Psychiatrist's Advice! Stress vs. COVID-19

 

 

Psychiatrist's Recommendation: Stress vs. COVID-19
By Dr. Suchart Treethipthikun, Psychiatrist

 

     Since late 2019, COVID-19 has emerged as a global pandemic, claiming the lives of over 3.71 million people worldwide out of approximately 173 million confirmed cases. In Thailand alone, as of June 7, 2021, there have been 1,213 deaths from 175,000 confirmed cases.
     In the early months of 2020, when the outbreak began to significantly affect the daily lives of many Thai citizens, hope was placed on the development of a COVID-19 vaccine, with the public eager to receive it as soon as possible.

 

 

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Eventually, the first COVID-19 vaccine—produced by Pfizer—was administered to Margaret Keenan, a 90-year-old British woman. Subsequently, vaccine distribution expanded across various countries.

 

 

     However, reports of severe allergic reactions and even deaths following vaccination led to growing doubts, fears, and public resistance to receiving the vaccine. Such sentiments were seen in countries like Hong Kong, Taiwan, South Korea, Japan, the United States, and Thailand. This prompted governments to implement various strategies to encourage public participation in the vaccination program.

 

Should You Receive the COVID-19 Vaccine?

     Currently, widespread anxiety exists among the Thai population, which can be categorized into three groups:

 

Group 1: Those eager to receive the vaccine

     These individuals have continuously called on the government to acquire a wide variety of vaccines in sufficient quantities and distribute them promptly.

 

Group 2: Those unwilling to receive the vaccine

     This group harbors significant concern about potential allergic reactions to the vaccine, including fears of paralysis or death. Such anxieties have been fueled by media reports lacking clear explanations from relevant authorities.

 

Group 3: Those who wish to choose their vaccine

     These individuals are open to vaccination but prefer to select a specific brand or type of vaccine.

 

Recommendations from a Psychiatrist

Many medical experts have provided insights on YouTube regarding whether one should receive the vaccine. I encourage readers to explore these resources for further information:

 

• “To Vaccinate or Not to Vaccinate?” – DR.V Channel
• “Who Should Avoid the Vaccine and How to Prepare for Vaccination” – DR.V Channel
• “Guidelines for Those Choosing Not to Vaccinate” – Dr. Tony
• “Which COVID-19 Vaccine is Best?” – Dr. Tony
• “Preparation Before and After Vaccination” – Dr. Winai Boweja
• “What You Must Know About the Vaccine” – Dr. Winai Boweja
• “24-Hour Advice Pre- and Post-Vaccination” – Dr. Nat Nutrition
• “Why You Should Get Vaccinated” – The Standard Podcast

 

Can Psychiatric Patients Receive the COVID-19 Vaccine?

As a psychiatrist, I offer the following guidance:

Psychiatric patients experiencing acute symptoms should be stabilized before vaccination. These include individuals with:

 

• Paranoid schizophrenia
• Bipolar disorder (either depressive or manic/aggressive episodes)
• Severe depression (especially with suicidal ideation)
• Uncontrolled panic disorder
• ADHD
• Severe stress or anxiety
• Other conditions (consult your physician)

 

Medication Guidelines

     Certain psychiatric medications—especially antidepressants such as amitriptyline or SSRIs (e.g., fluoxetine, sertraline)—may require temporary adjustment. It is advisable to pause these medications one day before and one day after receiving the vaccine (a total of two days), under the supervision of a physician.

 

For those uncertain about their condition or medication, individual consultation with a physician is essential.

• Patients should also ensure adequate rest the night before vaccination (7–8 hours of sleep). Those who wake up late (e.g., 9–12 PM) should schedule afternoon appointments.
• If in doubt, contact your primary physician or the medical facility where you intend to receive the vaccine.

 

Important Considerations Before Vaccination

Some individuals may experience a specific set of symptoms before or after receiving the COVID-19 vaccine, including:

 

• Sweating
• Slowed heart rate
• Dizziness or paleness
• Severe lightheadedness, potentially leading to fainting

 

     This condition is known medically as vasovagal syncope, commonly referred to as fainting. It often arises from acute stress, such as fear of needles or hearing nearby conversations about severe allergic reactions. This triggers an intense parasympathetic nervous system response, leading to slowed heart rate, widespread vasodilation, and a sudden drop in blood flow to the brain and limbs—resulting in fainting.

 

 

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Symptoms typically last only a few seconds to a maximum of two minutes. Recovery is spontaneous, and further care is administered by healthcare personnel on site.

 

 

 

Reflections on COVID-19 Vaccination

• The decision to receive the COVID-19 vaccine is a personal right.
• Each individual must take responsibility for their decision and its consequences.
• Effective control of the pandemic through vaccination requires immunity in at least 70% of the population. It is therefore a collective responsibility to support this effort.
• Those choosing not to vaccinate should consider the risk of contracting the virus from family members who work outside the home. Even vaccinated individuals can transmit the virus, as no vaccine offers 100% protection. Cases have occurred where elderly people, having remained homebound, were infected by asymptomatic family members.
• Should you contract the virus despite all precautions, and the hospitals are at full capacity, you may be directed to a field hospital. Reflect carefully on whether you are prepared for such a scenario.
• No vaccine can entirely prevent infection. Preventive measures like mask-wearing, hand hygiene, physical distancing, and avoiding poorly ventilated areas remain essential. Vaccines work by boosting the body’s immunity to help fight the virus.
• Like influenza, COVID-19 may require annual vaccination due to viral mutations—unless one is willing to accept the associated risks.

 

How to Manage Stress

• Consume news mindfully. Differentiate credible information from misinformation by relying on reputable academic institutions.
• Weigh the pros and cons of vaccination, especially the risks of allergic reactions versus the consequences of illness, death, or disrupted livelihoods.
• If you are naturally anxious or highly sensitive, consider taking a break from the news until you are emotionally ready to process all possible outcomes.

 

 

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Even after vaccination, continued adherence to preventive measures—such as wearing masks, maintaining social distance, and regular handwashing—is crucial for long-term protection.

 

June 22, 2021