Could COVID — Or The Paxlovid Prescribed To Treat It — Be Making Us Angrier?

After three years of boosters, wearing masks, and general avoidance of anything that felt "not safe," I've finally caught COVID. I'm on day three of my Paxlovid prescription. And after what can only be described as an out-of-character experience that involved me raging out, I'm left to wonder if the medicine prescribed to help fight my COVID could be the culprit behind the angry outburst I just experienced.

Let me set the scene. I've been up all night with a metallic taste in my mouth and a headache. After finally dozing off, I wake up to the sound of the curtain rod falling in our bedroom — it hung by a single screw for a month and was supposed to be fixed before visitors arrived two weeks ago. Instead, my 4-year-old just pulled it down on top of her head. I make it to the kitchen, where I find dirty dishes, old food on the stovetop, and general kitchen mess everywhere. I have spent my entire journey with COVID thus far still making the meals and doing all the clean-up. And, again, I start scrubbing dishes — this time in a less-than-quiet rage.

In walks my partner, who has been off for the length of my sickness despite testing negative. I whirl around, ask him why he's standing behind me, and then snap at him to leave me alone. What follows is anything but pretty. We storm through the house, yelling, cursing, and slamming. My poor empathetic 4-year-old, already upset and in a rare timeout, is now curled into a ball in her chair, crying.

I eventually calm down enough to go to our daughter and sit in her chair with her. We cry and hug, squeezing oh-so-tight. I apologize. I feel like an awful, terrible mom. My partner, still seething in the basement, is muttering all kinds of accusations about me — all feel true in the moment and would be true... if anything like this had ever happened. It hasn't, though. Not ever. I'm the mom who cries in the shower or simply imagines telling off her unhelpful partner while driving to Starbucks. I don't rage. I don't lose my sh*t.

So, as I cling to my daughter, I wonder, "What the actual f*ck is wrong with me?" The short answer: nothing. I was rational to be angry about those things, but how I reacted was irrational and out of character. The longer answer: It could be COVID or the Paxlovid.

Are mood swings among Paxlovid’s side effects?

Doctors often prescribe a medicine with a steroid in it to treat bad colds. While those steroids may not be in the exact dosages of someone who uses them for working out, they can still trigger some degree of "roid rage.” However, Paxlovid is not a steroid; it's an antiviral. Neither medicines that comprise Paxlovid (Nirmatrelvir and Ritonavir) have steroids in them.

The known side effects of Paxlovid are:

• Metallic taste in the mouth
• Diarrhea
• General unwell feeling
• High blood pressure

(If you're allergic to Paxlovid, you'll have allergic reaction symptoms like hives, throat closing, wheezing, etc.)

"High blood pressure," you say?

I don't have high blood pressure. As a matter of fact, my blood pressure has typically run so low that it has kept me from trying medicine that might alleviate migraines. But I'm not exaggerating when I say that during my outburst, I felt like my heart was pounding out of my body. Is there something there?

"There have not been any studies clearly linking Paxlovid with acute mental health problems or mood swings," says Dr. Ketan Parmar, a psychiatrist and mental health expert at ClinicSpots. "However, there are some studies showing that people who take Paxlovid experience an increase in blood pressure which could potentially lead to angry outbursts. This connection is still being researched, but it would be prudent for people taking Paxlovid to monitor their blood pressure carefully and seek medical advice if they experience sudden changes in their moods."

Can COVID induce mood swings?

There's actually a much bigger case for this outburst being caused not by Paxlovid but by the virus it's working against, COVID.

"Studies conducted on individuals affected by the virus have found some evidence suggesting that they may experience acute mental health problems such as depression, anxiety, and cognitive difficulties post-infection," says Parmar. "Some research even suggests that these symptoms could be long-lasting. It is also possible that people could experience sudden changes in mood due to the sudden onset of symptoms. However, it is important to note that this evidence is not definitive and further research needs to be conducted to understand the potential link between COVID-19 and mood swings."

While there's actual science and chemicals at play that suggest this might be the possible cause for "mom loses her sh*t," perhaps it's worth considering that it's something more emotional. While COVID or high blood pressure could easily have been contributing factors, we can't forget the very real issue of COVID fatigue.

Is COVID fatigue the real culprit?

"COVID fatigue" has become a placeholder for many versions of COVID-related stress or stubbornness. And, I gotta tell you, this also seems like a giant contributing factor to my outburst.

In the nearly three years since we started hearing about COVID, our household has been exposed to but not contracted COVID several times. It felt like a protective bubble was around our family full of medically fragile individuals for the last three years. Suddenly, with a couple of coughs and a night of fevers, that was ripped away.

"There is some evidence suggesting that the prolonged nature of the COVID-19 pandemic could be leading to increased levels of stress and anxiety, as well as feelings of anger," shares Parmar. "This could be compounded by millions having had to live under restrictions for almost a year. It is possible that this elevated level of stress, coupled with other factors such as an increase in blood pressure due to taking Paxlovid or the sudden onset of symptoms from a COVID-19 infection, could lead to sudden changes in mood or angry outbursts."

There was a lot to be angry about the morning I lost it. I was sick. Our precious Meme and Pop Pop were now sick. My partner, who pays our mortgage, missed a week of work. This list goes on. Any of those things could have finally driven me around the bend. Most likely, though, it was a combination of all of them.

"In conclusion, there is still limited evidence suggesting that either COVID-19 or Paxlovid could cause mood swings or sudden outbursts of anger," says Parmar. "However, it is important to consider other potential causes, such as COVID fatigue and the increase in blood pressure caused by taking Paxlovid. It is also important to note that further research needs to be conducted to understand the full extent of this phenomenon."

The biggest takeaway?

Talk to your doctor if you're feeling overwhelmed. Before COVID or after, with Paxlovid or after. If you're feeling extra angry or sad, check in with the doctor who knows your medical history best. The only surefire way to ensure the medicines we're taking continue to work and the viruses we face are tackled appropriately is to make sure we're reporting any "quirks."

And always make sure you're communicating your needs with your partner. You can't do this all by yourself, especially with COVID.