A 30-year-old Connecticut man provides one clue.His story, co-written by Pleasure of UCSF, was posted in August. Within days of getting a fever and a COVID diagnosis, the man came to believe a religious rapture was imminent and thought he was speaking with dead relatives. He kicked down a door. He shoved his mother. He was hospitalized, but discharged after doctors found no reason for his sudden psychosis. He was back in less than two weeks, his face expressionless and his speech and thinking dulled.A blood test identified high levels of two proteins, ferritin and D-dimer, hinting at a culprit: systemic inflammation.That led his doctors to suspect the coronavirus had triggered the inflammation, which caused an immune response that, instead of controlling the infection, “turned into a problem of its own,” Pleasure said. In this case, psychosis.So doctors at Yale New Haven Hospital chose a treatment typically aimed at autoimmune diseases, and infused the man with intravenous immunoglobulin. Made of purified antibodies from thousands of people, it’s believed to work by swamping out abnormal antibodies.The man’s delusions vanished. He returned to work and has remained healthy.
It's pretty dramatic when someone believes they're seeing dead people and that the apocalypse is upon us. However, it isn't that unusual. Anyone who's worked with homeless people can tell you that there are always a few who have such ideas. Mental illness can often be a reason—but by no means the only one—for people to be on the streets.
Consider, though, that we often deal with such folks on a regular basis who are perfectly functional in society and also believe that spirits are among us and/or that the end times are imminent. To our shame in the United States we have a significant number of people who believe that there is a secret ring of pedophile Democrats who are trying to rule the world from behind the scenes. These people work, study, raise children, vote, and do everything else with some degree of what might be viewed as 'normalcy.' And yet they have ideas completely out of touch with the real world.
What if it's biological? What if, like the man in Asimov's article, something is going on physically in the brains of people like these? Certainly it must be the case with the more extreme examples. Those who declare themselves to be prophets and think they see visions must have something unusual going on physiologically. What if our friends, family, and neighbors with really out there ideas don't just reason poorly, but actually have an untreated affliction of a biological nature?
This idea has me rethinking my ways. I'm not very charitable or compassionate towards anti-vaxxers and anti-maskers. They are a menace to society. And yet, maybe they can't help it. Perhaps it's not just their software that has an issue, but rather the hardware is faulty.
There's little to be done about it. Better education on mental health issues and greater efforts toward destigmatizing treatment would help, to be sure. Otherwise, we simply have to do our best to bring them along in a way that won't put the rest of us at risk. For all I know, I could suffer some sort of viral infection or other imbalance in my system and end up with a head full of notions that don't connect to reality. In my case, I hope that if it came to that some treatment would be available, and family concerned enough about me, to be restored to a healthy life, as seemingly was the case of the man described above. I would want compassion for myself, so why should I deny it to others?
