Brief
Overview of Depression, Herxheimer Reaction, and Treatment Suggestions in Lyme
Disease Patients by Anna Satalino, MS
Depression
from Lyme disease can be caused by a multitude of factors including predisposed
genetic history, direct physical dysfunctions seen in Lyme disease, indirect
effects of having an illness that effects multiple body systems, one’s support
system, financial impact, medical misinformation, social stigma of having Lyme
disease and other factors. Depression is the most common psychiatric syndrome in
Lyme disease and although depression is common in any chronic illness, it is
more prevalent in Lyme patients than in most other chronic illnesses. Levels of
depression may vary from simply
experiencing uncomfortable feelings of doom, or experiencing a more sustained
version, even to the point of gross debilitation. In a study of sero-positive
Lyme patients conducted by Dr. Fallon, 85% experienced sleep disturbances; 94%
experienced extreme fatigue; 84% suffered from irritability and agitation; 24%
had worked through suicidal plans, while many more admitted to suicidal
thoughts; 83% had difficulty with concentration and memory and most patients
reported a significant loss of libido and interest in other aspects of their
lives. Most of the patients commented on the guilt they felt for the length of
time they were ill; for the physical, mental, and financial toll their illness
was taking on their families; and for not being able to “will” themselves
well. The physical and psychological presentations of Lyme affect a patient’s
whole family. Bransfield (2008) noted that once depression or other psychiatric
syndromes occur with Lyme disease, treating them effectively improves other Lyme
disease symptoms as well and prevents the development of more severe consequences,
such as suicide.
Suicidal risk is increased in Lyme patients due to illness impairments.
However, suicidal tendencies associated with Lyme disease follow a somewhat
different pattern than is seen in other suicidal patients. Suicide is difficult
to foresee in Lyme patients. Some attempts are very determined and serious and
although a few attempts may be planned in advance, most are of an impulsive
nature (Bransfield, 2008).
While patients are undergoing their antibiotic therapy it is common to
experience a ‘Jarisch Herxheimer Reaction’ (healing crisis) in which both
physical and psychological symptoms may increase in intensity. Dr.
Bock (1999) described the
Jarisch Herxheimer reaction as an
exaggeration of symptoms (which is due to the spirochetes reaction to being
destroyed, similar to what occurs in case of syphilis). In Lyme disease, this
Herxheimer-like reaction can be quite prolonged-lasting a few days or longer-and
can be frightening to patients who are expecting a resolution, not a worsening,
of their symptoms. The reaction can sometimes be difficult to distinguish from
an allergic reaction to the medicine, a distinction with obvious and crucial
treatment implications. Both suicidal and homicidal tendencies can be part of a
Jarisch-Herxheimer reaction.
Antidepressants can treat depression and suicidal tendencies in adjunct
with psychotherapy. It has been demonstrated that anti depressants increase
natural killer cells and aid the immune functioning in other ways as well. It is
important to treat the mind and body in Lyme disease and a mental health
professional trained in the area of chronic physical disease can assist through
therapeutic protocols that have proven effective such as meditation and
relaxation exercises, exercise and nutrition, biofeedback, effective coping
skills, and helping patients follow and adhere to treatment regimens.
It is crucial to keep the lines of communication open, especially with
someone with Lyme and tick related diseases. The patient and family should
report any concerning changes in behavioral and/or physical symptoms to their
physician and therapist. There is a 24 hour crisis hotline available to those
that are feeling despair, suicidal, or just need to talk about what they are
experiencing; The hotline is called Response and the number is: (631)
751-7500,so utilize this service if you need to, this is what they are there for
J
Bock,
S. (1999). The integrative treatment of Lyme disease. Retrieved January 3, 2008,
from http://www.Rhinebackhealth.com
Bransfield,
R. (2008). Lyme, depression, and suicide. Retrieved January 3, 2008, from http://www.lymealliance.org/bransfield/bransfield_3.php
Fallon,
B., & Nields, J. (1994). Lyme disease: A neuropsychiatric illness. Retrieved
January 8, 2008, from http://www.jersey.net/~joebur/introfal.htm
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