Scientists debate Lyme disease, mental illness link

David Heitz

(Arik Karits/Unsplash)

The medical community has questioned whether mental illness and Lyme Disease go together for a long time. It's a fierce debate.

The latest piece of research out of Denmark says that if psychiatric problems arise after a Lyme diagnosis, they usually subside within a year. The research hypothesizes that patients given psych meds after hospital discharge likely took them for pain.

“In this cohort study of 2897 patients with Lyme neuroborreliosis in Denmark, Lyme neuroborreliosis was not associated with an increased risk of psychiatric disease or psychiatric hospital contact,” the authors found.

The study appeared in JAMA Psychiatry. The authors hail from various hospitals in Denmark, where records are not kept on why medications are prescribed.

Lyme disease is brought on by the bite of an infected tick. Ticks get Lyme from deer.

Why do so many Lyme patients take psych meds?

“Lyme neuroborreliosis was associated with increased receipt of anxiolytic, hypnotic and sedative, and antidepressant medications within the first year after diagnosis but not thereafter,” the authors explained.

But in this week’s JAMA Psychiatry, other doctors take issue with the way the study was conducted. They say it’s a leap to conclude that Lyme disease is not associated with long-term mental health problems.

They criticized the authors of the original investigation for investigating “possible neuroborreliosis” instead of confirmed cases of Lyme.

“It is unclear why ‘definite neuroborreliosis,’ confirmed by intrathecal index, pleocytosis, and registry-based diagnosis, was not the primary exposure as in other works from the authors,” the signatories of the commentary explained. “Of note, central nervous system infections overall have in previous Danish studies been associated with increased risk of mental disorders, particularly in the short term.”

Dr. Brian Fallon of Columbia University Department of Psychiatry in New York is the lead author of the commentary. It is co-signed by two Danish doctors.

Danish doctor defends her team’s research

In a response to the commentary, Dr. Malte Tetens defends her team’s research. “We agree with Fallon et al that our study is limited by the fact that the indication for prescription of psychiatric medicine could not be analyzed,” she wrote.

“We also agree that part of the increased redemption of psychiatric medication might be driven by pain management. However, owing to the observational nature of our study, any theory regarding the cause of the increased redemption remains speculative. Nonetheless, it is reassuring that the increased redemption of psychiatric medicine is temporary and that the level subsides to baseline within one year.”

Tetens et al defended their conclusions that Lyme disease does not lead to long-term mental illness. “We do not agree that the conclusion of the Abstract is premature because it merely summarizes our findings, and the language is not causal.

“Also, we disagree that stronger statistical methods are recommended, but we welcome all studies overcoming whatever shortcomings our study have.”

Much evidence linking Lyme disease, mental illness

In an article on the Columbia University website, professor Kathleen Pike discusses the links between Lyme disease and mental health.

“While the media and the public health community focus on many of the health consequences of Lyme Disease, less attention has been paid to the mental health consequences that can coincide with Lyme Disease,” writes Pike, director of global psychology for the university.

“It is also often the case that mental health symptoms are overlooked,” she continues. “Both are true for Lyme Disease, but increasingly significant cognitive and psychological symptoms are being recognized as part of the symptom pattern associated with untreated and/or chronic Lyme Disease.”

The evidence for mental health problems among patients with Lyme disease is vast. Depression has been reported in as many as 45 percent of patients with post-Lyme treatment symptoms.

“But these numbers don’t tell the whole story,” the Columbia website explains. “Many researchers believe that Lyme disease is vastly under-diagnosed. Diagnostic tests lack sensitivity, and the symptoms of Lyme disease often overlap with other disorders.”

Lyme symptoms resemble bipolar disorder, schizophrenia

Case studies have linked Lyme symptoms to several mental health disorders. They include schizophrenia and bipolar disorder. Bouts of paranoia and delusions also can occur.

“Thus, the true prevalence of depression in those affected by untreated or undiagnosed Lyme disease may be much higher,” the Columbia site continues. “And although better statistics are needed, Lyme disease may be so debilitating in some cases that it is associated with increased risk for suicidality.”

Many people with Lyme disease resent insinuations they have poor mental health. In early days, many doctors claimed Lyme disease was not even real. The online debates on news articles about Lyme disease raged for months after stories were written.

Lyme disease can be contracted in tall grasses or wooded areas when bitten by a tick. I had Bermuda grass that grew behind my garage. When it died off every November, I had to trim it back.

One year while trimming it back I sustained a bite. Sure enough, a bullseye formed around the bite, indicating a tick bite.

I took antibiotics for a short time. The bite got better, and I never suffered any immediate adverse effects.

However, about two years later I did suffer a nervous breakdown and ended up with varoius new diagnoses of mental illness. I already had a history of mental illness before the bite, but not as severe. My mental illnesses about a year or two after the bite led to homelessness.

What to do if you are bitten by a tick

If you are allergic to a tick bite, you’ll know right away. Redness and swelling will appear, as well as blisters. If you have a severe allergy, you may begin to have problems breathing.

According to the U.S. Centers for Disease Control and Prevention, if bitten by a tick you should:

* Grasp the tick with tweezers as close to the skin as you can. You don’t want to tear off a portion of the tick and leave the rest embedded in your skin.

* After removing the tick, sterilize the bite area with soap and water and rubbing alcohol.

* Flush the tick down the toilet.

If you want to show your doctor what the tick looked like, take a picture. If you insist on bringing the bug to the doctor, make sure it is in a sealed container.

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I've been in the news business 35 years, spending much of my career in editing roles at local newspapers in Los Angeles, Detroit, and the Quad-Cities of Illinois and Iowa. Upon moving to Denver in 2018, I began experiencing severe mental illness due to several traumatic experiences. I became homeless on the street for about a year before spending time in the state mental hospital. I am living proof that people can rebound from mental illness with proper treatment, even after experiencing homelessness. I consider myself a lucky guy to live in a great place like Denver. I hope my writing reflects the passion I have for living here.

Denver, CO

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