Archive for the ‘Psychological Aspects’ Category

Ketamine – Reduces Depression-related Behaviors in Mice, Limits Bb in vivo, & Relieves Chronic Pain

Ketamine reverses neural changes underlying depression-related behaviors: Mouse study

Summary: The formation of prefrontal cortex dendritic spine formation sustains the remission of depressive related symptoms and behaviors following ketamine treatment by restoring lost spines.

Source: NIH/NIMH

Researchers have identified ketamine-induced brain-related changes that are responsible for maintaining the remission of behaviors related to depression in mice — findings that may help researchers develop interventions that promote lasting remission of depression in humans. The study, funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, appears in the journal Science.

Major depression is one of the most common mental disorders in the United States, with approximately 17.3 million adults experienced a major depressive episode in 2017. However, many of the neural changes underlying the transitions between active depression, remission, and depression re-occurrence remain unknown. Ketamine, a fast-acting antidepressant which relieves depressive symptoms in hours instead of weeks or longer, provides an opportunity for researchers to investigate the short- and long-term biological changes underlying these transitions.

“Ketamine is a potentially transformative treatment for depression, but one of the major challenges associated with this drug is sustaining recovery after the initial treatment,” said study author Conor Liston, M.D., Ph.D., of Weill Cornell Medicine, New York City.

To understand mechanisms underlying the transition from active depression to remission in humans, the researchers examined behaviors related to depression in mice. Researchers took high-resolution images of dendritic spines in the prefrontal cortex of mice before and after they experienced a stressor. Dendritic spines are protrusions in the part of neurons that receive communication input from other neurons. The researchers found that mice displaying behaviors related to depression had increased elimination of, and decreased the formation of, dendritic spines in their prefrontal cortex compared with mice not exposed to a stressor. This finding replicates prior studies linking the emergence of behaviors related to depression in mice with dendritic spine loss.

In addition to the effects on dendritic spines, stress reduced the functional connectivity and simultaneous activity of neurons in the prefrontal cortex of mice. This reduction in connectivity and activity was associated with behaviors related to depression in response to stressors. Liston’s group then found that ketamine treatment rapidly restored functional connectivity and ensemble activity of neurons and eliminated behaviors related to depression. Twenty-four hours after receiving a single dose of ketamine, mice exposed to stress showed a reversal of behaviors related to depression and an increase in dendritic spine formation when compared to stressed mice that had not received ketamine. These new dendritic spines were functional, creating working connections with other neurons.

The researchers found that while behavioral changes and changes in neural activity in mice happened quickly (three hours after ketamine treatment), dendritic spine formation happened more slowly (12-24 after hours after ketamine treatment). While further research is needed, the authors suggest these findings might indicate that dendritic spine regrowth may be a consequence of ketamine-induced rescue of prefrontal cortex circuit activity.

This shows a brain

Although dendritic spines were not found to underly the fast-acting effects of ketamine on behaviors related to depression in mice, they were found to play an important role in maintaining the remission of those behaviors. Using a new technology developed by Haruo Kasai, Ph.D., and Haruhiko Bito, Ph.D., collaborators at the University of Tokyo, the researchers found that selectively deleting these newly formed dendritic spines led to the re-emergence of behaviors related to depression.

“Our results suggest that interventions aimed at enhancing synapse formation and prolonging their survival could be useful for maintaining the antidepressant effects of ketamine in the days and weeks after treatment,” said Dr. Liston.

“Ketamine is the first new anti-depressant medication with a novel mechanism of action since the 1980s. Its ability to rapidly decrease suicidal thoughts is already a fundamental breakthrough,” said Janine Simmons, M.D., Ph.D., chief of the NIMH Social and Affective Neuroscience Program. “Additional insights into ketamine’s longer-term effects on brain circuits could guide future advances in the management of mood disorders.”


Media Contacts:
Nick Miller – NIH/NIMH
Image Source:
The image is in the public domain.

