Chronic illness often has significant impacts on mental health, and Lyme disease is no different. With the accuracy and sensitivity of today’s recommended Lyme testing still so lacking, many Lyme patients have to wait too long to get accurate diagnoses and treatment. To compound this problem, many patients with Lyme-like symptoms are not even tested for the similar, but biologically distinct, Tick-Borne Relapsing Fever (TBRF). That gives infections time to spread throughout the body and cause neurological and psychiatric symptoms.
This article will outline the direct and indirect effects that Borreliosis – both Lyme disease and TBRF – can have on mental health, including how and why untreated Lyme can develop into neurological Lyme disease.
Infectious diseases and mental health
Lyme disease and TBRF are not the only infectious disease to have ties to mental illness. One of the earliest and most well-known examples of an infectious disease that causes neurological and psychiatric symptoms is syphilis.
This sexually transmitted disease, which – like Lyme – is caused by a spiral-shaped bacteria and treated at early stages with antibiotics, has been called “the great imitator” – also like Lyme – because its symptoms can be wide-ranging and non-specific, especially at late stages. That includes neurological and psychiatric symptoms that become much more likely the longer the disease goes untreated.
Given that ties between late-stage syphilis and mental illness have long been recognized by the medical community, it shouldn’t be surprising that untreated Lyme disease poses similar risks to patients’ psychological wellbeing. There are a lot of questions about mental health and Lyme disease. What is the link between Lyme disease and depression? Does Lyme disease cause seizures? How, if at all, does Lyme disease affect the brain?
Recent studies have investigated possible connections between Lyme disease and a host of mental health issues, including:
- Developmental disorders
- Schizoaffective disorder
- Bipolar disorder
- Depression
- Anxiety
- Eating disorders
- Sleep disorders
- Cognitive impairments
- Dementia
- Seizures
- Suicide
Yet there are still many doctors and scientists who doubt the existence of chronic Lyme disease, and/or do not realize how many different borrelia cause TBRF, hurting patients’ chances of fighting both the diseases themselves and their mental health consequences.
Why and how Lyme disease and TBRF affect mental health
Lyme disease and TBRF can wreak havoc on a patient’s mental health in the following ways:
- Direct (biological) effects – As with syphilis, the bacteria that causes Lyme disease and TBRF can invade the central nervous system and cause neurological and psychiatric symptoms that are organic in origin. This is what doctors call neurological Lyme disease or Lyme neuroborreliosis.
- Indirect effects – The discomforts and challenges of living with and/or being treated for Lyme disease or TBRF can lead to anxiety, depression, and other mental health conditions that are not necessarily caused by the bacteria, but are indirectly caused or exacerbated by the experience of the disease. Lyme disease and depression can go hand-in-hand, but depression is not necessarily caused by Lyme neuroborreliosis.
Of course, these effects are not either/or, but rather can coexist and compound one another. Learn more about each below.
Neurological Lyme disease
Neurological Lyme disease, also known as Lyme neuroborreliosis, occurs when the Lyme- or TBRF-causing bacteria invade the central nervous system. Some describe neurological Lyme disease as a Lyme infection of the brain. Research has found that up to 15-40% of late-stage Lyme patients develop neurological disorders.
Neurological Lyme disease can often take months or years to develop if the initial infection is left untreated. Once it does, its wide ranging symptoms can be much more difficult to treat, highlighting the importance of early detection.
Symptoms of neurological Lyme disease and other tick-borne infections
Neurological Lyme disease often begins with nerve pain that can start in the back and radiate down to the legs. This can develop into weakness, numbness, or tingling in the lower extremities over time. Some patients also experience Bell’s palsy, or facial palsy, in which one side of the face is temporarily paralyzed.
