Archive for the ‘Psychological Aspects’ Category

Overcoming NeuroLyme Live Webinar: Dec. 15, 8pm EST

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Watch December 15th, 8pm EST

Chronic Lyme disease can manifest in seemingly endless ways. But neurological symptoms such as brain fog, limb pain, muscle weakness, anxiety, and more can feel especially debilitating, and they’re notoriously difficult to diagnose and overcome.

Why are some people more likely to experience neurological Lyme disease — and what can you do to feel better?

Join a live webinar with Dr. Bill Rawls, author of the best-selling book Unlocking Lyme, who knows firsthand what it’s like to live with chronic Lyme disease and neurological symptoms.

He’ll demystify neurological Lyme and share effective ways to restore your health and get much-needed symptom relief.

PLUS: Don’t miss an exclusive gift for webinar attendees, and have your questions ready for a LIVE Q&A on neurological Lyme disease with Dr. Rawls.

 In this webinar, Dr. Rawls will discuss:
  • Why neurological symptoms such as nerve and limb pain, headache, brain fog, memory loss, and more are so prevalent among Lyme patients
  • What causes neurological symptoms to become chronic and predominant in some people (but not others)
  • What your gut and common Lyme coinfections have to do with it
  • Why go-to and conventional treatments typically don’t work, and the six essential steps to effective recovery
  • The best therapies for easing symptoms and restoring health at the root cause
  • Numerous insights during the live Q&A with Dr. Rawls

RESERVE MY SEAT »

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For more:

Category:

Activism, Lyme, Psychological Aspects

Japan: More Oct. Suicides Than COVID-19 Deaths. Mental Health ER Teen Visits Up 31%. Nearly 40% of Young Adults Thinking About Suicide

https://www.theblaze.com/news/japan-suicides-covid-deaths-pandemic

Japan had more suicides in October than all of the COVID-19 deaths during the pandemic

Is the cure more harmful than the disease?
Excerpts:

The CDC data found mental health-related emergency room visits increased 31 percent for children between the ages of 12 and 17 from March to October compared to the same period in 2019. There was also a 24 percent increase in emergency room visits for children between the ages of 5 and 11.

The increase comes as in-person school schedules have been dramatically reduced to stem the spread of COVID-19, limiting children’s interactions with peers and teachers. In addition, sports and extracurricular activities have been limited or canceled — conditions that could isolate children at home and causing anxiety, depression, lack of sleep and bad eating habits. (See link for article)

https://www.newswise.com/coronavirus/more-young-adults-are-thinking-about-suicide-and-death-national-survey-finds/

More Young Adults Are Thinking About Suicide and Death, National Survey Finds

11-Nov-2020 by Rutgers University-New Brunswick
Newswise — Over a third (37%) of young Americans 18-24 report having thoughts of death and suicide and close to half (47%) show at least moderate symptoms of depression, according to a new nationwide survey by researchers from Harvard Medical School, Rutgers University–New Brunswick, Northeastern, Harvard and Northwestern universities.

Researchers say this is about ten times the rate observed in the general population prior to COVID-19.

The survey was published by The COVID-19 Consortium for Understanding the Public’s Policy Preferences Across States.  (See link for article)

Category:

Activism, Psychological Aspects, Viruses

COVID-19 & Lyme Disease Symptoms Overlap

https://danielcameronmd.com/covid-19-lyme-disease-symptoms/

COVID-19 AND LYME DISEASE SYMPTOMS OVERLAP

covid-19 lyme disease symptoms

There are a growing number of COVID-19 symptoms. Many of them, including neurological and psychiatric complications, overlap with symptoms of Lyme disease. Varatharaj and colleagues described neurological and neuropsychiatric complications of COVID-19 in an article published online in Lancet Psychiatry. [1]

By

The authors described complications reported in 153 COVID-19 patients in the UK, who had been admitted to the hospital with acute neurologic or psychiatric complications. Treating clinicians included specialists in neurology, stroke, psychiatry, and intensive care. More than 9 out of 10 patients had a positive COVID-19 test.

The most common presenting complication was a cerebrovascular event. According to the authors, 2 out of 3 patients had an ischemic stroke, 1 out of 3 had an intracerebral hemorrhage and 1 had CNS vasculitis. Patients over 60 years of age were more likely to present with cerebrovascular complications.

Nearly 1 out of 3 patients presented with an altered mental state. The study found that about 50% of patients with altered mental status were younger than 60 years of age.

These patients presented with unspecified encephalopathy, encephalitis, new-onset psychosis, neurocognitive (dementia-like) syndrome, and an affective disorder. “Seven (30%) patients had another psychiatric disorder, including 1 case of catatonia and 1 case of mania,” the authors wrote.