Original Research: Open access.
Liston, C. et al. “Sustained rescue of prefrontal circuit dysfunction by antidepressant-induced spine formation”. Science. doi:10.1126/science.aat8078


Sustained rescue of prefrontal circuit dysfunction by antidepressant-induced spine formation

The neurobiological mechanisms underlying the induction and remission of depressive episodes over time are not well understood. Through repeated longitudinal imaging of medial prefrontal microcircuits in the living brain, we found that prefrontal spinogenesis plays a critical role in sustaining specific antidepressant behavioral effects and maintaining long-term behavioral remission. Depression-related behavior was associated with targeted, branch-specific elimination of postsynaptic dendritic spines on prefrontal projection neurons. Antidepressant-dose ketamine reversed these effects by selectively rescuing eliminated spines and restoring coordinated activity in multicellular ensembles that predict motivated escape behavior. Prefrontal spinogenesis was required for the long-term maintenance of antidepressant effects on motivated escape behavior but not for their initial induction.



Ketamine is used for starting and maintaining anesthesia and induces a trance-like state while providing pain relief, sedation, and memory loss. It can cause confusion and hallucinations as it wears off.  Discovered in 1962 it was used in the Vietnam War due to its safety and is on the WHO’s list of essential medicines.

It’s also used as a recreational drug in raves and as a club drug.  Due to this, it’s a schedule III substance in the U.S.

That said, it’s been shown to limit borrelia in vitro:

It’s also been shown to relieve her chronic pain, improve quality of life, reduce depression and suicidal ideation, and reduce opioid consumption:


Neuro-Lyme is Like Hitting My Head Against a Fog Wall

Neuro-Lyme is like hitting my head against a fog wall

Folate & You: Perfect Together

Folate and you: Perfect Together

Methylation also helps you clear toxins such as hormones from chemicals, and rogue neurotransmitters that can cause seizures, anxiety, rage, and insomnia.

If you are extremely sensitive to medicine you probably have a methylation problem.  Cohen also states that while some of this stems from genetics, there are other reasons for it such as a lack of the following vitamins:

  • Zinc
  • B2/riboflavin
  • Magnesium
  • B6/pyridoxine
  • B12/methylcobalamin
  • Folate (from food or folinic acid)

1) Poor diet, poor probiotic status, digestive issues, medications, medical conditions like Crohn’s or Celiac, and other genetic traits may cause any or all of these nutrient deficiencies.

2) Xenobiotics – which are chemicals found in our air, water, food, home, work, schools, parks, beds, cosmetics and more.

3) Taking medications that are drug muggers that deplete you of the nutrients in #1 above. Some of the worst offenders (in terms of stealing your methylation nutrients) are methotrexate, metformin, antacids, acid blockers, proton pump inhibitors, corticosteroids, estrogen-containing drugs and nitrous oxide.

4) Drinking alcohol will pretty much shut down your methylation and wipe out your glutathione stores.

5) Green coffee bean extract is incredibly high in catechols and those use up your methylation pathway nutrients fast!

7) If you have Lyme disease, and many people do whether they know it or not, the Borrelia burgdorferi germ uses up all your magnesium (this supplement is a unique and highly absorbable form) to make biofilms and hide. Low mag reduces your ability to methylate. As an aside, this explains why some ‘Lymies’ have bad reactions during antibiotic treatment. Those drugs kill the organism but then your body is faced with poison such as ‘dead bug parts’ as well as ammonia which spikes when Borrelia dies off. Point is, you can’t remove easily the toxins from your body and it backs up in your system (by christopher at If this is you, then use really low doses if you have to take antibiotics, until you’ve opened up your methylation (and other detoxification) pathways.

8) If you take nutrients that deplete methyl groups (like high dose niacin, or the prescription version of that called Slo-Niacin and Niaspan).

9) Heavy metals (think mercury in your diet, or your teeth) or lead in your bloodstream, cadmium if you smoke, high copper, arsenic, etc.

10) High levels of acetylaldehyde, this is a potent neurotoxin released by Candida, and also a by-product of drinking alcohol (even red wine). Don’t drink if you’re a poor methylator. Most of you know who you are, meaning you are a lightweight when it comes to alcohol. Yep, it is likely you are a poor methylator. I will share more about the Candida toxin known as “acetylaldehyde” shortly.

12) Anxiety or a lot of stress. I’m not sure why, but a pessimist or “I can’t do it” kind of outlook seems to make things worse. I think it has to do with your belief systems and how they impact your genes. In my summary, I’ll give you some links to an author and lecturer that has clues on how to change your outlook. (Dr. Bruce Lipton).

