A couple of days ago, a lovely family came to see me at my office. They were struggling with their 7-year-old son, who had started exhibiting neurological symptoms including tics and tremors, as well as quite severe behavioral issues including aggressive behavior, self-injurious behavior and paranoia. He became agoraphobic, and had incredibly high anxiety. The first thing I thought about was chronic infections that could underlie these types of issues. I have seen various pathogens in the body create all of these things. Often when children start exhibiting traits like this out of the blue, we often think of it as adaptive to their life circumstances, often a manifestation of stress or unhappiness, or simply that they are going through a stage. I’m sure there are absolutely cases where this is true. However, I believe that in many cases there is a physiological reason that must be found and addressed. Here are five infections that can cause aggressive behavior in children and can be fairly easily tested for:
(1) Group A beta-hemolytic streptococci (GABHS)
GABHS can cause the childhood illness rheumatic fever, but can also lead to neurological issues that gives rise to uncontrolled movements, motor tics, phonic tics, OCD and ADHD. It can also lead to aggressive/ defiant behaviors. This neurological symptom picture was renamed PANDAS – pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. It is autoimmune in that the antibodies the immune system creates in response to the strep infection actually attack the brain tissue, and this is what actually causes the symptoms. Blood testing for streptococcus antibodies can help identify this disorder.
(2) Candida albicans
Another potential cause of aggressive behavior in children in Candida overgrowth in their gut. Candida gives off toxins, including aldehydes, which are similar in structure to alcohol. They can cause all kinds of behavior – I have seen aggressive behavior resulting from Candida. I have also seen quite the opposite – giggly, silly, laughing-hysterically-for-no-reason type behavior. Bed wetting and night waking may be caused by Candida. I assess this by doing a Microbial Organic Acid Test (through the Great Plains Laboratory), which measures metabolites of yeast in the urine.
(3) Clostridia difficile
Anyone who has been infected with Clostridia difficile (aka C. diff) knows that it can cause unrelenting watery diarrhea, abdominal pain and cramping. That is certainly true in acute C. diff infection. Clostridia may also manifest in a less acute fashion – it may produce more chronic issues, both digestive and otherwise. I have seen Clostridia markers elevated in many kids I have worked with, as evidenced also by elevations in certain markers on the Microbial Organic Acid Test. Clostridia is a major cause of aggressive, oppositional behavior – I see this both in kids on the autistic spectrum and not on the autistic spectrum.
(4) Borrelia burgdorferi and other Borrelia species
By textbook definition, Borrelia burgdorferi is the bacteria that causes Lyme disease. Lyme disease is theoretically a tick-borne illness; in reality it has many other routes of transmission, including from mom-to-baby in utero. Lyme disease is well known for causing neurological issues. One of the terms that comes out of that is Lyme rage, manifesting as irritability, anger, aggressive and sometimes violent behaviors. Testing for Lyme is not a perfect science, there are many false negatives, and testing through labs such as Labcorp and Quest tends not to be highly sensitive. I do all my Lyme testing through IGeneX, a specialty Lyme lab.
(5) Bartonella henselae and other Bartonella species
Bartonella is one of the co-infections of Lyme, which means it is often transmitted through the same bite, or the same mode of infection, as the Borrelia bacteria. Bartonella is the co-infection that causes a lot of psychiatric symptoms – very high anxiety, panic attacks, OCD, paranoia and aggressive behavior. This is especially true in children. Bartonella can also be tested for via IGeneX labs but false negatives are possible there too.
These infections are among many possible causes of aggressive behavior in children, but they are prevalent enough to warrant testing for. Three out of these five do require a blood test (which can be done in a single draw), which can be challenging with kids, but the Candida and Clostridia can be assessed via a urine sample. I have seen (and treated) many kids who were housing these underlying, chronic infections, and I can attest to the fact that treating these infections can dramatically improve, and often resolve, these issues. I feel so sad for the kids that are impacted by underlying infections – their nervous system has been taken hostage and they cannot help the behavior they are displaying. To me it is worth looking into a physiological cause, rather than assuming that their behavior is simply rebellious, or that they are just inherently aggressive children.