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It is common for people who have Lyme and associated diseases to have mental health issues. These issues are either:
Depression and anxiety are the most common issues but mental health problems can also include manic depression (bipolar illness), obsession and compulsion, attention deficit and hyperactivity, and other mental health problems.
To be clear, the mental health issues as part of Lyme disease are correctly diagnosed as mental health problems. By comparison some are also told all of the symptoms they experience with Lyme disease are somatic or in their heads and that essentially they are crazy. These diagnosis and opinions are incorrect. Wrongly, doctors who do not understand or who deny chronic Lyme disease say that problems with the illness are solvable with a good counselor and psychiatric medications.
Symptoms of depression can include:
Anxiety is also common and can be generalized and ongoing with some hills and valleys or can occur in extreme waves from out of nowhere as panic attacks. As noted above there are also other mental health problems. However, supplements and natural approaches are mainly useful for depression and anxiety so this article addresses these mental health issues only.
Ultimately, treating the mental health problems seen in Lyme and associated disease requires treating the underlying infections. There is a growing body of scientific research showing that inflammation causes depression and mental health problems. Lyme and the co-infections cause increased production of inflammation chemicals called cytokines. Read more about cytokines in Herxheimer Die-off Reaction: Inflammation Run Amok.
The Lyme germ itself can cause the full range of mental health issues described here. Bartonella, one of the co-infections, is known to cause the full range of mental health disorders too and is commonly the cause of ongoing anxiety and restlessness as well as depression. Babesia is known for causing anxiety panic attacks. To sort out the germs causing mental health problems and to receive correct germ treatment with anti-microbials, see a Lyme literate medical doctor.
In some cases treating with supplements is not enough. In these situations people may benefit from seeing a mental health professional for prescription or psychotherapy management.
Exercise treats depression as well as prescription medicines. In a 16 week trial of aerobic exercise Babyak and his colleagues proved this point (1). In fact they also showed that exercise does a better job in preventing depression relapse than medications. Their study showed by 4 months of treatment, exercise or medications work about 60% of the time to completely lift depression. And 6 months after treatment nearly 90% of the exercise group no longer had depression compared to 60% of the exercise group.
Exercise also helps control anxiety.
Exercise appears to work by raising chemicals called endorphins. Another benefit is the endorphins can also help with pain.
In Lyme and other fatiguing illnesses, exercise has to be handled with care. Too much can cause worsening of Lyme overall. A general rule of thumb I tell my patients is to exercise to tolerance. This means find an amount of exercise you can do that does not leave you worse off the next day with your Lyme disease symptoms. This can include activities like walking.
Meditation has many helpful effects. A regular sitting meditation practice helps anxiety and depression.
Shamanic practitioners work with helping healing spirits to heal medical and mental health conditions. While shamanism may not be right for everyone, based on spiritual beliefs, for many it is very helpful.
To read more about Shamanism see The Foundation for Shamanic Studies established by Michael Harner PhD and Sandra Harner PhD. Dr. Michael Harner is an anthropologist who studied many of the shamanic cultures from across the world. He showed that shamanism is native to all people including caucasian populations. In fact the term Shaman comes from Siberia.
Curcumin, a component of the seasoning turmeric lowers inflammation cytokines by limiting production in white blood cells and lowering oxidizing agents that trigger cytokine production. Glutathione lowers cytokines by decreasing toxins and oxidizing agents that cause inflammation.
Hypericum perforatum (St. John’s wort) is a commonly used herb for depression. It is not entirely clear how it works. 5 hydroxy-tryptophan is a building block that raises the neurotransmitter serotonin in the brain. Increased serotonin can alleviate depression and anxiety. (By comparison common anti-depressants from the SSRI family like prozac, zoloft, paxil, and celexa decrease the brain's removal of serotonin leading to higher brain levels.) L-Theanine is an amino acid prologue that decreases nerve hyperexcitability and can raise the neurotransmitter gaba that calms nerves. Lithium orotate at supportive dosing changes neurotransmitters so there is calming. Dosing used to calm is 15 to 30 mg a day compared to prescriptive dosing of 600 mg to 900 mg a day used to treat manic depression. An herbal combination productcan contain a variety of calming herbs for the treatment of anxiety like valerian root, l-theanine, kava kava, hops, and/or chamomile.
Consider the Lifestyle recommendations discussed above and lower inflammation. If these are not effective then use the natural medicines for depression or anxiety listed below.
Start with either hypericum perforatum or 5 hydroxytryptophan. In 3 weeks if no benefit is seen then change to the other. (Note that neither one of these herbs should be taken with prescriptive anti-depression medicines because they may cause serotonin syndrome that could lead to death.)
Start with L-theanine for anxiety alone. For depression with anxiety start 5 hydroxyryptophan. Try the lithium orotate and the herbal combination product alone or in combination with L-theanine or the 5 hydroxytryptophan.
The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.
Marty Ross, MD is a passionate Lyme disease educator and clinical expert. He helps Lyme sufferers and their physicians see what really works based on his review of the science and extensive real-world experience. Dr. Ross is licensed to practice medicine in Washington State where he treated thousands of Lyme disease patients in his Seattle practice through late 2018. Marty is currently on sabbatical in Austin, TX. Dr. Ross plans to reopen his Seattle Lyme practice in early 2020.
Marty Ross, MD is a graduate of Indiana University School of Medicine and Georgetown University Family Medicine Residency. He is a member of the International Lyme and Associated Disease Society (ILADS) and The Institute for Functional Medicine.
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