The psychological symptoms of Lyme disease can sometimes mimic mental health disorders, which can lead to misdiagnosis.
During her decades as a mental health counsellor, Christine Hammond’s patients sought her help with disturbing psychological symptoms: severe depression, anxiety, paranoia, delusions, hallucinations, and even brief psychotic episodes. But in some of these patients, the cause of what appeared to be textbook mental health problems was not a chemical or functional disorder of the brain, but Lyme disease.
The US Centers for Disease Control and Prevention records around 30,000 cases of Lyme disease annually. Although the true number of infections – usually caused by the Borrelia burgdorferi bacterium – may affect as many as 475,000 people in the United States each year, whilst in Europe more than 30,000 cases of Lyme disease are recorded annually.
This figure is significantly higher than for diseases such as West Nile virus, dengue fever and malaria, which are spread by blood-feeding arthropods such as mosquitoes, ticks and fleas. In the United States, Lyme disease is primarily contracted through the bite of black-legged ticks, which carry the infectious bacteria.
Although the disease typically begins with a rash, fatigue, headaches and fever, which can usually be successfully treated with antibiotics within a few weeks, some patients develop such a wide range of physical and psychological symptoms that they cause long-term impairment of normal daily life, even long after the infection should have cleared.
Misdiagnosis of chronic symptoms
In cases where people are unaware that they have been bitten by a tick, doctors either misdiagnose these chronic symptom clusters or label the patient as having a psychosomatic condition. Hammond has encountered both.
“There really isn’t much information out there about Lyme disease and how it affects people mentally or psychologically,” says Hammond.
Whilst some patients arrived at Hammond’s practice having already been diagnosed with Lyme disease, others became his patients following misdiagnoses. One had been diagnosed with fibromyalgia, whilst another had been told they had early-onset Alzheimer’s and had begun treatment as a result.
Another patient – about whom Hammond wrote in a 2019 article on the overlap between Lyme disease and mental health issues – was struggling with anxiety and depression. A doctor ran several tests but was unable to establish a clear diagnosis and labelled the patient as having a psychosomatic condition.
According to Hammond, when doctors dismiss patients, this can sometimes exacerbate their mental symptoms, particularly depression and paranoia. The frustration of not finding acceptance or appropriate treatment can lead to tragic outcomes.
“I have had several clients who not only had suicidal thoughts but also attempted suicide, which was a direct consequence of their Lyme disease not being taken seriously,” says Hammond.
The overlap between long-term Lyme symptoms and those of other illnesses leads doctors to make poor or unconvincing decisions, says Daniel Cameron, a New York-based doctor who runs a private practice and specialises in the diagnosis and treatment of Lyme disease and other tick-borne illnesses.
Although Christine Hammond is a psychologist and not a doctor, she often encourages her patients to request further neurological investigations, particularly if their symptoms do not resolve with therapy or medication. Many have done so, and it has turned out that they have Lyme disease. And once they have been properly diagnosed and treated, their mental health problems have often improved, even if their physical symptoms have not subsided.
“I think we’re doing a great disservice when we don’t take our patients seriously, don’t believe them, and don’t really listen to what they’re saying, and don’t look for solutions beyond the usual, the tried and tested,” says Hammond.
However, this may be changing thanks to the COVID-19 pandemic. Hammond, along with many doctors across America, are seeing an increasing number of patients with so-called ‘long Covid’. Like those suffering from long-term Lyme disease, these patients report various clusters of symptoms that continue to affect their health for weeks, months or even a year after the infection has cleared.
“Many of the symptoms and problems that people experienced with Lyme disease are now also appearing in cases of long-term COVID,” says Hammond, noting that severe and recurrent depression is the most significant of these symptoms.
Hammond hopes this will encourage more doctors and counsellors to provide Lyme disease patients with the help and support they truly need to live a better life.
“As mental health professionals, it is our responsibility to take patients seriously when they come to us, and to be the support they truly need,” he says. “The difference this makes is simply enormous.”
Source: Discover Magazine
(C) Lyme Borreliosis Foundation
