Introduction

Did you know that mental well-being can affect how well the treatment works for respiratory syncytial virus (RSV) diseases such as pneumonia or bronchitis? Patients diagnosed with these conditions frequently face numerous mental health challenges in addition to their physical health difficulties; thus, it is critical to understand also the psychological complications that these patients may encounter, so that those closest to them can better understand their thoughts and feelings.

Key takeaways

1. Patients with RSV face not only physical but also mental health difficulties, and as psychological and physical health are closely intertwined, taking care of mental health can improve treatment outcomes
2. The most common mental health challenges include depression, anxiety, and trouble sleeping. Patients often experience fear of developing severe breathing conditions such as pneumonia or bronchitis, frustration and irritation over the symptoms of RSV, and emotional drain and isolation due to the prolonged illness, which can then be the cause of the above-mentioned mental health disorders
3. While one-on-one psychotherapy or counselling sessions may not suit everyone, alternatives like support groups, mindfulness techniques, and meditation can also be helpful

Respiratory syncytial virus (RSV) and the importance of understanding the psychological effects of RSV in adults

The RSV is a contagious virus that commonly causes pneumonia, bronchitis, and other respiratory diseases. It often affects vulnerable members of the public, such as infants, elderly adults, and individuals with heart or lung conditions. The virus impairs the lungs and other breathing passages by infecting cells lining the airway, causing inflammation and making it difficult to breathe ¹. Same as in any other significant medical complication, RSV has not only physical impacts on patients' bodies but also psychological impacts that come in a wide variety of forms, such as anxiety, depression, and difficulties sleeping, which have an overall effect on everyday life.

According to Curran et al. (2022),² the RSV virus had an emotional impact on 93% of their participants. The main reasons were:

• Concern that the symptoms would get worse
• Fear of pneumonia or another serious illness (especially for those aged 65 and older)
• Irritable or frustrated due to the severity and duration of the symptoms
• Emotional draining
• Depression
• Isolation

Anxiety

Anxiety is a psychological state, in which the impacted person can feel uneasy or distressed about something unspecified, uncertain, or formless, which is viewed as a threat.³ These feelings can commonly arise in RSV patients, as well as their loved ones, and can be related to the seriousness of the diagnosis, the uncertainty of the future, as well as the general impact of the illness on patients’ lives, such as the cost of treatment or time away from work. Additionally, patients with RSV are more likely to be anxious about any possible consequences that the virus may produce,² and therefore more likely to experience psychological illnesses like anxiety when RSV develops in serious respiratory infections like pneumonia or bronchitis. This can then impact how well a patient responds to treatment.⁴ Breathing difficulties can also have the 

potential to increase feelings of fear. The sensation of struggling to breathe can also cause anxiety or panic attacks, and the constant focus on the difficulty of breathing can therefore lead to an increase in anxiety.² For these reasons, it should not come as a surprise that, for example, patients with bronchitis, commonly caused by RSV, were found to have increased levels of anxiety and neuroticism, likely related to and caused by breathlessness. The high levels of anxiety symptoms can affect the outcome of the treatment.⁵

Depression

Depression is a psychological mood disorder that affects one's behaviour, thoughts, and physical health, as it hinders the ability to enjoy everyday life in its patients.⁶ However, in those infected by the RSV, depression can have further impacts. For example, as the body detects the infection, the immune system increases inflammation to “fight” the virus. Also, when the immune system is activated, the IDO enzyme (indoleamine-pyrrole 2, 3-dioxygenase) work increases. This enzyme breaks down tryptophan, which is an important amino acid. The increased activity of the IDO enzyme therefore lowers tryptophan levels and increases levels of kynurenine. Changes in the amounts of tryptophan and kynurenine in the blood, as well as an increase in inflammation, are linked to an increased probability of developing depression.⁷ These biochemical changes highlight the relationship between physical health and mental well-being. Any prolonged period of illness can lead to a decline in mood. As previously mentioned, patients with RSV are likely to feel irritable and frustrated due to prolonged illness, which can be emotionally draining and increase the likelihood of feeling depressed. Feelings of hopelessness or helplessness are also common in patients with prolonged respiratory conditions, causing them to feel trapped or believe that they will never fully recover. These feelings can also add up and cause the patient to feel more depressed.²

