The psychological effects of Lyme disease + Related Articles

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The psychological effects of Lyme disease

_http://www.igenex.com/psychological_effects.htm_

(http://www.igenex.com/psychological_effects.htm)

By Valerie Andews

 

Can a tick bite drive you crazy?

 

Doctors warn that Lyme disease may cause personality changes

 

 

A walk in the woods nearly cost Mike M. his sanity. After receiving

multiple tick bites, Mike broke out in an angry rash and his joints began to

ache. In the next few months, his behavior grew increasingly bizarre. He was no

longer able to read or concentrate, and became so anxious he couldn’t

leave the house. Eventually, Mike was treated for chronic Lyme disease, an

illness that can play havoc with the mind.

 

 

Since its discovery in 1975, Lyme disease has reached epidemic proportion

in the United States. While the Centers for Disease Control reports 19,000

cases of this tick-borne illness in 2002, the agency estimates that the

actual number may be tenfold higher: 190,000—that’s four times the rate of

new

HIV infections.

 

 

“Lyme disease is a major problem yet, tragically, many people fail to

receive the proper treatment,†says Bernard Raxlen, MD, a Greenwich, CT,

psychiatrist and secretary of the International Lyme and Associated Diseases

Society (ILADS), a medical organization dedicated to ongoing research and

increasing public awareness of this devastating illness.

 

 

Lyme often begins with flu-like symptoms, headaches, fatigue, swelling of

the joints, muscle pain and gastrointestinal distress. Most physicians have

been taught to look for evidence of a tick bite and a red bull’s-eye rash,

yet fewer than half of all Lyme patients recall being bitten or develop

tell-tale skin eruptions. As a result many are misdiagnosed with other

disabling illnesses such as chronic fatigue, fibromyalgia, or MS.

 

As Lyme disease progresses, it can attack the nervous system, producing

learning disabilities, mood swings, anxiety and depression, panic attacks,

obsessive behavior, sudden rages and other psychiatric diagnoses. Says

Raxlen, “When this happens, we’re looking at a completely different syndrome

and

one that is harder to cure.â€

 

 

A recent European study shows that psychiatric in-patients are nearly

twice as likely as the average population to test positive for Lyme, and the

National Institutes of Health are currently sponsoring a major study of

neuropsychiatric Lyme disease in an effort to illuminate specific changes in the

brain.

 

 

Psychiatric Lyme has been linked with virtually every psychiatric

diagnosis and can affect people of all ages and from every walk of life. A

former

honor roll student is diagnosed with Attention Deficit Disorder and pegged

as a “problem kid†because he can’t sit still in class. A lawyer has to

close her practice because she can’t concentrate and suffers from anxiety

attacks. A young mother is so sensitive to noise that she can no longer tolerate

her baby’s cry and is afraid that she will harm her child. A retired

salesman develops a compulsive habit of writing all over everything—he covers

everything from the tablecloth to matchbooks with meaningless scribbles.

 

 

Family members are baffled by these transformations; counselors and

physicians are consulted, often to no avail. While these individuals may also

have migrating muscles pain, headaches and problems with their joints—common

signs of Lyme—these symptoms are rarely picked up in a mental health

evaluation. And when traditional psychiatric medication fails to produce a

cure,

the patient grows more desperate.

 

 

The Search for a Diagnosis

 

 

“Most people come to see me because they’ve got something wrong that

nobody else can figure out,†says Debra Solomon, MD, a psychiatrist who

practices in North Kingston, RI. Fifteen years ago Solomon was confronted with

a

medical mystery. More and more patients were coming in with the same group

of symptoms—fatigue, headaches, migrating joint and muscle pain, accompanied

by anxiety, depression, and memory problems. When one of her patients

turned out to have Lyme disease, she tested the others, and found that nearly

all were positive.

