Archive for the ‘Psychological Aspects’ Category

Living Well When You Don’t Feel Well: Overcoming Lyme Disease & Illness

http://  Approx. 18 Min

Living Well When You Don’t Feel Well

Overcoming Lyme Disease & Illness

Joe Trunzo PhD Professor of Psychology

Dr. Trunzo highlights a different way of thinking and coping with diseases (and life), specifically Lyme disease. 

He earned his undergraduate degree in 1993 from Marywood University in Scranton PA and completed his graduate work in 2000 at Drexel University in Philadelphia, PA. He completed his pre-doctoral internship at the University of Vermont and his post-doctoral fellowship at the Centers for Behavioral & Preventive Medicine at Brown University Medical School in Providence, RI. He is a Professor of Psychology and Chair of the Department of Applied Psychology at Bryant University. He is also a licensed, practicing clinical psychologist with expertise in the psychological management of chronic medical illnesses such as cancer and Lyme disease, as well as the treatment of mood and anxiety disorders, especially obsessive compulsive disorder. He serves on several professional committees and belongs to a number of professional organizations. In his spare time, he enjoys being with his family, live music, running, and mountain climbing.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

_______________

**Comment**

A very sane and logical talk on the Lyme/MSIDS controversy involving three camps of thought, which then moves on into how to develop a mindset that focuses on living the best life you can while sick.  Dr. Trunzo utilizes the mindfulness based, values-oriented behavioral therapy called ACT (Acceptance & Commitment Therapy) to help patients.

He states that by not accepting what patients are feeling and going through, they can trap themselves and create more problems.  I must throw in a personal note here: one of the most helpful things I was ever told early on by another patient who reached the other side was:

“Don’t be depressed about feeling depressed.”

This may be laughingly simple; however, I found that I needed to give myself permission to feel depressed.  Knowing, understanding and accepting the fact I was going to feel miserable and have some really rotten days (or months!) helped me tremendously.  Being chronically/persistently infected with multiple pathogens that work symbiotically and that are in your brain and virtually every organ of your body wreaking havoc, not only affects you physically but emotionally and spiritually.  Add in the fact that mainstream medicine denies this fact entirely and that your friends and family may choose to believe you are a hypochondriac rather than an extremely ill person who needs help, because after-all you “look fine” – and you can become very depressed and isolated indeed, which doesn’t help the healing process at all!

Obviously, the goal here is not to remain sick, but to achieve wellness and health; however, with Lyme/MSIDS that may take years to accomplish, and even then there is a very real potential that facets of your health may never return to the way they were before you became infected.  As with all things in Lymeland, everyone’s journey is unique to them and no two cases look alike.

For more:

Category:

Lyme, Psychological Aspects, Treatment

Suicidal & Homicidal Lyme Concerns Podcast

https://danielcameronmd.com/suicidal-and-homicidal-lyme-concerns/

SUICIDAL AND HOMICIDAL LYME CONCERNS

Suicidal and homicidal Lyme concerns

Welcome to another selection from my book “An Expert’s Guide on Navigating Lyme disease.” The books highlights the findings of my first 600 Lyme disease Science blogs.  In this episode, I will discuss suicidal and homicidal concerns in Lyme disease patients.

By 

Dr. Robert Bransfield from Rutgers-Robert Woods Johnson Medical School, Department of Psychiatry, has described suicidal and homicidal concerns in patients with Lyme and related tick-borne illnesses in his private practice. Likewise, in my practice I have seen patients with suicidal thinking.

SUICIDAL AND HOMICIDAL BEHAVIORS IN LYME DISEASE.

Dr. Robert Bransfield reports observing suicidal and homicidal behaviors in patients with Lyme and related tick-borne illnesses. Out of 253 patients, he found:

43% were suicidal; 32% were suicidal but not homicidal; 11% were both suicidal and homicidal. No patient was homicidal without also being suicidal. 25% had explosive anger but were not homicidal or suicidal. 10% had pre-existing depression. 97% reported depression after infection. Patients were ill an average of 8.4 years before being diagnosed and treated. Read more.

