Have you ever been sick with a sinus infection or head cold and noticed how your brain seems stuck in neutral–or even reverse? Trying to focus on simple work tasks or remembering what someone said to you just an hour ago seems impossible. You know that if asked to add 2 and 2 while suffering from sinus inflammation, you’d probably give the wrong answer.
What happens to the brain during a sinus infection? Why is it so easily compromised by something as ordinary as sinusitis? Researchers studying the connection between sinusitis and cognitive performance have found that upper respiratory tract infections (with or without fever) will reduce memory, delay how long it takes to recognize facial emotions, and often cause clinical depression. People dealing with chronic sinusitis or year-round allergies may be at risk for reduced quality of life due to anxiety and major depressive disorders requiring professional treatment.
Sinuses and Mental Function: The Association Between Healthy Sinuses and Normal Cognition
Understanding the association between sinus issues and cognitive function begins with understanding how anatomically close these two systems lie to each other. The sinuses, particularly the sphenoid and ethmoid, are within just a few inches of the brain. In addition, the veins that provide blood to the sinuses are interconnected with the veins that supply blood to the brain.
When you have a cold or sinusitis, nasal passages swell from bacterial or viral inflammation. Swollen nasal tissues compress the blood vessels in the sinuses, leading to reduced blood flow to the brain. Cognitive issues such as difficulty concentrating, poor judgment, and memory problems will occur when the brain is temporarily deprived of sufficient oxygen.
The brain accounts for about 20% of the body’s oxygen consumption. Since the brain cannot store energy like other organs, it needs oxygen to metabolize glucose for on-demand energy. When brain oxygen levels fall under 20% because you can’t breathe normally due to congestion, you may notice the impact of sinusitis on cognitive performance.
Sinus-related Mental Challenges: Sinusitis and Depression
The general term for inflammation of the sinuses is sinusitis. Inflammation stimulates the release of proteins called cytokines. Your immune system floods inflamed tissues with cytokines to control the inflammation. Cytokines can penetrate the blood-brain barrier and alter neurotransmitter levels in the brain. Two neurotransmitters vulnerable to cytokine production are the mood regulators dopamine and serotonin.
Frequent bouts of sinusitis may increase the risk of depression when symptoms start interfering with daily activities. Individuals suffering from chronic sinusitis often report symptoms that mirror signs of depression: fatigue, irritability, concentration difficulties, reduced quality of sleep, and appetite changes. Researchers have also found that depression shares multiple inflammatory markers with sinusitis inflammation. Additionally, the physical effects of sinus inflammation, such as runny nose, sneezing, nasal discharge, and coughing, make social interactions difficult. Isolating oneself from others because of sinusitis can lead to depression and other mental health issues.
Effects of Sinus Medication On Nasal Health and Brain Function
Most people slog through a sinus infection by taking two over-the-counter medications to feel well enough to work and perform other daily activities. Daytime sinus medications typically contain a combination of acetaminophen, dextromethorphan (cough suppressant), and phenylephrine (nasal decongestant). Nighttime sinus medications contain acetaminophen, dextromethorphan, phenylephrine, and sedating antihistamines such as doxylamine or diphenhydramine to help you sleep.
While sinus medication can make you feel better, it will aggravate the impact of sinusitis on mental abilities. Brain function effects of OTC sinus medication include:
Drowsiness/Sedation: Some sinus medications, especially first-generation antihistamines like diphenhydramine, can cause marked drowsiness and sedation, reducing alertness and mental clarity.
Stimulant: Decongestants containing pseudoephedrine may increase anxiety, restlessness, and insomnia. Since pseudoephedrine is used to make methamphetamine, many states now have laws that give any store selling products containing pseudoephedrine pharmacies the authority to restrict customers from buying large amounts of pseudoephedrine sinus medication.
Frequent use of nasal sprays can lead to a condition known as the “rebound effect”. This occurs when you use a spray for more than several days. The rebound effect makes breathing without the spray more difficult. Over time, the blood vessels in your nose become less responsive to the spray, resulting in repeated congestion. Consequently, you may need to use nasal spray when you no longer have sinusitis because your nasal blood vessels no longer function properly.
Consulting Healthcare Professionals for Persistent Issues
If you have had more than three sinus infections over the past year that last more than a week, and symptoms worsen each time, consider consulting an ear, nose, and throat (ENT) doctor. They specialize in treating chronic sinusitis and may recommend one or more of the following procedures:
Functional Endoscopic Sinus Surgery (FESS): a minimally invasive surgery to remove blockages and improve sinus drainage.
Balloon Sinuplasty: another minimally invasive treatment involving the placement of a small balloon in the nasal passage. Once inside the nasal passage, the balloon is inflated to open blocked sinuses.
Nasal Polyp Removal: when benign growths called polyps are irritating and blocking sinus passages, a simple surgical procedure may be necessary to remove them.
Managing Sinus Issues for Mental Well-Being
Nearly 30 million adults in the U.S. will experience at least one occurrence of sinusitis every year. Most people take OTC medications to manage symptoms, while others may visit their primary care physician for a prescription medication.
Medical therapies for treating sinusitis include:
Nasal Corticosteroids: nasal drops or sprays containing corticosteroids, such as budesonide or fluticasone, reduce inflammation in the nasal passages to decrease congestion and facilitate breathing through the nose.
Saline Nasal Irrigation: saline solutions may help clear blockages and reduce irritation within the nasal tissues.
Oral or Injected Corticosteroids: when nasal corticosteroids are ineffective, doctors may prescribe injected or oral corticosteroids to reduce inflammation and minimize symptoms of sinusitis.
Antibiotics: doctors usually prescribe a three-day dose of antibiotics for bacterial sinusitis infections
Antihistamines or Allergy Immunotherapy: these treatments reduce congestion, sneezing, runny nose, and cough due to allergic sinusitis.
Try to breathe through your nose as much as possible when you have a sinus infection. Nasal breathing increases oxygen flow to your brain to help enhance cognitive functions and boost your mood. Additionally, sustaining a positive sense of well-being during sinusitis can strengthen your immune system’s ability to fight the infection.
Treating anxiety and depression that stem from chronic health problems such as sinusitis involves a multi-faceted approach that focuses on the mental and physical aspects of the individual’s health. The following psychological therapies should be used in conjunction with medical treatments applicable to the cause of the infection:
Cognitive Behavioral Therapy: CBT helps you identify and change negative thought patterns or behaviors that contribute to depression.
Counseling or Psychotherapy: talk therapies can provide support, education, and guidance to individuals struggling with the emotional aspects of a chronic illness.
Stress Reduction Techniques: meditation, yoga, or mindful imagery can reduce stress and improve mental well-being.
Support Groups: joining groups where members share similar health issues can provide a sense of belonging and reduce feelings of isolation.
The effects of sinusitis on mental health are complex and go beyond physical symptoms. Chronic sinusitis can contribute to various psychological issues, such as depression, anxiety, sleep problems, and persistent cognitive difficulties. When sinusitis disrupts a person’s social life, relationships, and self-esteem, managing it effectively involves more than just over-the-counter or prescription drugs. Comprehensive treatment should address the physical and psychological impacts of chronic sinus infections.