Please see Cohen’s article for options if you suspect a methylation defect:





Lyme Disease & Neurological Changes in Children

Lyme Disease and Neurological Changes in Children

By Somer DelSignore

Clinically we find a multitude of neuro-psychological symptoms that present with children afflicted with tick-borne illnesses. Many of those symptoms did not exist prior to  exposure.  The number of children with anxiety disorders, OCD, mood dysregulation, ADHD, bipolar disorder, gender dysphoria and others are prominent and included in the working diagnosis and treatment plan of Lyme and other tick b diseases.

There are countless studies linking neuro-psychological impairments with Lyme disease and other tick-borne illnesses many of which suggest a larger percentage of children are affected.

A review of literature reveals studies by Brian Fallon and others that link Lyme disease to neurological and psychological ailments. New onset depression, anxiety, schizophrenia, bipolar disorders and other mental illnesses were postulated to be the result of a Lyme disease exposure. Fallon outlined several supportive strands of evidence throughout his research. He noted the incidence of mental illness is greater in those with Lyme disease versus other medical conditions. These psychiatric conditions were new onset and did not exist prior to contracting Lyme disease. Lastly, these mental illnesses improved after administering courses of antibiotic therapy. 

So what is thought to contribute to the psychological changes? Further evaluation thru single photon emission tomography or SPECT scans as it’s known revealed that those with

“Lyme disease typically have multifocal areas of decreased perfusion in the cortex and subcortical white matter” Fallon et al. 1997.

Cortical and subcortical perfusion is studied extensively with PTSD patients. The pattern of poor perfusion is similar to those who also suffer from a tick-borne illness. A result of poor perfusion can lead to  breakdown of the neural pathways  that provide an interconnectedness between all regions of the brain. Specifically, the subcortical regions play a significant role in emotional regulation. This is where your fight or flight response stems via control of Dopamine and other neurotransmitters.  Your cortical regions control sensory, motor and visual response. In the presence of Lyme disease, which has an affinity for the neurological system, inflammation occurs contributing to this poor perfusion state. It’s plausible to suggest neurological and psychological changes as it relates to tick-borne illness.

Studies directed specifically at the pediatric population were conducted by Rosalie Greenberg, a pediatric and adolescent psychiatrist. Although small, Dr. Greenberg studied 14 children diagnosed with bipolar disorder. She noted

  • 6 had mycoplasma
  • 3 had B. Burgdorferi the bacteria that causes Lyme disease
  • 10 had Babesia
  • 4  had Bartonella
  • ALL had tick borne diseases
  • Out of the 14 only 1 described typical joint pain associated with Lyme disease

Bransfield and others discuss links for autism spectrum disorder development in children as evident by the spirochete that causes Lyme can be passed from an infected mother to her unborn child. This can lead to neurological ailments as well as significant immune dysfunction. Supportive evidence showed upwards of 30% of those diagnosed with autism spectrum disorder had a positive blood test for Borrelia Burgdorferi, the spirochete that causes Lyme Disease. I’ll certainly delve into autism and links to infection in the coming weeks as I’m fascinated!

Children present differently. Perhaps it is the vulnerable blood brain barrier or naïve immune system that contributes. We know in children the brain continues to develop until they reach their early 20’s.  Studies looking closer at the link between childrens’ neurological status and tick-borne illness speculates around 70% to present with onset of headaches, fatigue, mood disturbance, irritability and acute outbursts where symptoms did not previously exist. Anecdotally, I too have witnessed these accounts.

Let’s postulate, just for fun, out of the 4 million children currently diagnosed with mental illness at least 30% or more of those have a tick-borne illness. That’s roughly 1.2 million children whom could be cured of their mental illness by merely treating the infection with courses of antibiotics and/or natural remedies.

This certainly would present a fundamental paradigm shift within the mental healthcare community but isn’t it worth it? Shouldn’t we all Think Differently about mental illness?

The take home message here for parents. If your child (or you) present with sudden onset of neurological changes, mood swings, ADD/ADHD, sleep disturbances, motor or vocal tics, fasciculations, unfounded anxieties and fears, rage, impulsivity, concentration issues, dyslexia, regression with milestones etc, seek out an evaluation for tick-borne illnesses.

Should your primary care provider refuse to perform the test or argue otherwise….find someone else!

