Archive for the ‘Psychological Aspects’ Category

Tickborne Illnesses “Can Look Like Anything” Podcast

https://www.mindbodygreen.com/articles/physical-and-psychological-signs-of-tick-borne-illness Podcast in link

I’m A Functional MD & These Sneaky Signs Can Signal A Tickborne Illness

By Jason Wachob

Here’s the thing about tickborne illnesses: According to functional medicine doctor Kenneth Bock, M.D., they can cover different organ systems, and so patients often present myriad symptoms. “It can look like anything,” he shares on this episode of the mindbodygreen podcast, which poses a problem in clinical settings: If a patient comes in with a laundry list of complaints, some professionals may resort to a psychological diagnosis (especially if those said symptoms are, in fact, psychological, which we’ll get into later).

However, says Bock, “If you listen, and you look, and you think hard…these tickborne diseases can cause this myriad of complaints.” Meaning, it’s important not to rule out the possibility of a tickborne illness, even if you don’t necessarily live in a hotbed state. Below, he explains some of the most common signs he has seen.

Physical symptoms.

“It can range from skin rashes to heart palpitations, shortness of breath, brain fog, numbness, tingling, burning, dysesthesias (which is pain), and also general fatigue and headaches,” Bock says.

He also mentions that some ticks can carry Bartonella bacteria, which can “give you these purple-ish, reddish stretch marks” in uncommon areas you wouldn’t typically have stretch marks—like in the middle of the back or behind the knee. (We should note: There is little evidence to suggest the transmission of Bartonella from ticks to humans directly; most of the data shows that the bacteria can be transmitted from ticks to pets to a person during a scratch.)

He continues that Babesia, another tickborne illness that often goes hand-in-hand with Lyme disease, can cause symptoms like fever, chills, sweats, and air hunger (aka, feeling like you can’t get enough air).

The purpose of listing these symptoms isn’t to scare you—Bock emphasizes that when people point out their multiple symptoms, he takes tickborne illnesses into account. “Rather than [saying], ‘Oh, the person has air hunger, so they’re just anxious,’ these are clues to some of the tickborne illnesses.”

Psychological symptoms.

We mentioned brain fog, but Bock says tickborne illnesses can manifest as a host of psychological symptomssometimes for younger folks, the only symptoms at all are psychological. 

“The thing about kids and adolescents is that sometimes the only symptoms of tickborne disease are neuropsychiatric,” Bock explains. “All you see is anxiety, or OCD, or panic attacks, or depression, and sometimes rage.” In fact, studies show that a portion of Lyme disease patients can experience explosive anger and aggressiveness (commonly referred to as “Lyme rage”).

All that to say: It’s important we don’t rule out tickborne illnesses, even if someone only presents psychological symptoms. “They can carry a diagnosis of mood disorder, [like] anxiety and panic attacks, but if they have a tickborne disease, they’ll never get better. All the psychotropics in the world and all the therapy will not [help them] get better,” says Bock.

The takeaway.

Tickborne illnesses can be scary—understandably so. Again, explaining all of these symptoms is not to spook you into thinking you have a tickborne illness. But if you present myriad symptoms, it’s important to get to the root of the issue and make sure a tickborne illness is not the driver.

“The key is to recognize that they exist,” notes Bock.

**Comment**
Regarding ticks transmitting Bartonella directly to humans, I personally asked Dr. Breitshwerdt if this is true.  He strongly believes ticks transmit it.  Info here.  There are many people with Bartonella who have not had cat or pet exposure, although it is known that Bartonella is transmitted by numerous insects and arachnids.  BTW: you can have Bartonella without the purplish stretch-mark looking rashes.
For a nifty coinfection symptom chart go here, although it’s important to remember there are symptoms not on this chart, as well as the fact you may not present with the typical symptoms.  I appreciate the fact he said some peoples’ only symptoms are psychiatric.  This is very true but not considered by mainstream medicine.
One of the most telling quotes within the article is the phrase about having a “laundry-list” of symptoms.  Dr. Jemsek gives the following quote when speaking about Lyme:
“You either have 20 diseases or you have Lyme disease.”
I would add that you should also suspect other coinfections as well.
For more:

One thing the article did not mention is testing, which nearly all mainstream doctors will use, even though these tests have been proven to be a joke.  This isn’t discussed and you have to be your own advocate and understand this.  I would seriously bypass mainstream medicine and head directly to a Lyme literate doctor, who will diagnose and treat you clinically based upon symptoms.

