Jyoti Kinghorn 
Depersonalization is when a person feels completely detached from themselves and their surroundings. They do not feel an emotional connection with anything in their life. This is one of the symptoms of Lyme disease, a tick-borne illness that adversely affects a person’s physical and mental health.
The disease is contracted upon being bit by a tick infected by Borrelia burgdorferi and other species of this pathogen, such as Borrelia garinii and Borrelia afzelii. Being bacterial, the disease can be treated in a majority of patients with antibiotics if it is found early. The first symptoms often include fever, and fatigue, and a non-itchy and non-painful rash that can expand and look like a “bullseye”- a dark center with a ring around it.
Chronic Lyme disease and PTLDS
Lyme disease can be chronic due to delayed treatment because people don’t discover the disease in time. In other cases, the antibiotic treatment is given, but the patient’s symptoms do not fully go away. This condition is called post-treatment Lyme disease syndrome (PTLDS) and affects 5-30% of people who get Lyme disease.
Untreated Lyme disease and PTLDS can cause a variety of physical and neurological symptoms.
Symptoms of chronic Lyme disease include:
- Arthritis
- Severe headaches
- Stiffness of the neck
- Heart palpitations
- Irregular heartbeat
- Nerve pain, shooting pains, or numbness in hands or feet
- Dizziness
- Loss of muscle tone in the face causing facial palsy or facial paralysis
- Inflammation of the spinal cord or brain
- Cognitive impairment
- Mental health issues such as depression and anxiety.
Symptoms of PTLDS include:
- Fatigue
- Musculoskeletal pain
- Cognitive issues
- Light or sound sensitivity
- Mental problems such as mental fog, difficulty thinking, rage, anxiety, and depression.
Lyme disease and mental health
Lyme disease that does not get cured by antibiotics can have long-lasting adverse effects on mental health. The disease affects the psychiatric and psychological well-being of patients in two ways.
Firstly, the infection directly affects the brain and the central nervous system causing symptoms such as hallucinations (e.g. hearing sounds that are not there), sensitivity to light and sound, not being able to see vibrations, not being able to track words on a page, and depression.
Secondly, constantly experiencing symptoms such as never-ending fatigue and pain can cause depression and anxiety. Not being able to get the correct diagnosis for their symptoms, not being able to get a treatment that works, and feeling disbelieved and dismissed by their physicians can add extreme stress to a patient who is already being pushed towards rage, depression, anxiety, and decreased frustration tolerance due to the infection.
A study published in the American Journal of Psychiatry reports that being diagnosed with Lyme disease increases a person’s risk of developing a mental health disorder by 24%. The risk increases to 79% when the patient is diagnosed twice or more, which would happen if the patient kept experiencing symptoms and had to get tested again after completing the antibiotic treatment at least once. Long-term Lyme increases the risk of suicide and is a cause of over a thousand suicides every year in the U.S. alone.
What is depersonalization
Depersonalization and derealization are among the psychological and neurological symptoms that are sometimes experienced with chronic Lyme and PTLDS.
In depersonalization, a person feels disconnected from anything that is going on around them. No person, object, or event elicits a normal or expected emotional response. The patients feel complete apathy, even about themselves.
This can be a cause of distress and frustration not only for the patient but also for their family members and caregivers because it can make them feel unloved and unappreciated.
At least 52% of the patients with Lyme disease are found to experience depersonalization as a symptom.
Treatment options
Lyme disease is a physical infection that can turn into chronic physical and mental problems. The disease requires a multidisciplinary treatment approach.
In his publication about the neuropsychiatric effects of Lyme disease, Dr. Robert Bransfield from the Department of Psychiatry at Rutgers-Robert Wood Johnson Medical School wrote that “He who knows Lyme borreliosis knows about medicine, neurology, psychiatry, immunology, psychoimmunology, neurochemistry, ecology, epidemiology, entomology, law, politics, and ethics.”
Like syphilis, Lyme disease is called the great imitator. What appears as arthritis, schizophrenia, bipolar disorder, and the flu can be Lyme disease. Patients can sometimes spend years going from doctor to doctor getting treatments they don’t need for conditions they don’t have, which cause them unnecessary side effects and never treat the root of the problem
Even when Lyme disease is diagnosed, the treatment path is far from standard and what works for one patient may not work for another.
Currently, treatment therapies for Lyme include antibiotic therapy, followed by psychiatric treatments. Combination approaches can sometimes help patients. Experts recommend examining the patient’s particular symptoms and finding the treatment regimen that works best for them.
Scientists have noted that infection from Borrelia burgdorferi in its host species (deer and other animals) does not cause the same physical and psychiatric effects in the animals as it does in humans. They postulate that the effects of Lyme may not only be due to the infection itself but also due to the immune responses the human body generates in response to the infection. Therefore, it may be possible that treatments that modulate immune responses are also beneficial for Lyme disease.
Mental support strategies
Mental support strategies for Lyme patients differ from other patients with mental health disorders. Standard behavior therapies such as CBT (cognitive and behavioral therapy) may not be helpful to patients who have Lyme disease, who may instead benefit from a more tailored approach and therapies such as ACT (acceptance and commitment therapy).
Family members of people who suffer from Lyme disease can support the patient by offering compassion and understanding for their condition. People with Lyme may not get better until they find the right treatment. But a supportive family environment can reduce the feeling of rejection and frustration of not feeling heard or understood. Patients suffering depersonalization can especially feel alienated as their disease prevents them from enjoying day-to-day life. Understanding from loved ones can help them maintain some sense of social belonging.
The information provided in our blog posts is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