Author’s Note: The study has several limitations. The neurological and psychiatric complications of COVID­19 cannot be generalized to mildly affected COVID-19 patients. The study was not designed to determine how many patients had neurological and psychiatric problems prior to having COVID-19. Lastly, the study did not address how long these neurological and psychiatric problems last.

Neuropsychiatric symptoms of Lyme disease

Lyme disease patients can experience similar altered mental states, including encephalopathy.

According to one study, 24 out of 27 patients with chronic neurologic Lyme disease presented with mild encephalopathy. [2]

These altered mental states can have a wide range of presentations, explains Dr. Robert Bransfield from the Department of Psychiatry at Rutgers-Robert Woods Johnson Medical School.

“Lyme disease patients can also present with a wide range of neurologic presentations. LB [Lyme borreliosis] causes immune and metabolic effects that result in a gradually developing spectrum of neuropsychiatric symptoms, usually presenting with significant comorbidity which may include developmental disorders, autism spectrum disorders, schizoaffective disorders, bipolar disorder, depression, anxiety disorders (panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, intrusive symptoms), eating disorders, decreased libido, sleep disorders, addiction, opioid addiction, cognitive impairments, dementia, seizure disorders, suicide, violence, anhedonia, depersonalization, dissociative episodes, derealization, and other impairments.” [3]

Finally, Dr. Brian Fallon from the Department of Psychiatry, College of Physicians and Surgeons at Columbia University, described a wide range of neuropsychiatric complications of Lyme disease. In their paper, “Lyme disease: a neuropsychiatric illness,” the authors described Lyme disease patients who exhibited “paranoia, dementia, schizophrenia, bipolar disorder, panic attacks, major depression, anorexia nervosa, and obsessive-compulsive disorder.” [4]

Author’s Note: Neither Dr. Bransfield nor Dr. Fallon’s papers were designed to determine how many patients had neurological and/or psychiatric problems before becoming ill with Lyme disease.

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For more:  https://madisonarealymesupportgroup.com/2020/11/27/lyme-disease-the-other-epidemic-no-one-is-talking-about/

https://madisonarealymesupportgroup.com/2020/05/30/a-tale-of-two-pandemics-lyme-covid-19-dr-bransfield/

https://madisonarealymesupportgroup.com/2020/11/04/opinion-neurologic-problems-in-lyme-disease-also-seen-in-covid-19/

https://madisonarealymesupportgroup.com/2020/08/27/department-of-health-lyme-disease-covid-19-share-symptoms/

https://madisonarealymesupportgroup.com/2020/06/09/upstate-residents-seeing-a-tick-bite-illness-that-resembles-coronavirus/

https://madisonarealymesupportgroup.com/2020/08/01/as-symptoms-mirror-coronavirus-granville-family-warns-of-ticks-lyme-disease-threat/

https://madisonarealymesupportgroup.com/2020/08/03/is-it-coronavirus-or-lyme-disease-similar-symptoms-could-create-confusion/

https://madisonarealymesupportgroup.com/2020/07/02/lyme-disease-symptoms-could-be-mistaken-for-covid-19-with-serious-consequences/

Category:

Lyme, Psychological Aspects, research, Viruses

“Gaslighting” By Some Doctors Can Undermine the Chronically Ill

https://www.lymedisease.org/gaslighting-undermine-patients/

“Gaslighting” by some doctors can undermine the chronically ill

Carolyn Dedgnan, LymeDisease.org

By Carolyn Degnan

One of the biggest problems that chronically ill patients face is “gaslighting” from their physicians/practitioners. I’ve been familiar with that term when talking about a personal relationship.

However, I had never heard it applied to a doctor/patient relationship until I heard it used during the LymeMind 2020 conference. I was struck by how appropriate the term is to describe an abusive practitioner relationship.

What is gaslighting?

Gaslighting is a form of emotional abuse that causes someone to question their memory, perception, and sanity. (The expression originated from a play–then movie–called “Gaslight.” The word is now commonly used in the field of clinical psychology.)

Gaslighting in a personal relationship is usually when the abuser is a narcissist. The abuser denies, lies, minimizes, and undermines whatever it takes to plant seeds of doubt and confusion in the victim of his abuse.

When a physician practices gaslighting, the physician makes the patient feel like he/she is imagining their symptoms and then they tell the patient that he/she is depressed and needs anti-depression drugs.

Gaslighting happens to many patients, but it is most likely to happen to females with such conditions as chronic pain, sickle cell anemia, chronic fatigue syndrome, and chronic Lyme disease.

The reality is that the patient is NOT crazy and not all physicians gaslight–but the physician who does gaslight either:

1) doesn’t know how to treat the patient’s symptoms/disease or
2) has been taught by a national medical society to discourage and not treat this “type” of patient.