From my perspective with helping patients, mainstream doctors continue to utilize faulty testing, take a “wait and see” approach which is dooming patients to a life-time of suffering, and even IF they miraculously test positive on an abysmal test, treat them inappropriately with no more than the insufficient monotherapy of 21 days of doxycycline.

You can look up more articles by typing in key words into the search bar on the website.  For instance, if you want to know more about Bartonella, just type Bartonella into the search bar and other articles will pop up.

Lyme Borreliosis & Associations With Mental Disorders & Suicidal Behavior: A Nationwide Danish Cohort Study

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.20091347

Lyme Borreliosis and Associations With Mental Disorders and Suicidal Behavior: A Nationwide Danish Cohort Study

Objective:

Lyme borreliosis is a tick-borne infectious disease that may confer an increased risk of mental disorders, but previous studies have been hampered by methodological limitations, including small sample sizes. The authors used a nationwide retrospective cohort study design to examine rates of mental disorders following Lyme borreliosis.

Methods:

Using Denmark’s National Patient Register and the Psychiatric Central Research Register, and including all persons living in Denmark from 1994 through 2016 (N=6,945,837), the authors assessed the risk of mental disorders and suicidal behaviors among all individuals diagnosed with Lyme borreliosis in inpatient and outpatient hospital contacts (N=12,156). Incidence rate ratios (IRRs) were calculated by Poisson regression analyses.

Results:

  • Individuals with Lyme borreliosis had higher rates of any mental disorder (IRR=1.28, 95% CI=1.20, 1.37)
  • of affective disorders (IRR=1.42, 95% CI=1.27, 1.59)
  • of suicide attempts (IRR=2.01, 95% CI=1.58, 2.55)
  • and of death by suicide (IRR=1.75, 95% CI=1.18, 2.58) compared with those without Lyme borreliosis

The 6-month interval after diagnosis was associated with the highest rate of any mental disorder (IRR=1.96, 95% CI=1.53, 2.52), and the first 3 years after diagnosis was associated with the highest rate of suicide (IRR=2.41, 95% CI=1.25, 4.62). Having more than one episode of Lyme borreliosis was associated with increased incidence rate ratios for mental disorders, affective disorders, and suicide attempts, but not for death by suicide.

Conclusions:

Individuals diagnosed with Lyme borreliosis in the hospital setting had an increased risk of mental disorders, affective disorders, suicide attempts, and suicide. Although the absolute population risk is low, clinicians should be aware of potential psychiatric sequelae of this global disease.

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Research Consortium Aims to Develop New Drug For Bartonellosis

https://www.lymedisease.org/research-consortium-bartonellosis/

Research consortium aims to develop new drug for bartonellosis

July 15, 2021

Key infectious disease researchers at Tulane University, Duke University and North Carolina State University will collaborate on an initiative to develop a treatment for bartonelloses, a spectrum of vector-borne diseases that can cause debilitating symptoms.

The three-year, $4.8 million initiative funded by The Steven and Alexandra Cohen Foundation, will establish the Bartonella Research Consortium to develop a novel treatment for bartonelloses.

Bartonella are zoonotic, stealth bacterial pathogens that were not known to infect animals or humans prior to the HIV epidemic when immunocompromised patients began showing symptoms of bartonelloses.

