Depression & Anxiety: Basic Approaches and Natural Medicines.

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Mental Health, Anxiety, and Depression in Lyme disease treatment image from Marty Ross MD

It is common for people who have Lyme and associated diseases to have mental health issues. These issues are either

  • a normal and understandable reaction to feeling ill, or
  • organic: caused by the the Lyme germ or the Lyme disease co-infections.

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.

Lyme Is Not in Your Head

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.

Depression & Anxiety in Lyme Disease Treatment

Depression & Anxiety in Lyme Disease Treatment

Symptoms of depression can include:

  • a feeling of hopelessness,
  • difficulty falling or staying asleep,
  • decreased interest in the things a person normally likes to do,
  • guilty feelings,
  • poor concentration,
  • decreased energy,
  • increased or decreased appetite,
  • suicide or escape thinking, and
  • thinking over a problem again and again.

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 guideline addresses these mental health issues only.

Germs and Inflammation

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 our article 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.

Counseling

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.

Lifestyle

Exercise

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

Meditation has many helpful effects. A regular sitting meditation practice helps anxiety and depression.

Shamanism

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 has studied many of the shamanic cultures from across the world. He has shown that shamanism is native to all people including caucasian populations. In fact the term Shaman comes from Siberia.

Herbs

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-tryptophanis 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-Theanineis 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.

Recommendations

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.

Inflammation

  • Curcumin 500mg 1 pill 3 times a day and
  • Glutathione 500mg 1 time a day. Use a liposomal glutathione to increase oral absorption. Consider nebulized glutathione to breath in the medicine or IV glutathione for more severe cases. See Glutathione: The Great Fixer for more information about the various ways to take this medicine.

Depression

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.)

  • Hypericum Perforatum 300-350mg 1 pill 3 times a day.
  • 5 Hydroxy-tryptophan 50mg 2 pills 3 times a day.

Anxiety

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.

  • L-Theanine 100mg 1 to 3 pills 3 times a day (do not exceed 12 pills in 24 hour period). Adjust amount based on pain response and sleepiness.
  • 5 Hydroxy-tryptophan 50mg 1- 2 pills 3 times a day.  Try 1 pill 3 times daily intially for 2 weeks and if not effective enough then increase to 2 pills 3 times a day.
  • Lithium Orotate 5mg. 1-2 pills 3 times a day.
  • Herbal Combination 1 to 2 pills 3 times a day.

References

  1. Babyak, Michael et. al. Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months. Psychosomatic Medicine 62:633–638 (2000).

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