Managing mental health and neuropsychiatric symptoms of Lyme disease
By Dr. Jane Marke
The mental health problems associated with Lyme disease are varied and often call for a variety of specialists to help the patient: child psychiatrists, adult psychiatrists, and family therapists or social workers.
Parents especially must deal with a variety of issues: the symptoms themselves that children present, the stress of and between family members, parents and relationships, as well as getting and coordinating treatment and education for their children.
Children can present with myriad symptoms including attention deficit disorder, anxiety, autism, depression, eating disorders, insomnia, learning disorders, obsessive compulsive disorder, opposition disorder, PANS/PANDAS.
Any change in personality without obvious cause should raise suspicion. Children often present with “school refusal” because they are feeling unwell in a way they cannot express in words.
This could be due to sensitivity to light, sounds, or sensory integration. The activity of a classroom filled with children, social stimulation, and tasks to be accomplished maybe experienced as overwhelming, even bordering on painful.
The child may have changes in mood that approaches bipolar disorder seen in adults and be oppositional, angry, and difficult to manage.
Parenting these children is an unbelievable stress. They require a pediatrician who will treat the Lyme, a psychiatrist who understands it, and frequently, a social worker or psychologist who can help navigate the school situations and provide support to the family. Sometimes the parents find themselves at odds and end up in marital therapy.
Adult issues are different
Adults are a different story. Young adults dealing with college and post-college years miss key experiences they were anticipating to move into adulthood and lose out on their sense of entering adulthood.
They may present with any psychiatric disorder: bipolar disease, severe anxiety, depression, depersonalization, or OCD.
Hypersensitivity to light, sound, and smells can be profound, and the hypersensitivity may produce illusions or a sense of hallucination. Sometimes they are hospitalized in psychiatric hospitals with other very ill patients and the experience can be traumatizing.
Older adults may develop major psychiatric symptoms which interfere with their ability to work or care for family.
All these situations and stimuli can present major psychological issues for the affected patient. They may have personality changes. Their preoccupation with symptoms may make them seem self-centered or un-empathic with family or friends. They experience loss of sense of value, purpose, meaning and worth.
Relationship problems arise from feeling like a burden or being perceived as a burden by others and there is guilt and shame over psychiatric symptoms. It’s a lonely illness.
Project Lyme recently sponsored a webinar for the public on the mental health challenges of Lyme patients. Dr Rosalie Greenberg addressed the issues of children, I addressed the issues of adults, and social worker Audrey Amir addressed emotional and social issues.
You can watch the video here:
Jane Marke, MD, practices integrative psychiatry and psychotherapy in New York City.