Finding an engorged, blood-sucking tick attached to your skin can cause anxiety in and of itself. After all, Lyme disease, an infection that causes multi-systemic, waxing-and-waning symptoms, and a disease that isn't always detected or effectively treated early on, is on the rise. But researchers are starting to realize that, although getting bitten may be stressful, tick-borne infections could actually trigger panic attacks and other psychiatric disorders in some people. "After treating thousands of patients with tick-borne disease in the past 20 years, it appears psychiatric symptoms are more commonly seen when there is a co-infection," explains psychiatrist Robert Bransfield, MD, former president of the International Lyme and Associated Diseases Society (ILADS) and president of the New Jersey Psychiatric Association. Co-infections (when a tick passes along more than one disease) most often involve Lyme, babesiosis, a malaria-like infection that can cause fever, night sweats, and anemia; and bartonella (cat scratch fever), a bacterial infection that causes fever, headache, and raised skin rashes. Co-infections are most often culprits in tick-related panic attacks and anxiety, and these multiple infections from tick bites are quite common, occurring in an estimated 30 percent of cases.
Dr. Bransfield, who is also associate director of psychiatry at Riverview Medical Center in New Jersey (a state with a high prevalence of Lyme disease), points out that 240 peer-reviewed scientific articles demonstrate an association between Lyme and other tick-borne diseases and mental illness. For instance, a small study published in The Clinical Journal of Pain in 2005 found that patients experiencing panic attacks also suffered other symptoms not typical of standard panic attacks—extreme sensitivity to light, touch, and sounds, joint pain, mental fogginess, and migrating pain, all of which can be symptoms of Lyme disease—and those people tested positive for Lyme and babesiosis, which, like Lyme, is on the rise in the U.S. Once treated with antibiotics for both diseases, the patients no longer experienced panic attacks.
Another study published in the American Journal of Psychiatry in 1994 found that 40 percent of patients with Lyme disease develop neurological impairment, which may not surface for months or years after a tick bite. Psychiatric reactions included not only panic attacks, but also bipolar disorder, schizophrenia, dementia, obsessive-compulsive disorder, anorexia, and depression.
"Many of the psychiatric symptoms of Lyme and associated tick-borne diseases are mediated by immune mechanisms," Dr. Bransfield explains, adding that the in Lyme sufferers, the immune system gets thrown out of whack. Furthermore, things like infection and stress can weaken and provoke the immune system, causing chronic inflammation, which has been linked to mental disorders. Ultimately, there needs to be better interaction between infectious disease specialists, immunologists, and mental health practitioners, Dr. Bransfield says.
Tick-borne diseases could, quite literally, push you over the psychological edge. And although other insect-borne diseases like West Nile virus may garner more headlines, you're far more likely to be sickened by a tick, according to U.S. Centers for Disease Control and Prevention statistics. For instance, 2009 saw 720 cases of West Nile virus, while nearly 40,000 probable cases of Lyme disease occurred that year. (Many doctors specializing in Lyme treatment believe Lyme disease numbers could be much higher because tests detecting the disease are not very reliable.)