The only way for a patient to “win” is to walk away from that physician—but that also leaves the patient once again without any treatment and sometimes any hope of getting better. It may be hard for the patient to find another practitioner to work with them, because now the patient has been labelled as “difficult.”

Prevention

How do we help prevent gaslighting for the patient population?

  • Physician education about the disease is key
  • By empowering patients to know their rights to walk away from toxic physician relationships
  • Encourage support groups for every disease
  • Most importantly, promote physicians who are caring and do not gaslight their patients.

LymeDisease.org strives to provide names of qualified Lyme-literate practitioners through our Physician Directory. Many of them are members of ILADS (International Lyme and Associated Disease Society). Others are listed at the recommendation of a patient based on their experience with the practitioner or are listed at the behest of the practitioner.

Information garnered from MyLymeData, our patient-driven research study, shows that most Lyme patients who have improved substantially have been treated by a Lyme-literate practitioner.

Having a Lyme-literate doctor doesn’t guarantee that the patient won’t be gaslighted. But you have a much better chance of having a positive experience if the practitioner is educated on the disease.

Carolyn Degnan is Chief Operating Officer of LymeDisease.org. She recently blogged about “What I Learned From Having COVID-19.” She can be reached at cdegnan@lymedisease.org.

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For more:  https://madisonarealymesupportgroup.com/2017/01/11/sick-shaming-of-lymemsids-patients/

https://madisonarealymesupportgroup.com/2019/02/16/lyme-is-all-in-your-head-a-wake-up-call-to-mental-health-professionals/

https://madisonarealymesupportgroup.com/2018/06/04/ld-diagnosis-took-forever-because-of-mental-health-stigma/

https://madisonarealymesupportgroup.com/2019/11/29/its-all-in-your-head-medicines-silent-epidemic/

https://madisonarealymesupportgroup.com/2017/06/30/child-with-lymemsidspans-told-by-doctors-she-made-it-all-up/

https://madisonarealymesupportgroup.com/2019/11/22/differentiating-psychosomatic-somatopsychic-multisystem-illnesses-and-medical-uncertainty/

Category:

Lyme, Psychological Aspects

A Case of Borrelia Miyamotoi

https://www.nejm.org/doi/full/10.1056/NEJMcpc2004996?

Case 32-2020: A 63-Year-Old Man with Confusion, Fatigue, and Garbled Speech

Authors:  Shibani S. Mukerji, M.D., Ph.D., Kevin L. Ard, M.D., Pamela W. Schaefer, M.D., and John A. Branda, M.D.

The following was obtained from the case presented in the link above in the New England Journal of Medicine.A 63-year-old retired government employee who lived with his wife in northern New England had recently traveled to Florida and to rural Canada to hunt was evaluated at the hospital because of:

  • fever
  • confusion
  • headache
  • garbled speech
  • fatigue
  • vision changes & floaters
  • lymphocytic pleocytosis
  • elevated protein level in the cerebrospinal fluid (CSF)
  • worsening proteinuria and hypertension
  • flash of light accompanied by transient sharp pain in the left retro-orbital area and forehead, with monocular blurry vision
  • garbled and nonsensical speech with impaired comprehension
  • word-finding difficulty
  • photophobia
  • sonophobia
  • staring spells that lasted for 1 minute
  • low-grade fever 
  • somnolence
  • generalized weakness
  • unsteadiness
  • mild neck stiffness
  • unintentional weight loss of 10 kg in the past 6 months
  • nocturia
  • cachectic appearing
  • perseverative thoughts
  • unable to name days of the week backward
  • when asked to remember three words, he could recall only one word after 5 minutes
  • he reported that nine quarters equaled $4.25
  • dilated-eye examination revealed edema in both optic nerves

Interestingly, after IV acyclovir, ceftriaxone, ampicillin, vancomycin, and thiamine, he developed myoclonic jerks with marked lethargy, and the photophobia, and nonsensical speech persisted. He was intermittently impulsive and uncooperative. After 4 days of IV treatment he reported feeling better and having increased strength, allowing him to walk. On the fifth hospital day, he was calm and cooperative; oriented to person, place, and time; and able to follow complex commands.