“Further disease progression contributed to him feeling desperate as a result of multiple late-stage symptoms.”

THREE PSYCHIATRISTS SHARE SUICIDAL AND HOMICIDAL CASES.

Three psychiatrists share published case reports supporting Bransfield’s concerns (Munir et al., 2017). “A 44-year-old male without any past psychiatric history presented with a third unsuccessful suicide attempt and was later diagnosed as having a Borrelia infection” (Bransfield, 2017). One month of medical therapy with intravenous ceftriaxone improved his mental status and resolution of suicidal ideation (Banerjee 2013).

Fallon described two cases in a 1995 paper. “I treated both of these patients, and in addition, I have been able to follow the status of Patient B over a span of 30 years. This patient was highly suicidal, had horrific intrusive images of killing others, and had violent impulses, which were eliminated with treatment. Patient A was also suicidal, violent, and physically assaultive to her son. Combined antibiotic and psychotropic treatment helped both patients.” Read more.

HOMICIDE, TWO ASSAULTS, AND SUICIDE IN LYME DISEASE PATIENT

An article entitled “A Fatal Case of Late Stage Lyme Borreliosis and Substance Abuse,” describes a patient exhibiting aggressiveness, violence, and homicidality. Like many Lyme disease patients, the man experienced a delay in diagnosis and treatment. (One study reports that subjects enrolling in a trial of Lyme encephalopathy were ill an average of two years before being diagnosed.)

The patient’s Lyme disease symptoms progressed. “Further disease progression contributed to him feeling desperate as a result of multiple late-stage symptoms,” wrote Bransfield et al.  According to Fallon et al., the number of Lyme disease patients who feel desperate is not clear.

Based on more than 30 years of experience treating Lyme disease patients, Dr. Bransfield previously described a wide range of neuropsychiatric symptoms in Lyme disease patients. “… 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.”

“A 44-year-old male without any past psychiatric history presented with a third unsuccessful suicide attempt and was later diagnosed as having a Borrelia infection.”

The patient’s condition worsened.  “The pathophysiological effects of the infection resulted in an increased number and severity of multisystem symptoms, disability, and substance abuse,” the authors wrote. “He experimented with multiple substances in an effort for relief.”

The authors added, “During acute deterioration of his mental state from phencyclidine withdrawal, NMDA agonism increased, he committed a homicide, two assaults, and suicide.”

In an earlier study, Dr. Bransfield described substance abuse, cannabis use, and intoxication in Lyme disease patients.

Bransfield and colleagues advised prompt diagnosis and treatment of Lyme disease to help prevent addictive disorders, substance abuse, and death.

“More effective diagnosis and treatment and attention to substance abuse potential in these patients may help prevent some cases of addictive disorders, substance abuse, and death.” Read more.

988 Suicide & Crisis Lifeline

The 988 Suicide & Crisis Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people 24 hours a day, 7 days a week in the United States. Anyone with the following concerns can call, text, or chat 988:

  • Mental health-related distress.
  • Thoughts of suicide.
  • Substance use crisis.
  • Emotional distress.
  • There are specialized services available for veterans, LGBTQ individuals and other groups.
  • People who are worried about a loved one who may need support also can call.
The 988 Suicide & Crisis Lifeline, available by simply dialing 988, is a 24-hour, toll-free, confidential suicide prevention helpline available to anyone in suicidal crisis or emotional distress. When someone calls the helpline, his or her call is routed to the nearest crisis center. The Lifeline’s national network, consisting of more than 250 local crisis centers, provides crisis counseling and mental health referrals day and night.
Related Articles:

Mental health in COVID-19 and Lyme disease patients

Lyme disease and depression

Lyme disease patients at risk for suicide

Category:

Lyme, Psychological Aspects, research

Can Microdoses of Psychedelics Effectively Treat Neuro-Lyme?

https://www.lymedisease.org/microdosing-psychedelics-lyme/

Can microdoses of psychedelics effectively treat neuro-Lyme?

