Lyme disease, Depression, Anxiety, Inflammation, Hormones, Amino acid therapy, Spiritual healing

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A Top-Down Approach to Healing Mental-Emotional Disorders in Lyme Disease

By Connie Strasheim

As a former Lyme disease patient, researcher, and advocate for many others with Lyme disease, I’ve found that the mental and emotional symptoms caused by Lyme are amongst the most challenging to treat and debilitating to live with. Depression and anxiety are rampant in people with chronic Lyme and, depending on their severity, can complicate recovery on multiple levels.

Depression, anxiety, and the varied manifestations of these conditions may be caused, first and foremost, by inflammation and toxins from the infections, such as ammonia, as well as limbic system dysfunction, which puts the body in a perpetual sympathetic or “fight or flight” response. In addition, mold, heavy metals, and other toxicities common in those with Lyme cause mental-emotional issues that compound the problem.

Add to this the fact that people with Lyme disease face a myriad of situational challenges, such as financial stress, isolation, a lack of compassion and understanding from their health care practitioners and loved ones, and other symptoms such as unrelenting pain that compound the depression and/or anxiety.

Last but not least, Lyme disease often exacerbates mental-emotional disorders that preceded infection with Lyme. I believe that depression and anxiety can even open the door for infections and toxins to gain a foothold in the body. Prolonged trauma or stress can cause these conditions, and program the body to operate in a state of continual sympathetic dominance, or fight or flight mode, which weakens the immune system.¹ In addition, stress and trauma, especially when they occur as a result of long-standing childhood abuse, cause people to adopt harmful beliefs, thoughts, and behavioral patterns, which also adversely affect the immune system.

To illustrate, award-winning journalist Donna Jackson Nakazawa states in her book, The Last Best Cure, “Scientists are now showing in wide scale studies that long ago childhood trauma and adversity play a significant role in how well our immune system functions in adulthood, impacting our lifelong health.”² She also shares that Dr. Anastasia Rowland-Seymour, a clinician and assistant professor of internal medicine at Johns Hopkins, contends that early life trauma sparks neural pathways and a pattern of hormone and inflammatory chemical cascades that impact the body at a cellular level for decades. It sets in place an early pattern of inflammation and cellular aging that significantly increases the person’s risk of developing all kinds of disease later in life.³

Therefore, healing must address all causes of the depression and/or anxiety. Often, I’ve heard practitioners state, “The patient will feel better (emotionally) once we address the infections.” They may then prescribe an antidepressant or a benzodiazepine, or some valerian root or 5-HTP to manage their patients’ symptoms in the meantime.

Unfortunately, for people battling severe depression and anxiety, these measures are often insufficient; and, if patients are given pharmaceuticals, this can cause them greater harm in the long run, as I just shared.

I myself took a variety of antidepressant medications and benzodiazepines for years, to manage the severe anxiety and depression that accompanied my battle with Lyme disease. However, in hindsight, I regret doing this as I paid a very high price—psychologically, physiologically and otherwise—as a result of taking them. The withdrawal process was horrendous, and I believe they further damaged my body.

It is no small matter to take prescription antidepressants and benzodiazepines. While they can be helpful in the short run, and even essential for people who find themselves in life threatening or very debilitating situations, they can present a whole new array of unacceptable symptoms and long-term challenges that affects patients’ health adversely, on top of whatever infections they may be battling.

Benzodiazepines, in particular, have been shown to cause brain damage and cognitive dysfunction, and cause dangerous, protracted and sometimes months or years-long withdrawal symptoms.⁴

Robert Whitaker, New York Times bestselling author of the book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, says, “French researchers surveyed 4,425 long-term benzodiazepine users and found that 75 percent were ‘markedly ill to extremely ill . . . a great majority of the patients had significant symptomatology, in particular major depressive episodes and generalized anxiety disorder, often with marked severity and disability.”⁴ Lyme disease patients have enough of that as it is.

Again, I believe there is a place for medications in recovery, but I have found that there are often better tools to manage depression and anxiety in Lyme disease—but it takes time, patience, wisdom, and understanding to learn how to utilize these effectively. It took me over a decade to discover and implement these tools for myself; but because of what I’ve learned, I am now fully recovered, without medication.

During the years that I was really sick though, the depression and anxiety, which were caused by Lyme and other factors, affected every aspect of my life: from my ability to interact with people and participate in society, to my ability to follow my treatment regimen and find work opportunities. Most importantly, these conditions affected my motivation, judgment, and my belief in my body’s ability to heal. This is because depression and anxiety cause people to see reality in a pessimistic, fearful, and negative light, and foster a chronic state of hopelessness that can keep them mired in symptoms and a mindset that treatments can’t and don’t work for them.

This is why I believe that physicians and other health care practitioners must address depression, anxiety, and/or related mental-emotional disorders in their Lyme patients because it is a person’s spirit and mindset that impacts his or her recovery above all else. This is what I’ve learned from a decade and a half of personal experience, as well as from my experiences with other Lyme patients and interviews with doctors.

Further, anxiety and depression keep the body in a perpetual state of sympathetic dominance, which isn’t conducive to healing. When the body is in this state, the immune, digestive, and neuroendocrine systems don’t work properly, and toxins build up in the body.¹

Yet depression and anxiety are multifactorial in people with Lyme disease, so remedying the symptoms isn’t always a simple as taking an antidepressant or an herb. Again, these simplistic approaches can work for some, but probably not most, although it depends on the severity of the symptoms, among the other challenges that the patient may be facing, such as a lack of social or financial support.