Administration of broad-spectrum antimicrobial agents resulted in rapid improvement in his clinical condition within days despite increasing neurologic symptoms over the course of several months, findings that suggested meningoencephalitis.  Despite an extensive evaluation for likely causes of meningoencephalitis, a definitive diagnosis was not established. This patient’s presentation and clinical course are emblematic of challenges faced by clinicians, given that the causative agent in meningoencephalitis is identified in only 30 to 60% of cases, despite extensive and invasive testing.1,2

There are three important clinical features of this patient’s presentation:

  • uveitis associated with meningoencephalitis
  • subacute cognitive decline
  • clinical improvement after the administration of antimicrobial therapy

A unique feature of this patient’s presentation is his exposure to rituximab, a humanized chimeric anti-CD20 monoclonal antibody that causes B-cell depletion. The effects of rituximab should be considered when interpreting the results of IgG and IgM serologic tests. This concern is relevant to testing for West Nile virus infection and eastern equine encephalitis, both of which can cause neuroinvasive viral encephalitis and are endemic in the northeastern United States. The antibody response during these infections can be delayed or absent in patients with B-cell depletion.4,5 Such a response may also occur in Powassan virus infection, an emerging cause of viral meningoencephalitis in the United States that is transmitted by ticks.6

A key question remains: What pathogen can cause uveitis and meningoencephalitis and result in rapid clinical improvement after the administration of vancomycin, ampicillin, ceftriaxone, and acyclovir?

The authors point out that spirochete infections can cause uveitis and meningoencephalitis.

Due to the patient’s history of living in an endemic area for tick-borne diseases, is an avid hunter, whose condition improved dramatically after IV antibiotics, infection with borrelia species seemed a logical diagnosis.

The authors point out the problem with testing:

Testing for Lyme disease occurs as a part of a two-tiered algorithm and measures a person’s antibody response to the spirochete. Whether treatment with rituximab delays formation of antibodies in blood and CSF is unknown, thus complicating the interpretation of this patient’s serologic test results.

They further state that those with neurological Lyme infection often have abnormal imaging findings of the head or spine but that this patient had neither.

Then they state that B. miyamotoi, another borrelia species, causes a symptom complex that is consistent with this patient and that there are two case reports of meningoencephalitis in immunocompromised patients receiving rituximab, where B. miyamotoi was the causative agent.  These patients received rituximab for hematologic cancers, and in both, Wright-Giemsa staining of CSF showed spirochetes, and a definitive diagnosis of B. miyamotoi infection was made based on nucleic acid testing of the blood.

The authors state the patient’s recurrent fever but lack of rash also support a B. miyamotoi infection, but that the opthalmologic findings do not.  They admit; however, that there is limited understanding of B. miyamotoi but since other spirochetes can cause eye issues, B. miyamotoi is likely no different. ( I must add here that I know many Lyme disease patients who get recurrent fevers and have never seen a rash.  This is a perfect example of how researchers and doctors have falsely pigeon-holed Lyme symptoms into a box of their own making).  For more:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Regarding testing, a lumbar puncture targeting the glpQ gene of borrelia that causes relapsing fever, which is absent in Lyme disease, was positive. Serum showed strong reactivity on the ELISA that detects IgG antibodies directed against the GlpQ protein of B. miyamotoi.  Corresponding IgM ELISA was negative, consistent of B. miyamotoi infection of several months duration.

Unfortunately there are no randomized controlled trials and no formal treatment recommendations.  Patients typically receive Lyme disease treatment.  An in vitro study showed B. miyamotoi was susceptible to doxycycline, azithromycin, and ceftriaxone but not amoxicillin. (Again, I must add that current Lyme disease treatment advocated by the CDC/IDSA only works for a small percentage of patients and that studies from the beginning have shown treatment failures using their approach.  For more:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/)

The patient was sent home with 4 weeks of IV ceftriaxone but developed a facial rash and was switched to doxycycline.  After 3 weeks all symptoms had resolved but the blurry vision which improved slowly over 3 months.

This patient should be followed up for years, but won’t be.
And the question begging to be asked is: how many people with B. miyamotoi are falling through the cracks?  It isn’t even reportable to the CDC yet (which notoriously undercounts all things tick-borne-related).

For more:  https://igenex.com/tick-talk/what-you-need-to-know-about-borrelia-miyamotoi/

This article points out the confusion with B. miyamotoi: 

  • many separate it from other tick-borne relapsing fevers
  • while it can cause relapsing fevers, it sometimes doesn’t
  • it appears to be the only TBRF transmitted from a hard bodied tick, unlike TBRF which is mainly transmitted from a soft bodied tick (I remain skeptical of this as ticks have repeatedly been found to transmit things they shouldn’t – just like they are found in places they shouldn’t be.)
  • symptoms often resemble Lyme disease
  • you can be infected with BOTH B. miyamotoi AND Lyme disease (as well as numerous other coinfections) which will complicate symptom presentation
  • testing for B. miyamotoi is just as abysmal as it is for Lyme/MSIDS:  https://madisonarealymesupportgroup.com/2020/03/01/study-cdcs-2-tier-lyme-testing-inaccurate-in-more-than-70-of-cases/

Category:

Psychological Aspects, research, Tickborne Relapsing Fever, Treatment