By Amber Ellis
If Lyme didn’t have enough symptoms to go around, add depression to the list. As with any multi-systemic infection, the nervous system is not an exempt target. Changes to the brain and nervous system result in depression, as well as irritability, anxiety, apathy, depersonalization, and other mood imbalances. The medical community calls this Neuroborreliosis.
Depression or infection?
Physicians who diagnose depression aren’t often aware of or understand how common the connection is between depression and Lyme Disease. Instead of recognizing depression as the body’s indicator that something is awry, many doctors see depression as the problem itself.
This means patients seeking answers to their failing health are often diagnosed with depression well before they’re diagnosed with the core issue: infectious disease.
And the hard part about a prior depression diagnosis is that it predisposes very ill patients to stereotyping. Non-Lyme literate physicians who grasp at straws when faced with ambiguously connected, ever-changing symptoms say, “You don’t look sick,” “Everyone feels sad sometimes,” or “It’s all in your head.”
Trust your instincts
If you’ve received this kind of feedback from a doctor, don’t give up. Statistically, most Lyme patients have, unfortunately, heard these lines. Trust your instincts; the neurological aspects of Lyme are real and are gaining increased attention, in part to the awareness gained by Yolanda Hadid sharing her Lyme experience. And Professor Turhan Canli from Stony Brook University shared research gaining traction in his Ted talk that depression is actually a form of infectious disease.
Does that mean by treating Lyme your depression will subside? For some patients, that happens. For others, that claim is an oversimplification.
What to try
Like any puzzle, sometimes depression needs to be solved piece by piece. The nature of depression is complicated and the body’s inflammatory response to chronic infection is complex. Given that, there may be more than one reason why your nervous system is plagued with the effects of Lyme. Here are some to consider:
Anyone with chronic illness, like Lyme, can attest to the physical and mental toll being sick takes on you. There can be financial strains, changes to personality, loss of productivity, and a lack of overall control over life that trigger fear and frustration. The add-up of these factors can make for a heavy emotional load. Our brains repetitiously search for patterns in information and seek a dopamine reward for answers to the unknown. This dopamine reward system can incidentally lead to rumination. Over time, if these appropriate but unbound situational feelings continue to flood unchecked without the perspective of loved ones or qualified professionals, they can prompt depression and anxiety.
- Sleep Deprivation
A body fighting Lyme and its co-infections is usually a body chronically fatigued. Sleep is never refreshing. And sleep often doesn’t come easy with Lyme, as the many effects of the infection cause difficulty falling asleep and staying asleep. This becomes a problem long-term. Research from the Journal of Neuroscience, the Centers for Disease Control, and the UC Berkeley Walker Sleep Lab indicate that a lack of sleep causes physical changes to the brain.
Areas like our prefrontal cortex, amygdala, hippocampus, parietal lobe, brain stem, and other areas are affected. This means cognitive processes, communication between brain regions, and overall function are altered. Those changes on the inside show up on the outside as depression, lethargy, a tendency to focus on the negative, an inclination to include misinformation into our memories (which changes our outlook), and a struggle with dulled judgment and inhibited decision-making.
- Neurotransmitter Imbalances
Neurotransmitter reuptake is typically the area of focus when physicians treat depression. However, it’s important to focus both on reuptake of your existing neurotransmitters as well as production of new neurotransmitters. If you’re dealing with depression and Lyme, look into minimizing the bacterial overgrowth in your gut where neurotransmitter production and absorption occurs. Reduce inflammation (as much as possible) to help decrease the cytokines that inhibit neurotransmitter receptor sites. Decreasing stress can also aid in improving neurotransmitter production, particularly seratonin.
In Lyme, there are at least three pairs of neurotransmitters that can be out of balance:
Seratonin and Melatonin
If you’re feeling depressed, experiencing changes in appetite and sleep disturbances, you might be affected by low serotonin production. Melatonin pairs with serotonin; when serotonin suffers so does melatonin—the neurotransmitter that helps you fall asleep and stay asleep.
Dopamine and Norepinephrine
If you’ve noticed difficulty with alertness, balance, memory, or your sleep cycles are delayed, you may be dealing with a dopamine deficiency. Dopamine pairs with norepinephrine, which aids in the “fight or flight” response, decision-making, and motivation.
GABA and Glutamate
If you’re experience waves of anxiety and panic without triggers, trouble relaxing, and issues with muscle function, you could have a GABA deficiency. GABA works in tandem with glutamate. Since Lyme patients typically have an abnormal abundance of glutamate, their GABA is abnormally low. High glutamate causes depression and low cognitive function in general, indicating the need for more GABA.
- Hormone Imbalances
As with neurotransmitters, imbalances can exist with hormone levels during your immune system’s ongoing fight against Lyme. If you’re experiencing depression, it’s important to monitor your levels of thyroid hormones, cortisol, estrogen, progesterone, and testosterone. Depression, a lack of motivation, feeling in a fog, and a decreased sense of well-being and confidence could be indications of a hormonal imbalance from hypothyroidism, adrenal fatigue, insulin resistance, and/or low testosterone.
- Magnesium Deficiency
Lyme bacteria feeds on magnesium, so many Lyme patients experience a deficiency in this crucial mineral. If you’re dealing with depression, exhaustion, weakness, muscle cramps or spasms, headaches, head swelling, leg numbness, sleeplessness, or an abnormal heart rhythm, your magnesium serum levels may be depleted.
- Bartonella Infection
Bartonella is one of the common co-infections Lyme patients are exposed to along with Borrelia. There are several species of Bartonella, but the common factor between them is their ability to cross the blood brain barrier and affect the nervous system. It’s worth suspecting Bartonella if you have depression which doesn’t improve much with traditional treatments (like antidepressants). That could indicate you have less of a neurotransmitter imbalance and more of a structural defect in the brain brought on by inflammation from a Bartonella infection. Bartonella symptoms include:
- Neuroretinitis (inflammation in the brain)
- Aseptic meningitis (inflammation of the layers lining the brain)
- Transverse myelitis (inflammation of the spinal cord)
- Radiculitis (inflammation of the spinal nerve roots)
- Cerebral arteritis (inflammation of the small and medium-sized arteries in the brain)
If you’re on treatment for Lyme but your depression hasn’t subsided, keep up your patience and stay proactive. Talk to your physician about raising the priority level of your depression as a symptom. Look into reasons like those above one at a time to better determine if they apply so you know what treatment options can provide relief.