Bartonelloses are often self-limiting diseases that can be cleared by the immune systems of healthy individuals. In immunocompromised individuals or as co-infections, they can cause severe neuropsychiatric, cardiovascular, and rheumatological symptoms. Cats and fleas often harbor the pathogen, which increases the likelihood of transmission to humans.

The principal investigators of the consortium support a collaborative approach to the study of complex, poorly understood infectious diseases. By working together to prevent and treat Bartonella infections, they will provide patient-relevant solutions that improve both animal and human health. Targeted antimicrobial strategies to eliminate long-standing Bartonella infections will dramatically improve patient outcomes.

Similarities between Bartonella and Lyme infections

Bartonella symptoms overlap with those of other vector borne organisms such as Borrelia burgdorferi, the bacteria that causes Lyme disease. In some instances, patients have been infected with both Bartonella and Borrelia burgdorferi infections, which can cause an exacerbation of symptoms

As often seen in Lyme disease patients, a subset of people with bartonelloses develop chronic symptoms despite prior antibiotic therapy. Treatment failures have been documented with both infections, thus the need for drugs that specifically target and eliminate these bacteria.

Associate Professor Monica Embers, a microbiologist and immunologist at the Tulane National Primate Research Center, focuses on the persistence of tick-borne infectious disease despite antibiotic therapy and will bring her expertise to the consortium.

“There are a lot of similarities between Bartonella and Borrelia infections, both of which are notoriously difficult to detect and treat. Developing targeted treatments has the potential to alleviate a lot of suffering, both in the human and pet populations,” said Embers.

There are over 40 known Bartonella species or subspecies and at least 17 have been associated with a spectrum of disease symptoms. Although Bartonella remain neglected in human and veterinary medicine, more recent evidence supports an important role for these bacteria in a variety of diseases.

Funding for this research initiative combines the strengths of research laboratories located at Duke University, North Carolina State University and Tulane University.

Principal investigators include Drs. Edward B. Breitschwerdt, Monica E. Embers, Timothy A Haystead and Ricardo G. Maggi. During the next three and a half years, these established investigators and their highly skilled research teams will develop a novel drug for the treatment of bartonelloses.

SOURCE OF PRESS RELEASE: Tulane University

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Pediatric Bipolar Disorders & Tick-borne Illnesses

https://www.lymedisease.org/pediatric-bipolar-disorders/

Pediatric bipolar disorders and tick-borne illnesses

July 23, 2021

By Rosalie Greenberg, MD

Pediatric Bipolar Disorder (PBD) refers to a child or adolescent experiencing a distinct period of time in which he or she has changes in mood, energy, thought and behavior that can have a significant effect on the youngster’s ability to function.

This diagnosis, like most, is on a spectrum. A young person can have manic episodes with or without depressive episodes. This is called Bipolar I. Or, the child can have episodes of depression with only mild hypomanic episodes (not as severe as mania and which don’t require psychiatric hospitalization.) This is called Bipolar II.

Other Specified or Unspecified Bipolar and Related Disorder are two other categories that are used when the full criteria for the diagnosis are not met. In the past, this was called Bipolar Disorder Not Otherwise Specified (NOS).

Making a diagnosis

The symptoms required to make the diagnosis of a manic episode are the following: a clear period of abnormally elevated or irritable mood and heightened energy or activity lasting at least a week (or less if hospitalized) accompanied by three or more of the symptoms below (four if only irritable):

  • Decreased need for sleep
  • increased self-esteem or grandiosity
  • More talkative or pressured speech
  • Flight of ideas (loosely connected thoughts) or feeling like one has racing thoughts
  • Distractability
  • Increase in goal-directed activity or overall heightened psychomotor agitation
  • Increased impulsivity that can cause excessive involvement in activities that have a high potential for painful consequences

In the majority of cases, the cause of bipolar disorder is uncertain. But it is probably a mixture of genetics, the environment (including exposure to certain infections) and immune system dysfunction.

