It IS Too in Your Head: Cognitive and Psychiatric Impact of Tick-borne Disease
Apr 01, 2017 04:30AM
By Roseann Capanna-Hodge
Lyme and tick-borne disease are complex diseases that produce physical, cognitive and psychiatric symptoms. One person may experience severe joint pain while another may have brain fog and anxiety; yet they both have a tick-borne illness. These symptoms can occur acutely or they can wax and wane in a more long-term, chronic manner. Symptoms can appear immediately after a tick bite, or sometimes weeks, months or years later, which make diagnosis and treatment even more complex. This also causes uncertainty for those questioning whether or not they have the disease. This waxing and waning of symptoms is confusing, making one wonder if the tick bite or Lyme disease one had months ago could be related to current symptoms.
Educating ourselves about Lyme and tick-borne disease—as well as finding a Lyme disease specialist—is critical for proper treatment. It is also important to understand that there are two stages to the disease: early- and late-disseminated Lyme disease. The former occurs within days to weeks after the tick bite. Treatment at this stage helps to prevent later problems. If not caught early, the infection may spread to other parts of the body, affecting the central nervous system (brain), the peripheral nervous system (nerves), the cardiovascular system, the liver, the eyes, and the muscles and joints.
During late-disseminated Lyme disease, inflammation most commonly affects the joints and nervous system; symptoms occur weeks, months or even years after a tick bite. This stage can also set in as little as two weeks after a bite. In some individuals, these symptoms may be the first symptoms of the disease, so they aren’t able to connect current depression or anxiety with a tick bite they had months or years before. Moreover, if we had issues like depression, anxiety or learning difficulties before Lyme disease, we may not make the connection to Lyme disease when these issues worsen.
One pediatric patient with a long history of learning issues was identified as having Lyme disease after a dramatic cognitive decline on IQ testing, as well as a decline in learning and behavior. He had been seen by a long list of physicians and psychologists over a two-year period without ever being treated properly, before we were able to clearly see on a QEEG brain map what was happening, and refer him to a Lyme disease physician for proper treatment. Sadly, this child had a clear-cut case of Lyme disease, which was identified and treated with antibiotics, but for only two weeks. When his symptoms immediately returned after the two-week period, his physician chose not to treat him further. Patients think, “Well, this doctor is a trained physician, so I have to trust them.” The patient’s mother objected to the physician’s lack of further treatment and sought help from other professionals, including a neurologist, but the patient was never tested or treated for Lyme disease again. This is an all too familiar story that leads to a case of Late-Disseminated Lyme, and more importantly, a lot of suffering and heartache.
Neurocognitive and neuropsychiatric symptoms can emerge either early or late in the disseminated phase of infection. In untreated Lyme disease, the encephalopathy can be moderate to severe, and can wreak havoc on an individual’s life. Unfortunately, the average person sees five to seven doctors before they are correctly diagnosed. A common scenario is that an individual is certain they have Lyme disease and go to their physician, only to be told they don’t have it or don’t meet the clinical criteria. Unless we take control of our own medical care or see a Lyme disease specialist, we may find ourselves thinking we just have a psychiatric issue without a medical source. Individuals often go down this road only to find that they don’t get much relief this way either.
Common Cognitive Symptoms of Lyme
The following symptoms are common cognitive issues:
• Short-term memory loss
• Difficulty with working memory and executive functioning tasks
• Difficulty sequencing information, verbal fluency difficulties (such as name or word retrieval)
• Slow processing (listening, oral and with written word),
• “Brain fog”
• Sustained attention
Common neuropsychiatric problems include irritability, emotional dysregulation, sudden rage/anger, nightmares, impulse control, conduct problems/oppositional behaviors, easy tearfulness, and anxiety or panic attacks. Depression, withdrawn behaviors, confusion, mania, OCD, paranoia and auditory/visual hallucinations are other issues. In addition, sleep disturbances, sensory hyperarousal (typically auditory, visual and touch) and social skills deficits are problems.
Other common problems include chronic fatigue, headaches, nausea, fibromyalgia, Bell’s palsy, nerve pain, arthritis symptoms, joint pain, multiple sclerosis symptoms, seizures and stomach problems. Frequent urination, constipation, vestibular dysfunction, unusual infections, low nutrient levels in the blood, and autism diagnosis or symptoms are issues as well. Look for a change in behavior or cognitive, social or physical functioning—especially after a known case of Lyme disease or a tick bite. It is important to recognize that Lyme and tick-borne disease can create new symptoms or exacerbate what was already there.
Because so many children and adults experience intense and acute psychiatric symptoms, we would be remiss if we didn’t discuss PANS, or pediatric acute-onset neuropsychiatric syndrome. This is when an infectious trigger (such as Lyme or tick-borne disease), environmental factors or other possible triggers create a misdirected immune response, resulting in inflammation in a child’s brain. In turn, the child quickly begins to exhibit life-changing symptoms such as OCD, severe restrictive eating, anxiety, tics, personality changes, decline in math and handwriting abilities, sensitivities to sensory input, and more (check PANDAsNetwork.org for more information). These behaviors and psychiatric issues can come on with such intensity that they are often completely debilitating.
Since the body is physiologically designed to deal with stress first and healing second; practicing daily relaxation techniques needs to be part of our healing regimen. A variety of brain-based techniques—such as neurofeedback, biofeedback, advanced bio-regulation therapy, meditation, hypnosis and EFT/tapping—can help the central nervous system to calm down, which then promotes self-healing.
Prevention is key. Even if Lyme disease is already present, other tick-borne illnesses may come from another tick bite. Be sure to follow the BLAST protocol (LymeConnection.org). Diet, exercise and stress reduction are essential for healing Lyme and other tick-borne diseases.
Roseann Capanna-Hodge, EdD, LPC, BCN, LLC, is a Ridgefield and Newtown-based educational psychologist and a board-certified neurofeedback practitioner with a focus on tick-borne disease and PANS/PANDAS. She is a mother of two boys, one of whom has chronic Lyme disease and PANS. Connect at 203-438-4848, [email protected] and DrRRoseann.com.com. See ad, page 10.