in my elderly patients with flu symptoms and intervened with treatments before they need hospitalization.
Generally patients go to standard MD in treatment facility for psychosis, however some patients are made worse by this experience and do better with an out patient approach. By working as a team with a Psychiatrist and experienced Holistic doctor such as myself that specializes in mental health, antivirals and anti-inflammatory natural medications can be given along with mental health drugs to stabilize the patient and help them resolve the inflammatory response from the immune system causing the brain to be under attack.
Thankfully my two year internship at the Ryan White HIV Center at Bastyr University gave me a much better understanding in antiviral treatments both natural and prescription than the average naturopathic doctor. This training is what I have heavily relied on to rehab my West Nile patients battling a chronic infection and lingering symptoms as it is one of the more challenging viruses to tackle and there are no known prescription drugs that are found to be helpful which is why natural antiviral herbs targeted to Flavivirus family seem to be the best option once the patient is discharged from the hospital and stable enough to partake in our patient treatments.
Keep in mind this blog is for informational purposes only and not self help. I consider it utterly dangerous to self prescribed for West Nile Virus as the same herbs that are helpful for other viruses generally work against DNA and this is an RNA single strand virus similar to Dengue and Zika that is more complicated to treat than the average case of herpes.
Herpes is a double stranded DNA virus. If you do not know the differences in how these viruses operate and replicate you will fail to be successful disrupting their replication. Antiviral treatments that work on DNA are useless for RNA viruses. RNA viruses are generally the worst type of viruses to contract and include HIV, Hepatitis C, Dengue, Polio, West Nile, Ebola, Measles, Mumps, and Rabies.
Of further concern is that not all medications or herbs cross the BBB or "Blood Brain Barrier" so any antiviral drugs or natural medicines for Viral Psychosis that fail to reach the brain are utterly useless as well. You must work with a skilled and experienced Naturopathic Doctor that has successfully treated patients with West Nile and Viral Psychosis. This is a job for a Naturopathic Doctor not a Facebook group, health coach or herbalist.
How long does it take to treat post viral psychosis:
Every patient is different with their mental health issues. From my experience working with patients discharged from the hospital or psychiatric facility after having West Nile Virus I can report that many of them improve in a timeline of 1-6 months. While some will not ever improve, most likely because they lacked adequate support from their family to facilitate a treatment plan and require a caregiver.
Many family members do not understand how severely ill the patient is suffering with this and the staring, and failure to talk can be misinterpreted as laziness or depression.
What are the symptoms of West Nile Virus?
Most people infected with West Nile Virus don't develop symptoms. Others may experience fever, headache, body aches, or more severe symptoms like encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes surrounding the brain and spinal cord). You do not have to be camping or in the deep woods to get West Nile Virus. It is endemic in our neighborhoods in Arizona. However, I do see more patients develop West Nile Virus that live out in Rio Verde, and rural areas of Arizona.
Do you have to be extremely sick to have Post Viral Psychoses?
No. Some of my patients have had no symptoms of West Nile virus at all and simply went from feeling completely fine to becoming hospitalized from this neuroinvasive virus that invades the brain and nervous system. Signs that there is something wrong with the patient may first occur such as one patient left his car running overnight and forgot to turn it off and his wife found the car without any gas. Another patient “forgot” to pay all of the family’s bills and all of their power and water were shut off without notice because she also was not checking her voicemail or email and had lost touch with reality. Another patient called our clinic in a garbled voice talking nonsense crazy talk that made no sense to my assistant. Upon calling 911 the patient was admitted to the hospital for encephalitis (infection of the brain) caused by West Nile Virus and Valley Fever infection coinciding at the same time. None of these patients recall being bit by a mosquito or recall being sick prior to their brain going under attack by the virus.
Only 50% of my suspected WNV patients with post viral psychosis actually tested positive for the virus. Antibody testing is not always accurate as it requires a healthy immune system to create antibodies and some patients are simply too sick to make the antibodies. I did have a patient with negative blood antibodies to west nile virus however the spinal tap was positive. Therefore the cluster of abnormal symptoms and the sudden presentation of new mental health abnormalities should be taken into consideration.