A few infectious agents have been accepted as being directly associated with bipolar disorder symptoms. Two of these are:

  1. the parasite Toxoplasmosis Gondii which causes toxoplasmosis
  2. the spirochetal (corkscrew shaped) bacteria, Treponema Pallidum which causes syphilis

Of note, both syphilis and Lyme disease (caused by Borrelia burgdorferi), are caused by a spirochete-shaped bacteria and they share a variety of other commonalities.

The Borrelia bacteria has more DNA and is much more complex in composition and function. Individuals who experience late stage, or tertiary, syphilis can exhibit manic-like behavior, which also can be seen at times in those with neurologic Lyme disease.

PANDAS/PANS

For a while, I was looking at new patients for any evidence of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) or Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).

The former refers to a group of psychiatric symptoms precipitated by a Group A Beta Hemolytic Streptococcal infection. In the latter, the cause remains unspecified and might include factors such as infections, trauma and environmental toxins.

Because of the similarities I observed between PANDAS/PANS  and PBD, I started to check some of my PBD patients for evidence of infection.

One such patient was P, an 11-year-old, who came to see me following four psychiatric hospitalizations over the course of one year, because of difficulty with mood shifts, oppositional behavior and verbal and physical aggressive outbursts.

He was diagnosed as having PBD, attention-deficit hyperactivity disorder (ADHD) – combined type and oppositional defiant disorder. His difficulties had only mildly improved despite multiple psychiatric medication trials.

I first saw him after his last hospitalization.  At that point, he was no longer acutely dangerous to himself or others but had limited self-control and awareness.

I learned that his family history was strongly positive for bipolar disorder in at least three generations. Alcoholism was present in both maternal and paternal relatives. Furthermore, there were a variety of autoimmune disorders in relatives on both sides of the family tree.

After eight months of medication treatment under my care as an outpatient, he suddenly once again became highly agitated, argumentative and threatening. It was clear that he could not continue to live at home unless his behavior drastically changed

High strep titers

Despite the fact he had been healthy, with no known medical history of a Streptococcal infection (the bacteria responsible for causing strep throat), I decided to check him for evidence of infection causing PANDAS or PANS. To my surprise, his strep titers were quite high and he was subsequently diagnosed with PANDAS.

A few months of treatment with antibiotics eventually resulted in a dramatic change. His mood was happier and more even, he was much less oppositional, more affectionate and he even became a more diligent student.

He was on a low dose antibiotic prophylactically to protect against recurrent streptococcal infection. This protective approach is similar to what occurs in those with rheumatic heart disease.

Over time, P’s negative behavior would return and escalate on occasion if he was exposed to someone who was sick. But his symptoms usually responded quickly with anti-inflammatory treatment or, if needed, a change in antibiotic.

Bartonella

When P was in the 8th grade, he had a severe angry depressive episode. By this time, I had become familiar with tick-borne disorders and their potential neuropsychiatric effects. On testing, he was positive for the bacteria Bartonella henselae.

Once again, proper antibiotic treatment resulted in a significant lessening of his psychiatric symptoms. It is important to note that he also needed an antipsychotic and anticonvulsant for mood maintenance whether or not he was taking antibiotics.

Given the observation that P’s mood and behavior dramatically changed once his infections were identified and properly treated, I decided to screen many of my new patients for evidence of infection.

To my surprise, I found evidence of infections in the majority of those newer patients who underwent blood testing during psychiatric evaluation.

I am known as being an expert in pediatric bipolar disorder, having written Bipolar Kids: Helping Your Child Find Calm in the Mood Storm, as well as having lectured to the public and professionals and written a variety of articles for both groups.

It’s important to keep in mind that my practice is somewhat atypical in that it experiences what is called “a referral bias,” with many parents coming to see me to determine whether or not their child really has bipolar disorder.

Once I kept finding evidence of infections, and often positive mood or behavioral changes when the newly discovered illnesses were addressed, I decided that it was important that I go back and check for infections in my bipolar patients with whom I had worked for years.