Dr. Dan Kinderlehrer

By Daniel A Kinderlehrer, MD

Those of us dealing with Lyme disease are well aware that most symptoms reside in the musculoskeletal and nervous systems. And for many of us, the worst symptoms in the nervous system are neuropsychiatric. The severity of anxiety, panic attacks, depression, irritability and rage can be overwhelming.

Chronic tick-borne infections can also cause bipolar disease, addiction syndromes, eating disorders, obsessive compulsive disorder and psychosis.1-8 And of course, it is all compounded by impaired sleep, brain fog, fatigue and chronic pain, not to mention physician ignorance.

Neuroinflammation

It turns out that these mental health symptoms are primarily caused by inflammation from infection outside the nervous system.9

For example, kids with PANS—Pediatric Acute-onset Neuropsychiatric Syndrome—have infections in which antibodies to different microbes cross the blood brain barrier and attack the brain, resulting in severe mood and behavioral disturbances.10 A similar process occurs in adults with neuropsychiatric Lyme disease.11-13

There is increasing recognition that many mood disorders are linked to infections and autoimmune disorders, and the common link is neuroinflammation—brain on fire.14

It is no surprise that people with neuropsychiatric Lyme disease have elevated levels of inflammatory mediators including antineuronal antibodies, cytokines, chemokines and inflammatory lipoproteins.9  Think of neuropsychiatric Lyme disease as autoimmune inflammation of the brain. The primary legs of treatment are antimicrobials, psychotropic medications and anti-inflammatory agents. Ideally, an anti-inflammatory agent will decrease inflammation but not suppress immune function.

In March 2023, I published a report describing a patient with long standing Lyme disease, Babesia and Bartonella infections in which the primary symptoms were neuropsychiatric.15 He experienced anxiety with panic attacks, depression with suicidal ideation and sleeplessness.

These symptoms gradually came under control with appropriate treatment, but a change in his regimen resulted in a severe relapse. He could no longer tolerate even low dose antimicrobials without Herxheimer reactions, Zoloft was not helping and he could not tolerate Ativan for anxiety. In fact, any benzodiazepine increased his suicidality. That is when his daughter suggested he try microdosing.

A new approach: psychedelic microdosing

This is from the case study that I published:

After a 40-year prohibition in the US of lysergic acid diethylamide (LSD) and psilocybin, there has been renewed interest in their potential for therapeutic benefit. The preponderance of research in the past two decades has been in controlled clinical settings in which subjects are administered a single high dose of a hallucinogen while under the supervision of a therapist/guide. In 2018 the US Food and Drug Administration categorized psilocybin as ‘a breakthrough therapy’ in the treatment of depression, a designation the agency applies to drugs that in early trials demonstrate substantial improvement over existing treatments.16

There is compelling evidence that psilocybin has potential value in the treatment of some mental health conditions. Multiple studies have documented its effectiveness in patients with depression, anxiety syndromes, end of life anxiety, and suggested benefit in OCD and addiction disorders.17-23

Microdosing is the practice of consuming very low, sub-hallucinogenic doses of a psychedelic substance on a regular basis. The intention of microdosing is to offer similar benefits to full dose psychedelic therapy, but without perceptual distortions, the need for clinical oversight, or the risk of a bad trip.” 24

Microdosing has become increasingly popular. In one online microdosing forum that was begun in 2013, the number of subscribers rose to 40,000 in 2018 and 219,000 in October 2022.25 LSD and psilocybin continue to be listed as schedule I controlled substances, meaning legally they have no accepted therapeutic value. Nevertheless, possession of psilocybin has been decriminalized in many US cities and is on the ballot of many states to be legalized in clinical therapeutic settings; Oregon and Colorado have already done so.26

No longer suicidal

The subject of my case history began microdosing three times weekly at doses one-fiftieth of a typical hallucinogenic journey. Within two days he was no longer suicidal and within two weeks he felt well. He continues to microdose and feels well three years later.