Recent Tick-Task Force initiatives, passed by NY state legislators and championed by Senator Sue Serino, secured 1 million dollars to fund research that allow better understanding of the link between Lyme, tick-borne diseases and mental health issues. These funds will also help support preventative actions as well as raise awareness. It’s solid movement in the right direction. This recent legislation would direct the Office of Mental Hygiene and Department of Health to conduct these studies. Fingers crossed for the follow thru! You can find more information about critical legislation passed recently in the NY senate and full description of the tick-borne illness initiatives by visiting



More and more coming out daily on how pathogens are implicated in brain diseases and mental disorders.  This article should be shared widely as there are multitudes of children being misdiagnosed with mental illness that could be cured by treating the underlying infection(s).

One prominent Wisconsin Lyme doctor states that 80% of his Autistic and PANS patients have Lyme/MSIDS.  Please share widely.






Abstract: Bartonella in Boy with PANS

Bartonella henselae Bloodstream Infection in a Boy With Pediatric Acute-Onset Neuropsychiatric Syndrome

First Published March 18, 2019 Case Report

In March 2017, Bartonella spp. serology (indirect fluorescent antibody assays) and polymerase chain reaction (PCR) amplification, DNA sequencing, and Bartonella enrichment blood culture were used on a research basis to assess Bartonella spp. exposure and bloodstream infection, respectively. PCR assays targeting other vector-borne infections were performed to assess potential co-infections.

For 18 months, the boy remained psychotic despite 4 hospitalizations, therapeutic trials involving multiple psychiatric medication combinations, and immunosuppressive treatment for autoimmune encephalitis. Neurobartonellosis was diagnosed after cutaneous lesions developed. Subsequently, despite nearly 2 consecutive months of doxycycline administration, Bartonella henselae DNA was PCR amplified and sequenced from the patient’s blood, and from Bartonella alphaproteobacteria growth medium enrichment blood cultures. B henselae serology was negative. During treatment with combination antimicrobial chemotherapy, he experienced a gradual progressive decrease in neuropsychiatric symptoms, cessation of psychiatric drugs, resolution of Bartonella-associated cutaneous lesions, and a return to all pre-illness activities.


Please note that this boy would be in a psych ward if not treated with antimicrobials for Bartonella.




Missing Links? Connect the Dots Between Lyme & Mental Health

Missing Links?

Connect the Dots Between Lyme and Mental Health

Is it possible that a tiny little tick could assault the brain and body and cause lingering mental health issues in its wake? Yes. But even with decades of research that demonstrates a causal link between infectious disease and psychiatric issues, our healthcare system still isn’t appropriately identifying and treating those afflicted with Lyme disease. The real question is: why are we missing these individuals?

It isn’t an easy answer. Ultimately the complexity of how the disease impacts the brain and body and how uniquely the symptoms can present is a major factor, as some show symptoms right away and delete others not until months or years later. A lack of definitive diagnostics is another factor in accurate identification. Lastly, a lack of acceptance of the disease and not enough Lyme-literate medical and mental health professionals is a hurdle in both diagnosis and treatment.

Research on Lyme Disease and Mental Health

Since the early 1990s, research has demonstrated a clear link between psychiatric conditions and Lyme disease, and continues to signify a connection. In 2002, Tomáš Hájek, MD and colleagues found that 33 percent of screened psychiatric patients showed signs of an infection with the Lyme spirochete, Borrelia burgdorferi. Many mental health issues have been linked to tick-borne bacteria, including: depression, mood lability, bipolar disorder, irritability, anxiety, panic attacks, obsessive compulsive disorder, attention and executive functioning problems, memory issues, word finding difficulties and even psychosis.

A 2018 study by Shreya Doshi, MA and colleagues found that in patients with post-treatment Lyme symptoms, they had depression symptoms 8 to 45 percent of the time, and suicidal ideation was reported by 19.8 percent of these patients. In 2017, Dr. Rosalie Greenberg’s study found that 89 percent of participants diagnosed with Pediatric Bipolar Disorder tested positive to one or more pathogens, including tick-borne Babesia, Bartonella and Lyme, as well as Mycoplasma pneumoniae.

Even with many research studies over decades that demonstrate a causal link between infectious disease and mental health, the average person sees between five and seven doctors before a diagnosis of Lyme disease.

Lyme’s Effect on the Brain

When Lyme disease affects the brain, it is frequently referred to as Lyme neuroborreliosis or Lyme encephalopathy. Neuroborreliosis is an infection within the brain that can mimic virtually any type of encephalopathy or psychiatric disorder and is often compared to neurosyphilis. Both are caused by spirochetes, are multi-systemic and can affect a patient neurologically, producing cognitive dysfunction (memory, word finding, attention problems) and organic psychiatric illness (anxiety, depression, OCD).