Again, I was surprised to find that many of these kids also tested positive for evidence of infection, especially tick-borne illnesses (TBIs).

Tick-borne illnesses

Ten years ago, I learned that New Jersey, where my practice is located, is a Lyme-endemic state. But how was it possible that so many of my patients tested positive? Maybe the testing was wrong? I even submitted samples of my own blood to two of the specialty laboratories (Igenex and Galaxy Diagnostics) to check the accuracy of the testing and found the results quite credible for a variety of reasons.

I also noted that as I kept learning more and more about Lyme and the other TBIs at different specialized meetings, I often heard presentations of adult patients who were diagnosed with bipolar disorder and later found to be suffering from some form of tick-borne illness. This sounded just like “my kids.”

With this experience as my background, I decided to do a retrospective chart review to determine the rate of evidence of tick-borne infection exposure in 27 consecutively seen bipolar youth whom I treated between February 2013 and July 2015.

Of the 27, 81% (22/27) were males and 19% (5/27) were females with an average age of 7.3 years. Fifteen of the kids were diagnosed as having Bipolar I (had manic episodes) and 12 had Bipolar II (episodes of depression with periods of hypomania).

Using a variety of different laboratories, blood testing was done to check for evidence of exposure to Group A Beta Hemolytic Streptococcal bacteria, and other infectious agents including Mycoplasma pneumoniae (which can cause walking pneumonia), Borrelia burgdorferi (Lyme disease), BabesiaBartonellaAnaplasma and Ehrlichia.

24 out of 27 bipolar children had TBIs

In the end, 89% (24/27) showed evidence of exposure to one or more of these pathogens (infectious agents). The frequency of the positive testing results in the 27 bipolar child patients were as follows:

  • Babesia =16
  • Mycoplasma pneumoniae = 11
  • Bartonella = 8
  • Lyme = 6
  • Anaplasma + Ehrlichia = 1

All individuals who had a positive test were recommended to see a doctor familiar with TBIs to determine if the patient should receive the clinical diagnosis and get appropriate treatment.

Twenty-two of the 24 agreed to this assessment. All of those children who followed the recommendation and sought consultation were found by the evaluating physician to meet the clinical criteria for the diagnosis of having TBIs.

In the end, 20/27 or 74% of those with PBD were positive for TBIs by both laboratory testing and clinician assessment. Four of the 27 (23.5%) patients tested were positive for PANDAS. Another important observation is that only three of the 27 with PBD had a known tick bite.

The results are clearly quite provocative. It’s important to keep in mind that the association found between TBIs and PBD does not mean there is a causal relationship. Interestingly, for some children, treatment of their TBIs resulted in variable degrees of improvement of their psychiatric symptoms.

The case of P, presented earlier, is a clear example of how treating the infection improved the child’s mental health. Studies are needed before making a definitive statement regarding the neuropsychological effects of treating underlying infections. It would be wrong to generalize the results from a small, specialized psychiatric practice without more evidential support from other pediatric populations.

“Bipolar-like” symptoms

I also noted that some of the kids in my practice exhibited what I call “bipolar-like” symptoms. They clearly do not fit the full criteria for a bipolar mood disorder. Yet, they exhibit definite elements consistent with a significant amount of mood unsteadiness, especially depression, as well as exhibit similar co-morbidity to youth with PBD.

The potentially accompanying psychiatric illnesses include anxiety disorders (e.g. obsessive-compulsive disorder [OCD] and separation anxiety), ADHD and behavioral disturbances with intense temper outbursts.

I can’t help but wonder how many of these children have been given the diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) by other psychiatrists.

This particular diagnosis was created as a way to help identify children who did not show clear mania or hypomania but who struggle with long standing temper dysregulation, sadness and irritability. Could many of them be in this “bipolar-like “ group? Again, the answer requires more study.

The natural question from these findings for both parents and professionals is: Does treating the TBIs make any difference in how these kids actually end up functioning in real life?