One common symptoms of Post West Nile Virus I have heard from patients that did and did not have Psychosis is the feeling of nerve “Zaps or stings” throughout their body. Any neurological tingling, neuropathy, buzzing, burning, sharp stabbing pain, or new pain would be an important symptom to pay attention to that is not common with standard onset Schizophrenia.
You do not have to be super sick to have Post Viral symptoms or Psychosis.
How Can I Protect Myself?
Wear bug spray at all times. Use Citronella torches in your yard. Plant rosemary bushes and other herbs that naturally repel bugs such as citronella grass, lavender, catnip, lemon balm, marigolds, basil, peppermint, and geraniums. Clear clutter, debris and shrubs from around your house. Empty daily any standing water that attracts mosquitoes and provides them a breeding ground from your yard.
Where long sleeved clothing and tuck socks into pants. Buy clothing that is resistant to bugs.Hire an organic bug spray company to spray your yard for mosquitoes that transmit the virus. Call animal control if there are suddenly a bunch of dead birds or animals in your yard as this is a strong sign of West Nile or something worse like Hauntavirus if dead rodents or bunnies.
When is West Nile Virus at Peak in Arizona?
Mosquito season is at peak from May through October and heightens from July to September. The majority of the cases I have found presented to me in September and October. Or had prolonged symptoms that started around that time. With viral illness the body can try to fight the virus for a while before it eventually gives up and the virus starts to win. So being outside in July/August getting bit by a WNV mosquito means we may see Psychosis immediately in an immunocompromised patient or person with a weak immune system, whereas someone with a healthier immune system may be able to fight the virus off for a month or two before losing the battle. Keep in mind most people exposed to WNV have no symptoms at all or maybe feel too hot and tired for a day or two which is often considered very normal in Arizona “I was out in the heat too long and felt sick, tired, and nauseated with a bad headache” I have heard from many patients with heat stroke as well as those with West Nile Virus.
What should I do if I suspect myself or my loved one has post viral psychosis?
First and foremost go to the emergency room for a diagnosis of any type of psychosis. Never shall anyone book an appointment with a Naturopathic doctor for new onset psychosis. This is a medical emergency and we need to act fast and use the hospital to get quick lab answers and treatments. They can perform a spinal tap to determine if there is an infection in the nervous system. This blog post is for educational purposes only and explanation of how to rehabilitate yourself or loved one after going through this horrifying experience.
Please get on my schedule ASAP so I can help you, as I have had good success helping patients with this complicated condition involving their mental and physical health. I always recommend all patients with psychosis have a Psychiatrist working with them on their medications to help stabilize their mood although a hallmark sign of Postviral Psychosis is the patient is being made WORSE by the standard antipsychotic drugs and may improve more from my treatments that are anti-inflammatory and antiviral specific to West Nile virus while treating anxiety, insomnia, and depression related to the condition with MD Psychiatry medications.
Will I ever be normal again after having Post Viral Psychosis?
Yes. I believe firmly with proper treatment using a holistic integrated team approach that the majority of patients are healthy enough to return to normal. I have only had one case I was not able to resolve since WNV became endemic in Arizona. The majority of my patients improve with natural medicine faster than if they are just working with a Psychiatrist which is why I highly recommend a team approach and have taken the time to write about this condition to save people from wrongly being diagnosed as “crazy” or “schizophrenic” after contracting West Nile Virus.
More importantly family members need to understand that in order to recover their loved ones mental capacity and mental health they also need to address their physical health and immune system or they will not improve and probably end up in a mental institution permanently or skilled nursing facility as they may never be able to take care of themselves again. Treating Viral Psychosis requires a Naturopathic Integrative Mind/Body/Spirit approach as we work as a team with the patient’s psychiatrist.
If you or your loved one are struggling to recover properly from the “Desert Flu” aka West Nile Virus or Valley Fever (fungal infection that can also infect the brain) I would be happy to help, as this is something I have helped many patients with over the fifteen years I have practiced in Arizona and I would hate for anyone to end up in a psychiatric institution.
Simply visit my SCHEDULE page to get started with my Naturopathic process!
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene has twenty six years of experience in health care and is the author of "The Hormonal Acne Diet." She specializes in Autoimmune Disease, Women’s Health, Holistic Dermatology and Hormones. She is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. Dr. Sundene specializes in Holistic Women's Health conditions for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 26 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 30 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