The causative agent of Lyme disease, Borrelia burgdorferi, is a highly neurotropic organism that not only can produce neurologic disease, but also can exist dormant within the central nervous system (CNS) for long periods—even months or years. It is an evolved pathogen that uses several strategies to survive in both human and animal hosts, including using a screw-like mechanism that allows the bacteria to embed in the cell’s membrane.

There are multiple ways in which Lyme disease affects the brain and body and produces changes in the CNS that leads to mental health issues. The Lyme spirochete can burrow into the brain and nervous system, causing damage within the brain that leads to long-term issues. It causes brain swelling or inflammation that leads to psychiatric issues, causes immune reactions to the bacteria and impacts the endocrine system and hormones. Lyme can impact any area of the brain, including the emotional center of the brain: the limbic system. The bacteria in Lyme releases toxins in the brain and body, and these exotoxins are continuously released as waste material that may cause symptoms.

Why is Lyme Disease Hard to Identify?

Lyme disease is known as the great imitator because its symptoms mimic and overlap with so many other diseases that it can be hard to diagnose. It is a multi-systemic illness that can affect the CNS, causing a wide array of neurologic and psychiatric symptoms. In 1994, Fallon and Nields noted up to 40 percent of patients with Lyme disease develop neurologic involvement of either the peripheral or central nervous system.

Most people don’t realize that there are three stages of Lyme disease: early with dermatological symptoms, disseminated, and late stage. Late stage Lyme is when there is a dissemination of the bacteria to the CNS, which can occur within as little as two weeks. Lyme disease may lie dormant for months to years before symptoms of late infection emerge when something (head injury, toxins, EMF) causes the bacteria to cross the blood-brain barrier into the brain.

Patients with late stage Lyme disease present with a variety of neurological and psychiatric problems, ranging from mild to severe, which makes it very hard to connect to infectious disease. Most patients have no recollection of tick bite or falsely believe that a tick has to be engorged to carry bacteria and parasites that can be transmitted. Moreover, they are often told that their prior Lyme disease was “cured” and can’t be related to their current symptoms. These problems delay treatment and make it more likely to have late stage Lyme with a neurocognitive or neuropsychiatric impact.

Common Features of Psychiatric Issues Due to Lyme

Since tick-borne bacteria affects the CNS as noted previously, a multitude of symptoms can present. Afflicted individuals can show symptoms immediately or months later and can show a combination of physical, cognitive or psychiatric issues.

Common symptoms of tick-borne disease include: chronic fatigue, sleep problems, brain fog, cognitive and memory impairments, slowed cognitive processing, attention or executive functioning deficits, depression or mood dysregulation, anxiety, OCD, sensory sensitivity, irritability, anger and headaches.

It is important to note that one can have a pre-existing condition prior to Lyme disease that can exacerbate with infectious disease, which further complicates proper diagnosis and treatment. Lyme and tick-borne disease is co-morbid with ADHD, autism, sleep disorders, depression, anxiety disorder, pain and migraines, and can be a source of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).

What Should You Do? 

If you or your child has a history of unexplained medical and mental health symptoms or haven’t gotten better with traditional therapies and psychotherapy, consider that infectious disease might be the source of your mental health issue. It is important to note that infectious disease takes many forms and that one may have a single illness, but it is more likely that one is affected by more than one infection, including strep, virus, other bacteria or environmental contaminants such as mold.

The first step is to find a Lyme-literate medical or mental health professional for proper diagnosis and treatment. The best way to do that is to seek a referral from a trusted friend or from Lyme organizations at the regional or national level, such as ILADS, your state Lyme organization or As many a patient who has taken this path can attest, you waste your time and may cause further damage to your health by going to an untrained professional. 

Dr. Roseann Capanna-Hodge is an integrative psychologist, certified neurofeedback practitioner and director of wellness centers in Ridgefield and Newtown. She is a member of ILADS and is a co-author of Brain Under Attack: A Resource Guide for Parents and Caregivers of Children with PANS, PANDAS, and Autoimmune Encephalitis for the nonprofit organization Epidemic Answers. Connect at 203-438-4848, or



So thankful for mental health professionals who understand what’s happening in Lyme-land.  Her advice about finding a Lyme literate professional was also spot on as you will waste a lot of money if you see mainstream medicine for this.