 

 

Recent studies show that certain areas of Rhode Island have the highest

tick population in the world. Today many of Solomon’s patients come from the

island Jamestown, a small farming community where ticks are abundant. Among

her cases are:

 

 

A college student in her early twenties who started hearing voices. “She

came from a good family and had no previous emotional problems,†says

Solomon. A businesswoman who suddenly became manic-depressive. “In periods of

high energy, she wouldn’t sleep and felt all-powerful. She’d start a new

business and begin spending lots of money, then she’d crash.†A high school

athlete had to drop basketball because he didn’t have the stamina and

couldn’

t get through his classes without falling sleep. “The teachers accused him

of not paying attention, but he didn’t have the concentration to do the

work.†A 40-year-old book editor who was gaining weight and getting lame in

her left leg. “She couldn’t think or process information, and was worried

about her job.†“Lyme affects nearly every person on this island,†says

Solomon, “yet each person responds to it in very different ways.â€

 

 

How can a physician tell the difference between true mental illness and

symptoms linked to Lyme disease? With Lyme disease, a patient’s psychiatric

symptoms don’t quite fit the textbook definition. There is usually no

previous history of psychiatric illness. Symptoms often come in cycles.

Patients

usually do not respond well to psychiatric medication. And they often

describe their problems in very physical terms.

 

 

Lyme patients often say, “There’s a wall in my brain and I can’t seem to

move my thoughts from the back to the front.†“This arises from

encephalopathy, an inflammation in the brain that affects cognitive function,â€

Solomon explains.

 

 

Symptoms often worsen as the Lyme bacteria grow active and begin to

reproduce. At the same time, a patient may experience physical symptoms, such

as

fatigue, muscle pain or headaches. Flare-ups are often triggered by stress,

as in the case of Bob C. who ran a shipping department for a manufacturing

company. Bob had dozens of people answering to him, but Lyme disease made

him anxious and unable to concentrate. Because he couldn’t think, he lost

his job, and his symptoms grew more intense.

 

 

Family problems, economic changes, job loss, surgery, an auto accident, or

a bad case of the flu, can send Lyme patients into a sudden tailspin.

Along with antibiotics, these people need to rest—and do anything they can to

lessen their emotional load.

 

 

The catch-22 is that chronic Lyme disease makes it hard to think and

perform one’s daily tasks. This inevitably causes financial hardship and puts

a

strain on family relationships.

 

 

Effects of Lyme Disease on Marriages

 

 

“My patients come in to talk about their marital problems and are

surprised to learn that they are linked to an organic illness,†says Virginia

Sherr, MD, a psychiatrist who practices in eastern Pennsylvania, another region

known for its high rate of tick-borne infections. Ninety percent of Sherr’s

patients test positive for Lyme disease. She then has the job of

describing to them just how this condition can affect the mind and the emotions.

 

 

Lyme disease can cause increasing irritability and dramatic flares of

anger, says Sherr.

 

 

“Suddenly you hear bone-cutting verbal assaults from people who are

usually more measured and benign. They may have been harboring some small

grievance for years, then that hot spot comes to life and they spew out all

this

venom. Such outbursts cause lasting wounds.â€

 

 

While some Lyme patients become verbally abusive, others lose confidence

and withdraw from social situations. Mary L. tried to explain to her husband

that she no longer had the stamina for dinner parties and that she dreaded

going out. The husband felt that she was faking it. “Mary’s husband and

her internist, who knew little about Lyme disease, ganged up on her,†Sherr

reports. “The doctor said, ‘You used to be so full of life, but you’ve

less

yourself go completely. You’re not even trying!’â€

 

 

“Physicians who don’t know that Lyme causes personality changes may be

dismissive or sharply critical of the patient. Our goal should be to educate

couples and help them cope.â€

 

 

Sherr cites one devoted couple who are both infected with Lyme disease. “

The man has major cognitive problems and the wife helps him with his memory.

She has bouts of extreme impatience, yet he gently guides her through them.

†They have begun to weather the storm together—with the help of

antibiotics and marriage counseling.

 

 

Lyme Disease and Domestic Violence

 

 

“Lyme disease often strikes an entire families and the result is a higher

incidence of divorce, family dysfunction, and domestic violence,†says

Robert Bransfield, MD, a psychiatrist in Red Bank, New Jersey. “Tempers flare

and you see increasing conflict.â€

 

 

“Lyme disease is like an injury of the brain,†says Bransfield. “Patient

are less able to think things through, and tend to act impulsively. A

mother may suddenly lash out at her child and a husband may lose control and

abuse his wife. “We underestimate the role of infectious disease in domestic

violence,†he adds.