No wonder they call psilocybin magic mushrooms. It is a potent stimulator of serotonin and may also have some influence on dopamine.27 But what may be more crucial is its anti-inflammatory action. It significantly inhibits pro-inflammatory cytokines such as tumor necrosis factor-alpha, interleukins IL-1b, and IL-6, and cyclooxygenase-2 concentrations in human macrophage cells.28-30

It turns out that most mental health disorders are caused by neuroinflammation. That’s right: most patients with anxiety, depression, bipolar disorder and even psychosis have inflammation in their brains driving their mood disorders.31

Neuroinflammation in these patients may be caused by undiagnosed tick-borne infections, but there are multiple other drivers of inflammation. Autoimmune diseases such as lupus, Sjögrens syndrome, rheumatoid arthritis and multiple sclerosis are well documented causes of neuropsychiatric illness.32-37  Stress by itself can result in inflammatory conditions.38 People with childhood histories of adverse events such as physical or sexual abuse have an increased risk of autoimmune problems.39

Patients with PTSD—Post Traumatic Stress Disorder—don’t just have hypervigilance and anxiety disorders. They develop the same nervous, immune and endocrine system dysregulation as patients with persistent tick-borne infections and neuropsychiatric disease.40

The role of genetics

Meanwhile, genetics plays a significant role in the development of autoimmune conditions. Add to this epigenetic transmission that alters gene expression without changing the underlying DNA expression, and allows for trauma to be handed down from one generation to the next41—just ask children and grandchildren of Holocaust survivors.

Microdosing psilocybin holds the potential to help patients suffering from these mental health issues. Numerous studies suggest that microdosing is effective in the treatment of anxiety and depression.42-46 Unfortunately, these studies are not controlled and are reliant on subject reporting—it is impossible to separate benefits from placebo effect. We clearly need better research on microdosing.

Presently Johns Hopkins University is recruiting for a study in which patients with PTLDS—Post Treatment Lyme Disease Syndrome—are treated with full hallucinogenic doses of psilocybin under the supervision of a therapist/guide.47 These ‘journeys’ last four or more hours in controlled settings. I hope this research finds positive benefits of treatment, but full dose psilocybin treatment demands excessive resources that will never be available to most patients with Lyme.

Those of us with “Chronic Lyme” know that PTLDS is actually persistent infection with Borrelia burgdorferi complicated by the existence of co-infections resulting in systemic inflammation—it is an autoimmune illness.48 In a review of the physiological effects of psychedelics, the authors Caitlin Thompson and Attila Szabo “…propose that psychedelics hold the potential to attenuate or even resolve autoimmunity.”

The bottom line is that microdosed psilocybin may be an important adjunct to the treatment of mental illness. It is time that we find the resources to perform properly controlled double-blind investigations into the impact of microdosed psilocybin on patients with neuropsychiatric Lyme disease as well as those suffering from the ever-increasing numbers suffering from mental health disorders.

Click here to read the entire case report.

Dr. Daniel Kinderlehrer is an internal medicine physician in Denver, Colorado, with a practice devoted to treating patients with tick-borne illness. He is the author of  Recovery From Lyme Disease: The Integrative Medicine Guide to the Diagnosis and Treatment of Tick-Borne Illness.