After these initial symptoms (which may or may not occur in all patients), common late stage Lyme disease symptoms include:
- Depression
- Anxiety or panic attacks
- Sleep disorders
- Irritability
- Rage or aggression
- Obsessions and/or compulsions
- Hyperactivity
- Attention and focus problems
- Antisocial behavior
- Hallucinations
- Brain fog
- Confusion or memory problems
- Executive functioning problems
- Disorganization
- Getting lost
- Communication problems
- Processing difficulties
This is only a portion of potential emotional, behavioral, and cognitive problems arising from late-stage Lyme and other tick-borne infections. ILADS notes that symptoms can range from the general (such as fatigue and headaches) to the specific and severe (such as GI or bowel problems, seizures, strokes, and even progressive dementia).
It’s important to note that these symptoms can often mimic other conditions such as Parkinson’s, MS, or ALS, leading them to be commonly misdiagnosed. Again, early detection is key to preventing or properly treating neurological Lyme disease.
Chronic Lyme and mental health
The CDC lists “having a chronic disease” as a risk factor for developing mental illness. This underscores the reality that even for patients who do not develop neurological Lyme disease, the experience of Lyme disease alone can cause or exacerbate mental health problems like depression, anxiety, and others listed above.
Getting diagnosed and treated for Lyme disease can be stressful and exhausting, especially the longer this process takes – which, for many, can be several years. Patients often must deal with conflicting or inaccurate diagnoses, lack of support from health care professionals, and exorbitant medical bills, all while battling physically and mentally debilitating symptoms with no end in sight. This experience can lead to a drastic reduction in quality of life that creates the perfect conditions for mental illness, which is why there is often a link between Lyme disease and depression.
The role of coinfections
Ticks carry more diseases than just Lyme and TBRF, and it’s not uncommon for patients to be infected with more than one type of disease-causing bacteria.
Common coinfections such as Babesiosis and Bartonellosis can not only cause neurological and psychiatric symptoms of their own, but they can also complicate the diagnostic process, delaying proper diagnosis and treatment – all of which increase the risk of developing emotional, behavioral, or cognitive problems from the infection.
Treating neurological Lyme disease
Though neurological and psychiatric symptoms can be reduced with antibiotic treatment, emotional and cognitive problems arising from late-stage or chronic Lyme often call for a broader range of interventions. Neurological Lyme disease treatment includes lifestyle changes in such areas as diet, exercise, and environment.
Again, it’s worth reiterating that the longer an infection goes undetected, the harder it is to treat, and the more likely it is that symptoms will require multi-pronged, multi-system interventions besides antibiotics alone. Neurological Lyme disease treatment can also include medications or therapy designed to treat the symptoms, such as depression and anxiety.
For example, someone with chronic Lyme disease and depression may seek out coginitive behavioral therapy (CBT) to help work through the feelings of hopelessness and anguish they’re experiencing.
Lyme is not the only threat
As mentioned earlier in this article, there is another group of borrelia that causes a disease that is similar to, but biologically distinct from, Lyme. This disease, called Tick-Borne Relapsing Fever or TBRF, is often characterized by fevers that wax and wane every few days. However, many patients never experience relapsing fevers or any fevers at all. Like those of Lyme and other tick-borne diseases, TBRF symptoms can often go undetected or be mistaken for other conditions, which can give the disease time to develop into neurological symptoms.
So, as with Lyme, it is crucial to get an early and accurate diagnosis of TBRF. Be aware that TBRF will not show up on a Lyme test – the test must be designed to test for TBRF borrelia in order to show accurate results. If symptoms are Lyme-like but test results are negative, doctors should consider the possibility of TBRF.
Get tested and treated early
Studies acknowledge that up to 30% of patients go on to suffer further Lyme symptoms (including neurological and psychiatric symptoms) even after treatment, sometimes called Post-Treatment Lyme Disease Syndrome (PTLDS). One of the biggest risk factors for this condition is delayed treatment.
Research is finally, if slowly, catching up to the reality that letting Lyme disease slip through the cracks of insufficient diagnostic testing causes real suffering for patients. IGeneX is at the forefront of solving this problem, offering more sensitive and accurate testing for Lyme disease and other tick-borne diseases that can cause mental health problems when left untreated. Learn more today.