 

 

An aggressive response is more likely if, in addition to Lyme disease, a

patient has another tick-borne infection called Babesia. More than one

infection can be transmitted by the same tick, and when Babesia is added to

Lyme, this may make the patient more aggressive. “It’s like putting a match

to

gasoline,†Bransfield says.

 

 

Bransfield has testified in court on behalf of such patients who have been

accused of everything from assault to murder. (In one instance, a patient

killed his partner, killed the family pet, then killed himself.)

 

 

People with Lyme disease alone usually don’t go to these extremes.

However, they may be irritable and prone to sudden rages. Bransfield says young

people are the most likely to act out. “I’ve seen so many straight-A kids

whose grades suddenly start to slip. Then they rebel against the family and

start fighting with their peers.†They can also turn their rage against

themselves. “I’m often on the phone with a teen in a state of crisis,â€

says

Bransfield, “Feeling suicidal comes in waves and these reactions are very

hard to predict. However, these kids generally improve after being treated

with antibiotics.â€

 

 

Schools are becoming more enlightened about the problems caused by

tick-borne diseases, Raxlen notes. In Newtown, CT, for example, teachers are

asked

to report any sudden dips in grades or unusual behavior that may be linked

to Lyme disease. And many make special arrangements for at-home tutoring

while the student convalesces.

 

 

Losing Control of Life

 

 

When Lyme disease goes undiagnosed—or isn’t treated long enough—it can

bankrupt businesses and destroy whole careers.

 

 

A CEO of an insurance company was diagnosed with Lyme disease and given

antibiotics—but he didn’t take them long enough. Months later, his symptoms

returned with a vengeance. He had ghoulish nightmares and woke up drenched.

At work, he felt anxious and couldn’t concentrate. Eventually he forgot

everything he’d learned about insurance. When he neglected to send in a

disability payment on his own policy, the company denied his claim. “This man

lost tens of thousands of dollars that would have helped him through his

illness,†say Raxlen. “In the end, he had to sell his building and disband

his

business.â€

 

 

People with Lyme disease often have trouble keeping up with ordinary tasks—

one Connecticut housewife walked into the library, dumped her dry cleaning

on the counter, and waited with increasing irritation for an attendant to

help her. Finally a friend walked up and asked, “Don’t you know where you

are?â€

 

 

Lyme disease can also affect the part of the brain that deals with signs

and symbols—making it hard to read maps or drive from place to place. A real

estate agent with Lyme disease stopped at a traffic light. When the signal

turned green she didn’t move. An angry motorist yelled, “What’s the

matter with you. Why can’t you go on the green?†The woman replied,

“I’ve

forgotten what green means.â€

 

 

“Lyme produces a microedema, or swelling in the brain,†says Raxlen. “

This affects your ability to process information. It’s like finding out that

there’s LSD in the punch, and you’re not sure what’s going to happen next

or if you’re going to be in control of your own thoughts.â€

 

 

ILADS physicians say these symptoms can be alleviated or reversed with

antibiotics, but stress that Lyme disease must be diagnosed early and treated

right away.

 

 

Treating Lyme Disease

 

 

Most doctors prescribe three to four weeks of antibiotics for initial

cases of Lyme disease. Yet according to the ILADS, this is not enough. The Lyme

bacteria has a “cloaking device†that enables it to hide in the cells and

body tissues. If it’s not completely eradicated, symptoms will recur and

with great intensity. To avoid relapses, ILADS recommended six to eight

weeks of antibiotics.

 

 

When Lyme disease moves into a chronic stage, it’s more likely to lead to

neurological or psychiatric conditions. Chronic Lyme patients are harder to

cure and may need to take antibiotics—orally or intravenously—for months

as a time. In this case, ILADS recommends continuing treatment for at least

six to eight weeks after all symptoms are resolved.

 

 

“Lyme disease is often misdiagnosed and it’s costing our healthcare

system untold millions of dollars,†says Raxlen. “No one is spared, neither

young nor old and each individual can display a puzzling array of symptoms.

This illness can have a wide-ranging affects on marriages, families and

jobs.â€

 

 

 

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