For more on what Lyme/MSIDS can do to the brain:



Be a Victor Not a Victim

by Jennifer Crystal

Many patients of tick-borne disease take years to get diagnosed. A lucky few ones find a bull’s-eye rash or an embedded tick, go to a physician who just happens to be Lyme literate, and get started on antibiotics right away. If they respond well to initial treatment, they can be cleared of Lyme in a month’s time.

Most patients are not this lucky. Even of those who do get treated right away, 10-20% go on to suffer after treatment. And for people who are not immediately treated, Lyme bacteria and quite possibly other co-infections the tick has introduced to ones body can spread through their bodies and brains for months, years, even decades before they are  accurately diagnosed. By the time of diagnosis, the person is often bedridden, plagued by exhaustion, joint aches, migraines, brain fog, and other neurological impairments. The unluckiest can suffer paralysis or schizophrenia.

When you’re a victim of unbearable physical and neurological suffering and you’re fighting to get a diagnosis, it can be the most natural thing in the world to also fall victim to a woe-is-me mentality. In some respects, you have to. Just to get people to take you seriously. If you’re like me, you might be used to putting on a good face even in the toughest times.

I’ve always been a glass-half-full person, an optimist fundamentally, but in order to get people to really understand what was going on under my mask of a smile, I had to complain. I was doing myself no favor by remaining stoic. Some might say I was throwing a pity party. But I needed to do so in order to be heard.

When I finally did get accurately diagnosed with Lyme and two of its co-infections, babesia, and ehrlichia, I wanted to shout from the rooftops, “Hey world, guess what? I have Lyme disease!” After eight years battling mystery symptoms, two years being utterly bedridden, and countless pointless doctors appointments where I was told, “Maybe it’s all in your head” or “You just need to exercise more,” I finally felt validated, I had a true physical disease—multiple diseases, in fact three of them—and the tests and clinical diagnoses to prove it.

Getting that validation can make you want to go back to all those naysayers and gleefully howl, “I told you so.” But many of those same people are the ones you will still need support from, whether it’s emotional or financial support from friends and family or medical support from physicians. For that reason, you have to take the moral high road. You have to extend understanding to those people, recognizing that they simply didn’t know enough about tick-borne diseases. Yet you have to educate them so they can meet you where you are and help you the manner best suited for your illness.

Inside, you may be very angry indeed. You may feel like a victim for all you’ve been through. When you start having Herxheimer reactions and start feeling worse than ever, you may even curse the tiny tick that did all this to you, the doctors who wouldn’t listen to you, the friends or family who didn’t advocate for you. You may curse the world for not understanding your suffering.

I say you may only to suggest that this could happen, but also to give you permission to have these feelings. It’s okay to be angry. It’s okay to be sad. It’s okay to be frustrated. It’s okay to mourn the months or years of your life that you’ve lost.

It’s not okay to stay in that place. It’s not okay to get stuck in your own anger. For then, you indeed become a victim, you become bitter. The tick, the disease(s) it carried, and the naysayers all win, because you’ve let them get the best of you. Please don’t do this. You are better than that.

You are a fighter. You deserve to regain your health. But your body cannot heal if you weigh it down with toxic emotions. You can have them, sure; that’s only natural. But at some point you must need to move beyond them. You must release yourself from them, so that your body has a real fighting chance to heal.

Don’t send your body the message that you’re a victim because it will believe you. Send your body the message that you are going to treat it kindly, be patient with it, and support it every step of the way on its journey to health.

Be a victor instead of a victim.

jennifer crystal

Opinions expressed by contributors are their own.

Jennifer Crystal is a writer and educator in Boston. She has written a memoir about her journey with chronic tick borne illness, for which she is seeking representation. Contact her at:

Great, great reminder.  You can have all those emotions but don’t stay in that place forever.  Rise above it.  Come to support group and vent.  That’s what we are here for.
One point that is important – way more than 10-20% of us have chronic symptoms.  Microbiologist Holly Ahern wrote an incredible piece pointing out it’s more like 60%:  This is a prime example of how this plague has been downplayed using statistics and wrong definitions.  
We need to issue well known as it is being used against patients. Researchers are taking the falsely skewed statistic of 10-20% and making this sound rare – when it is not.
Please get the word out.  This PTLDS definition must change.