References
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  2. Bransfield RC. Lyme Disease, comorbid tick-borne diseases, and neuropsychiatric disorders. Psychiatr Times. 2007 Dec 1;24(14):59–61.
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  16. approval-priority-review/breakthrough-therapy (Accessed October 10, 2022)
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  24. Hutten NRPW, Mason NL, Dolder PC, Kuypers KPC. Motives and Side-Effects of Microdosing With Psychedelics Among Users. Int J Neuropsychopharmacol. 2019 Jul 1;22(7):426-434. doi: 10.1093/ijnp/pyz029. PMID: 31152167; PMCID: PMC6600464.
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  28. Nkadimeng SM, Steinmann CML, Eloff JN. Anti-Inflammatory Effects of Four Psilocybin-Containing Magic Mushroom Water Extracts in vitro on 15-Lipoxygenase Activity and on Lipopolysaccharide-Induced Cyclooxygenase-2 and Inflammatory Cytokines in Human U937 Macrophage Cells. J Inflamm Res. 2021 Aug 5;14:3729-3738. doi: 10.2147/JIR.S317182. PMID: 34385833; PMCID: PMC8352634.
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  41. Yehuda R, Lehrner A. Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms. World Psychiatry. 2018 Oct;17(3):243-257. doi: 10.1002/wps.20568. PMID: 30192087; PMCID: PMC6127768.
  42. Rootman JM, Kryskow P, Harvey K, et al. Adults who microdose psychedelics report health related motivations and lower levels of anxiety and depression compared to non-microdosers. Sci Rep. 2021 Nov 18;11(1):22479. doi: 10.1038/s41598-021-01811-4. PMID: 34795334; PMCID: PMC8602275.
  43. Lea T, Amada N, Jungaberle, H. Psychedelic microdosing: A subreddit analysis. Psychoactive Drugs. 2020;52:101-112. https://doi.org/10.1080/ 02791072.2019.1683260.
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  45. FadimanThe psychedelic explorer’s guide: Safe, therapeutic, and sacred journeys.  Simon and Schuster, New York, 2021.
  46. Johnstad PG. Powerful substances in tiny amounts: an interview study of psychedelic microdosing. Nordic Stud Alcohol Drugs. 2018; 35(1):39–51. https://doi.org/10.1177/1455072517753339
  47. https://classic.clinicaltrials.gov/ct2/show/NCT05305105 (Accessed June 30, 2023)
  48. Yehudina Y, Trypilka S. Lyme Borreliosis as a Trigger for Autoimmune Disease. Cureus. 2021 Oct 10;13(10):e18648. doi: 10.7759/cureus.18648. PMID: 34786243; PMCID: PMC8578812.
  49. Thompson C, Szabo A. Psychedelics as a novel approach to treating autoimmune conditions. Immunol Lett. 2020 Dec;228:45-54. doi: 10.1016/j.imlet.2020.10.001. Epub 2020 Oct 7. PMID: 33035575.

Category:

Inflammation, Lyme, Psychological Aspects, research, Sleep, Treatment

Unraveling Bartonella: Dr. Mozayeni

https://www.betterhealthguy.com/episode185

Episode #185: Unraveling Bartonella with Dr. B. Robert Mozayeni, MD

 
 
About My Guest

My guest for this episode is Dr. B. Robert Mozayeni.  B. Robert Mozayeni, MD is an expert in Translational Medicine, the science and art of advancing medical science safely and efficiently.  He is the Chief Medical Officer of Galaxy Diagnostics, LLC.  He is a co-founder of the Foundation for the Study of Inflammatory Diseases.  He serves as an advisor to pharmaceutical and nutraceutical companies and serves on an Institutional Review Board specializing in nutraceutical products for pain management.  He is the immediate past President of ILADS, the International Lyme and Associated Diseases Society where his goal was to advance the science of translational medicine.  In late 2019, Dr. Mozayeni launched T Lab Inc., a research and clinical laboratory engaged in research using advanced microscopy to understand better the pathogenesis of disease in inflammatory conditions associated with persistent infections.  He has research and clinical expertise with regard to autoimmune diseases and the effects of chronic infection and inflammation on vascular physiology and neurovascular conditions seen commonly with autoimmune and neurovascular diseases.  With a strong foundation in the basic sciences and evidence-based medicine, he analyzes complex medical cases using a combination of basic scientific principles and clinical experience along with the balance of the evidence base.  Dr. Mozayeni has published numerous papers on immunology and cerebrovascular blood flow hemodynamics.  He has been actively researching and publishing his work on chronic rheumatic diseases and their relationship to persistent human Bartonella spp. infection.  Of note, chronic persistent Bartonella spp. infections are strongly associated with neurovascular diseases.  Thus, Dr. Mozayeni is uniquely qualified in the combined areas of chronic persistent endovascular infections and related rheumatological and neurovascular diseases.   He has also published papers providing new insights as to a potential infectious  (Bartonella spp.) cause of osteoarthritis and also, a case of arthritis associated with hypermobility that was likely caused by Bartonella spp.

