Lyme and tick-borne diseases have been shown to adversely impact mental health. Because of the high incidence of these infections in our state, Vermont’s mental health providers should be aware of the psychiatric and cognitive symptoms of tick-borne diseases.
Vermonters with tick-borne diseases may be misdiagnosed as having mood or anxiety disorders, eating disorders, learning disabilities, dementia, or psychiatric illness.
Dr. Brian Fallon, director of the Lyme Disease Research Program at Columbia University, cites five questions that suggest warning signs of Lyme encephalopathy:
- Are there markers of non-psychiatric disease such as erythema migrans rash, arthralgias or arthritis, myalgias, headaches, sound or light sensitivity, paresthesias, tremors or twitching, cardiac palpitations, word-finding problems, short-term memory loss, cranial neuropathies, radicular or shooting pains?
- Is the psychiatric disorder atypical or unusual? For example, does a panic attack last longer than the expected 1/2 hour? Or is it a first ever panic attack at age 50?
- Is there poor or paradoxical response to psychotropic medications, or excessive side effects/sensitivity to these medications?
- Is this new-onset disease without psychological precipitants such as new stressors or secondary gain?
- Is there an absence of a personal history or family history of major psychiatric disturbances?
Neuropsychiatric symptoms of Lyme disease/Lyme encephalopathy**:
Mood and cognitive disturbances
Slowed processing—visual and auditory
Visual-spatial difficulties—e.g. trouble finding things, getting lost
Auditory processing disorders
Visual processing disorders
Sensory integration disorders
Short-term and working memory difficulties
Word-finding, word generation and communication difficulties
Decline in executive functions—planning and organization
Confusion, decline in overall intellectual performance
Anxiety, often with panic attacks
Irritability/rage attacks/impulse dyscontrol/violent behavior/oppositional defiance disorder
Rapid mood swings that may mimic bipolarity (mania/depression)
Obsessive Compulsive disorder (OCD)
Autism Spectrum-like disorders
Vermonters with late-stage Lyme and tick borne infections may present with a variety of neurological and psychiatric problems, ranging from mild to severe.