Mental illness, in general, is a huge problem in children and adolescents. Anyone in the United States can attest to the gravity of the problem by observing some of the mass shootings and suicides that have occurred in the past five years. In the United States alone, 4,000,000 children and adolescents suffer from a serious mental disorder that interferes with functioning. In fact, one-half of all lifetime mental disorders start by age 14.[i] I am not implying that Lyme disease is the root cause of this mental illness, but it is important to consider the relationship between children, mental illness and Lyme disease. Lyme disease is one possible cause of psychiatric symptoms in kids.
Children with Lyme disease have exhibited psychiatric symptoms such as rages, social withdrawal, suicidal ideation (approximately 40% of kids, according to parents, with 11% actually making a suicide attempt or gesture), irritability and mood swings, anxiety, panic attacks, paranoia, hallucinations and, in some cases, violent and criminal behavior. Children can also have violent and vivid dreams that are frightening and disturbing for them.
Rosalie Greenberg, M.D., a pediatric and adolescent psychiatrist, presented on tick-borne illness and the pediatric brain at the ILADS convention in Washington, DC in 2014. She described her work with children who are diagnosed with bipolar disorder (she has also written a book on the topic called Bipolar Kids: Helping Your Child Find Calm in the Mood Storm). Dr. Greenberg cites a study that she undertook of 14 subjects.[ii] Of the 14, 6 were diagnosed with Mycoplasma, 3 with Borrelia, 10 with Babesia, and 4 with Bartonella. All 14 bipolar children were diagnosed with a tick-borne illness of some kind, with Babesia cited as the most common infection. However, only one of those children also presented with joint pain. This indicates that children may present differently than adults, and it also supports the idea that children tend to present with more central nervous problems than peripheral problems.
In another study of 11 children with anxiety and/or mood disorders, five males and six females between 6 and 13 years of age were examined.[iii] Ten out of eleven children tested positive for a tick-borne illness (Fry lab testing was also performed and all 11 children tested positive on their tests). Four tested positive for Borrelia, eight for Babesia, one for Bartonella, two for Protomyxzoa and six for Mycoplasma pneumonia.
Therefore, in the two previous studies, of the 25 children diagnosed either as bipolar or having an anxiety/mood disorder, 12 had Mycoplasma pneumonia, 7 Borrelia, 17 Babesia and 5 Bartonella.
I also found it interesting that Babesia was easily the most common co-infection, where I have historically associated Bartonella with more severe psychiatric manifestations. This has significant clinical repercussions, and it reflects the importance of screening for all co-infections through lab work but also through observation and clinical presentation.
Certainly these studies are small and, as Dr. Greenberg herself stressed, need replication and further investigation. However, it does point to an association between tick-borne illness and psychiatric manifestations in children. As Sandy Berenbaum, LCSW, stated to me once during an interview: “Better an accurate diagnosis be made and the child treated, than they be committed to a lifelong road of medication and psychiatric diagnoses.”
What if a portion of those 4 million children have been affected by tick-borne illness? And what if antibiotic therapy could reduce or ameliorate some or all of those symptoms in those children? I’ve seen plenty of cases where children’s mental states have shifted and improved dramatically throughout Lyme treatment. As with anything, it’s not going to be the case for everyone and there are many causes of mental illness. But if one child finds relief and freedom for their life, isn’t that worth looking for?
[i] Kessler, R C, W T Chiu, O Demler, K R Merikangas, and E E Walters. “Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.” Arch Gen Psychiatry 62, no. 6 (July 2005): 617-27.
[ii] Greenberg, Rosalie. “Tick-Borne Diseases and the Brain: Implications for Pediatric Psychiatry.” ILADS Conference 2014. Washington, DC, October 10th, 2014.
[iii] Greenberg, Rosalie. “Tick-Borne Diseases.”