Physical symptoms and their impact on stress and fatigue

RSV, like any other illness, presents with physical symptoms that can cause stress in patients’ bodies and minds. The most common symptoms caused by the RSV virus are:

• Cough
• Shortness of breath
• Sputum production
• Weakness
• Fever
• Wheezing

Importantly, chronic fatigue is one of the most debilitating symptoms of RSV, leading to some mental health challenges such as stress and irritability. Chronic fatigue in patients with respiratory issues was found to be correlated with increased stress levels and bigger mental health difficulties.^{2, 8} Sleep, which in a healthy population helps to improve fatigue, is largely impacted by cough, which is both physically and mentally challenging as it has the potential to interfere with daily activities as well as disturb the patient's sleep. Breathing issues and wheezing can also disturb sleep in RSV patients. Reduced sleep quality and quantity can impact patients’ mental health, as a lack of sleep causes an increase in fatigue and has also other cognitive impacts, which can heighten the likelihood of developing a mental health disorder such as anxiety or depression.²

Social and lifestyle impacts

Due to the patient's inability to participate in regular social activities and to stop the spread of infections, prolonged illnesses like RSV frequently come with a period of social isolation, which alters patients' social lives and affects their mental health by causing feelings of loneliness, which are identified as risk factors for mental health problems including depression and anxiety.² Being ill for a prolonged period often goes hand in hand with frequent periods of absence at work, potentially causing further stress and anxiety, this time related to workload, job security, or finances. Additionally, not being able to complete daily tasks can lead to frustration and a lower sense of self-worth, which could have a negative effect on mental health.⁹ The changes in everyday life and increased dependence on others can cause further stress, increasing the likelihood of developing anxiety or depression.

Psychological support

As mentioned above, RSV can leave its patients in quite difficult mental health situations; therefore, implementing counselling and psychotherapy sessions may be beneficial, as they can provide the support the patient needs to successfully overcome their mental health difficulties. Mental health professionals can give advice, and help propose strategies to manage anxiety, depression, stress, etc. This can then possibly improve patients’ quality of life.¹⁰ Understandably, not everyone feels comfortable in one-on-one psychotherapy sessions, even when psychotherapists come in all shapes and sizes. However, there is no need for worry, as there are alternative ways to prioritise mental well-being. It can be support groups, where a patient can connect with others facing similar difficulties, they do provide a sense of belonging, community, and understanding, by doing so, they have the potential to significantly improve mental health outcomes.¹¹ Other than support groups, mindfulness techniques and meditation can help with stress management and the improvement of overall well-being.¹²

Summary

The RSV can cause severe respiratory complications such as pneumonia or bronchitis, and since physical and mental health go hand in hand, it is important to consider the patient's psychological state. Patients with RSV can face a wide range of psychological complications, from anxiety and depression to sleeping difficulties and stress, which all impact their overall quality of life and well-being. Taking care of mental health can enhance the effectiveness of treating physical illnesses, highlighting the importance of mental well-being in overall health outcomes. These can be achieved by counselling sessions but also support groups, mediating, or mindfulness techniques.

FAQs

Can RSV cause brain damage in adults?

Yes, there is evidence that RSV can cause brain damage and neurological complications, such as encephalitis, encephalopathy, seizures, and other disruptions in brain development and functions.¹³

Does RSV cause extreme fatigue in adults?

Yes, RSV can cause extreme fatigue in adults, which can potentially lead to other mental health difficulties.^{2, 8}

Can RSV cause anxiety?

Yes, RSV can cause anxiety, mainly related to the fear of potential complications and impacts of the virus.²