Key Takeaways
  • What advances have been observed in recent years in the realm of Bartonella?
  • What are common symptoms of Bartonella?
  • How is Bartonella transmitted?- Might Bartonella lead to autoimmunity?
  • Can Bartonella be a trigger for PANS?
  • Might Bartonella be a contributor to osteoarthritis?
  • Is there a connection between Bartonella and hypermobility or EDS?
  • Does Bartonella contribute to MS?
  • What is the connection between Bartonella and SIBO?
  • Can Bartonella act as a trigger for MCAS?
  • Is Bartonella activation observed in those with COVID?
  • What is the state of the art in Bartonella testing?
  • What is Babesia odocoilei?
  • What agents are most helpful in the treatment of Bartonella?
  • Is there a place for herbs and other natural interventions in Bartonella treatment?
  • Should pets be considered as a potential source of exposure to Bartonella?
Connect With My Guest

http://TMGMD.com

Related Resources

Article: Unraveling the Mystery of Bartonellosis

Transcript

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Category:

Bartonella, Cancer, Eye Issues, Heart Issues, Inflammation, Psychological Aspects

Abnormal MRI Leads to Lyme Encephalitis Diagnosis

https://danielcameronmd.com/abnormal-mri-leads-to-lyme-encephalitis-diagnosis/

ABNORMAL MRI LEADS TO LYME ENCEPHALITIS DIAGNOSIS

elderly woman with lyme encephalitis laying in hospital bed

Encephalitis is a rare manifestation of Lyme disease with brain parenchymal inflammation being documented in only a handful of cases. In this study, the authors present the case of Lyme neuroborreliosis with encephalitis with “significant parenchymal inflammation on MRI imaging in an immunosuppressed patient.” [1]

By 

In their article “Lyme neuroborreliosis with encephalitis: A rare case,” Rosendahl and colleagues describe a 74-year-old immunocompromised woman, who was admitted to the hospital with confusion, paranoid delusions, weight loss, back pains, and a history of fever and vomiting suspect of cancer and infection of unknown origin.¹

The woman had been hospitalized 4 times over a 4-month period.

She had a history of Lupus, myasthenia gravis (azathioprine and pyridostigmine treated), osteoporosis and atrial fibrillation. But did not have a history of dementia or psychiatric illness.

Initially, she was treated for possible bacterial meningitis and viral encephalitis.

The woman did not recall having a tick bite, EM rash or painful meningoradiculitis. “However, approximately three months prior the patient was efficiently treated for a non-itching universal skin rash with a topical steroid and antihistamines.”

This is the “first case of confirmed [Lyme neuroborreliosis] encephalitis with significant parenchymal MRI changes in a broadly immunosuppressed patient.”

Based on her spinal tap and MRI results, the woman was diagnosed with Lyme meningitis and treated with IV ceftriaxone followed by a week of oral doxycycline.

Her repeat spinal tap findings had improved. The hyperintensities in basal gangliae and thalamus resolved. However, she was left with cognitive problems, such as memory loss.

The authors discussed the need to consider Lyme encephalitis in a patient presenting with uncharacteristic symptoms for 3 months.

Note: This is a European case study involving a woman suspected of contracting Lyme disease from the tick species B. garinii. The results of this case may not apply to those in the U.S. involving infections from B. burgdorferi.

Related Articles:

Tick-borne encephalitis and Lyme disease can lead to chronic illness

Powassan virus encephalitis contracted during winter months

Lyme disease triggers inflammation in the ‘hindbrain’

References:
  1. Rosendahl SB, Ravn P, Lebech AM, Midtgaard Stenor CP. Lyme neuroborreliosis with encephalitis: A rare case. IDCases. 2023;31:e01704. doi:10.1016/j.idcr.2023.e01704

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Category:

Lyme, Psychological Aspects, research, Testing, Treatment