Observations

Without more research, I can only comment about what I have observed in my practice with these children. There appears to be three groups:

  1. Kids who are treated for their bipolar symptoms as well as TBIs who at some point are able to do well once the infections are resolved or at least controlled. Their psychiatric symptoms appear to have been eliminated or significantly lessened enough that over time they can stop all psychiatric medication. This group is fairly small but definitely exists.
  2. Kids who are treated for BPD and TBIs but require less psychiatric medication (yet still need some) when their infections are under better control. One clue that the psychiatric medication can be lowered is the occurrence of side effects from the psychiatric medication (e.g. new onset of lethargy and sleepiness) that were previously not present while the child appeared to benefit from that dose of medication in the past.
  3. Kids who are treated for BPD and TBIs but still require significant doses of psychiatric medications as their infections come under better control.

Therefore treating the underlying psychiatric illness has the potential to change the long-term outcome in some youngsters who manifest bipolar disorder symptoms and were exposed to tick-borne illnesses.

The true prevalence of TBIs in youth who reside in the geographical area where my practice is located is unknown. This data is crucial to be able to interpret properly what I’ve found in my patients.

To what extent do infectious agents and autoimmune processes contribute to the present escalation in child and adolescent mental disorders? The mounting evidence supporting the connections of infections, autoimmune processes and mental disorders appears significant and demand more scientific investigation.

Dr. Rosalie Greenberg is a Board-Certified Adult, Child and Adolescent Psychiatrist, known for her expertise in the diagnosis and management of complex psychiatric problems in children, and pediatric psychopharmacology. For the past few years, she has focused on the psychiatric manifestations of infectious diseases, especially, tick-borne illnesses in children and adolescents. Her website is rosaliegreenbergmd.com.

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Lyme Brain & Fibro Fog: Natural Solutions Webinar

https://rawlsmd.com/webinars/lyme-brain-fibro-fog/?

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Lyme Brain & Fibro Fog

Live Webinar with Dr. Bill Rawls

Wednesday, July 21st
8pm EDT

Webinar can be viewed on any device

The physical symptoms of chronic Lyme disease and fibromyalgia are challenging on their own. But when your mental capacities start to waver, it can take levels of frustration and fear to a whole new level.

Why are Lyme and fibromyalgia sufferers so prone to brain and neurological symptoms, and what can you do to find effective and lasting relief?

Join an updated live webinar with Dr. Bill Rawls, author of the best-selling book Unlocking Lyme, who knows firsthand what it’s like to live with Lyme brain and fibro fog. He’ll explain why Lyme disease and fibromyalgia tend to target the brain, and share insights on the best herbs and other natural lifestyle remedies for overcoming symptoms and reducing the risk and severity of long-term degenerative cognitive conditions such as dementia.

You’ll learn exactly what you need to clear the fog and restore healthy cognitive and neurological function, so that you can get back to thinking and feeling like yourself again.

RESERVE MY SEAT »

In this webinar, Dr. Rawls will also discuss:

• Why cognitive symptoms like confusion, short-term memory loss, anxiety, anger, and depression are so common in chronic illness patients such as those with Lyme disease, fibromyalgia, and Long COVID.

• How microbes, inflammation, and immune dysfunction disrupt cognitive function

• The best herbs and natural remedies for restoring and protecting brain health

• Numerous insights during the live Q&A with Dr. Rawls

About Dr. Bill Rawls

Bill Rawls, M.D., is a physician and leading expert in Lyme disease, integrative health, and herbal medicine. In the middle of his successful medical career, Dr. Rawls’ life was interrupted by Lyme disease. In his journey to overcome it, he explored nearly every treatment possible – from conventional medicine to a range of alternative therapies. In the more than 12 years since his recovery, Dr. Rawls has helped thousands of patients find their path to healing from Lyme disease and chronic illness. He is the author of the best-selling book Unlocking Lyme, and the Medical Director of RawlsMD.com and Vital Plan, an online holistic health company and Certified B Corporation®.

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