So, is Lyme disease the direct cause of psychological symptoms or is it the stress of having Lyme disease (and having no one believe you) that results in a diagnosis of depression, mania, bipolar disorder, or even schizophrenia?
Lyme disease can be a complicated illness, causing various symptoms that are inconsistent, temporary, cyclical, and seemingly unconnected. Proving that you have Lyme disease can be difficult, and many patients spend months, if not years, being assessed for all manner of diseases and conditions before anyone even suggests a test for the infection.
Cognitive and Mental Health Issues Linked to Lyme
Having your symptoms doubted, not knowing why you feel ill, and never quite knowing when to expect symptoms to return can obviously cause immense stress, and it seems that psychiatric symptoms often arise associated with Lyme disease in people with no prior history of mental illness. Fallon and Nields (1994) have linked Lyme disease with:
- Major depression
- Panic attacks
- Bipolar disorder
- Anorexia nervosa
- Obsessive compulsive disorder
Others have also linked Lyme disease with Multiple Sclerosis and Alzheimer’s Disease. Of course, these conditions may develop independently of Lyme disease, as well as being caused by the stress of chronic illness, or the infection itself. Lending support for the latter theory, it seems tht patients with Lyme disease often have decreased blood flow (perfusion) in a number of areas in the cortex and subcortical white matter.
Symptoms connected to neuroborreliosis may include:
- Headache and neck ache
- Encephalomyelitis and facial paralysis (Bell’s palsy)
- Loss of sensation / paraesthesia / tingling, numbness, pain
- Schizophrenia-like psychosis
- Dizziness, vertigo
- Tinnitus (constant ringing in the ears)
- Acute sensitivity to light and noise
- Drooping shoulders
- Urinary incontinence or retention
- Cranial neuritis (resulting in double vision or other visual disturbance)
- Peripheral neuropathy
- Gastrointestinal disturbance
- Excessive fatigue
Worryingly, as cases of Lyme disease appear to increase due to the spread of ticks, so do misdiagnoses resulting in improper treatment and even death from Lyme disease. In cases where a condition like MS or arthritis is suspected, patients may be prescribed steroids to try to alleviate symptoms. As these suppress the immune system this leaves patients with an infection more vulnerable to the spread of that infection, making symptoms even harder to shake.
Early Neuro-Lyme Disease
Early symptoms of Lyme may include flu-like illness, the bull’s-eye rash and joint pain, along with cardiac or neurological issues. In early stage Lyme disease the infection can usually be treated with antibiotics before any lasting tissue damage occurs.
Some patients report issues with memory, information processing, verbal fluency, dyslexia, visual processing and spatial awareness (resulting in disorganisation and losing things or getting lost), impaired abstract reasoning, poor concentration, and decreased ability to follow conversations. Clearly these symptoms then impair a person’s ability to navigate complex medical institutions and processes, which may impede a timely diagnosis.
Psychiatrists may be the first line of medical attention that a patient with neurolyme encounters, meaning that it is essential for mental health professionals to have a basic knowledge of Lyme disease and how it can manifest. Sleep disorders, delirium, mood swings, manic episodes, hallucinations, suicidal thoughts and a range of other symptoms may arise connected with Lyme disease, all of which can adversely affect a person’s ability to advocate for their health and wellbeing.
Children, Lyme Disease, and Mental Health
Even some children are at risk of being diagnosed with autism or Asperger’s syndrome, or attention deficit disorder or attention deficit hyperactivity disorder, resulting in the use of medications, the removal of them from mainstream education, and an increased level of stress for both them and their caregivers.
Anyone living in a Lyme-endemic area who experiences uncharacteristic and unprecedented psychiatric symptoms may, therefore, be wise to consider being tested for Lyme disease in addition to accessing appropriate psychiatric care.