In my earnest passion and desire to provide people with Lyme disease with better answers and to spare them the same kind of intense suffering that I went though, I published a book this year entitled, Happy, Healthy and Free: Spirit-Soul-Body Solutions for Healing from Depression. While the book primarily focuses on depression, most of the principles also apply to those with anxiety disorders, as well. It is targeted to those with neurological illness, although I don’t provide protocols for eliminating infections or toxins in the book because there are plenty of other books that do that.

Instead, I share tools and strategies for addressing the spiritual, emotional and physiological causes of depression in people with neurodegenerative diseases like Lyme and mold illness, the latter of which is a common Lyme co-condition.

First and foremost, the book is based on the premise that we are a spirit with a soul and a body, not a body with a soul and a spirit. The distinction is important because if our spirit is the core or essence of who we are and the highest level of our being, then it means that it can influence the lower two levels of our being: our soul and body, when we care for and nurture the spirit properly. Renowned integrative Lyme-literate doctor Dietrich Klinghardt, MD, PhD, who contributed a chapter to my 2016 book, New Paradigms in Lyme Disease Treatment: 10 Top Doctors Reveal Healing Strategies that Work even alludes to the fact that spiritual healing is the highest level of healing there is, in his 5 Levels of Healing philosophy.⁵

Yet, I’ve observed that spiritual and emotional healing are often given lesser priority in Lyme disease treatment by many doctors and patients. It’s usually treated as secondary to the physical causes of disease such as infections and toxins because, in general, little focus is devoted to emotional health as part of patients’ recovery. Even those of us that espouse emotional and spiritual healing as foremost in recovery often invest little time or energy in it in our day-to-day lives.

I believe this lack of focus is because 1) deep down, we don’t really believe healing emotional and/or spiritual issues can be the key to resolving severe illness; 2) healing the emotional or spiritual aspects of disease feels too difficult or time-consuming; or 3) treatment guidelines for healing the soul (mind, will, and emotions) and the spirit are often vague and provide no guarantee of any kind of physical healing, which is what a person in agony with Lyme disease believes they need most.

However, I found in my own healing journey that addressing the psycho-emotional causes of illness was at least as important as addressing infections, toxins and other physical causes of disease, if not more. I progressed exponentially faster in my healing by paying attention to and investing in my recovery from the mental-emotional causes of disease. I’ve witnessed the same in many other Lyme patients.

Therefore, in Happy, Healthy and Free: Spirit-Soul-Body Solutions for Healing from Depression, I share tools and strategies for healing depression on all three levels of the person, regardless of the initial triggering cause of the depression. The spiritual component of healing is based on the premise that our human spirit was created for relationship with a loving God who is energy and light (as some know God) but also a person with a will and emotions.⁶ Spiritual healing isn’t about following rules or religious practices but realizing that all of us are deeply loved by our Creator, who desires for us to be totally healed and in a close relationship with Him. I have seen people healed by this realization alone; and in Happy, Healthy and Free, I suggest some ways for readers to connect with God and receive divine healing.

For the healing of the mind and emotions, which can also take place as a byproduct of spiritual healing, I share a variety of mind-body tools. Among the most important of these tools are brain re-training programs. These involve re-wiring the brain, especially the limbic system, using affirmations, visualizations, and body movements, among other techniques. Brain re-training programs such as Dynamic Neural Retraining (DNRS) or Gupta’s Amygdala Retraining entrain the brain out of a “fight or flight” response, while re-programming, or teaching the mind to adopt healthier beliefs and thoughts.

Many anecdotal reports from Lyme-literate physicians such as Neil Nathan, MD, author of Toxic, illustrate that these programs have been extremely effective for healing people from depression and anxiety and disorders linked to limbic system dysfunction such as Lyme disease, chronic fatigue syndrome, fibromyalgia, and others.⁷ I’ve even heard of people experiencing remission from multiple sclerosis and Parkinson-like symptoms, which are often related to Lyme.

Brain training teaches people how to identify harmful beliefs, thoughts and behaviors related to disease, and how to replace those with life-giving beliefs, thoughts, and behaviors. This is not so easy to do when you are battling a neurological disease; but speaking from personal experience, it can be done. In Healthy, Happy and Free I share this, as well as a few other tools for creating a positive, life-giving mindset. I believe that it’s difficult to get well if your mind is a constant mess of negativity, but the good news is, I have found these and other tools to help even the most depressed and brain-fogged of people to get well in this area.

Additionally, I encourage readers to examine their relationships, and I share tips for how to identify those that may be life draining versus life giving. Toxic relationships can be a hindrance to recovery and a major cause of mental-emotional symptoms. Lyme presents a whole slew of challenges when it comes to relationships, and throughout the book, I share some of my own challenges and how I handled those so that I could recover.

Discovering one’s purpose in life and taking practical steps to walk that out can also help some people to overcome depression and anxiety. When people are sick, it can be difficult for them to see the forest for the trees and believe that they have something to offer the world—that their life yet has meaning and purpose, even when they can’t do much or their emotions are in disarray. Helping people to discover their life’s purpose, even while they are in recovery, and helping them to take baby steps to walk that out in practical ways (even if that means simply spending a few minutes daily to create a mental picture of an ideal future, in as much detail as possible) can become a source of hope that gives people something to look forward to as they recover.

Finally, in Healthy, Happy and Free, I share tools that address the physiological causes or aspects of depression, which include but aren’t limited to infections, neurotransmitter, hormone and nutrient imbalances, inflammation (especially in the brain), gastrointestinal problems, mitochondrial dysfunction, and blood-sugar imbalances—among a few others.

Following, I highlight, in very basic terms, solutions for some of the most important of these. More about these and the other tools that I recommend can be found in Happy, Healthy and Free. I am also currently creating a companion workbook that people can use to more easily implement the tools contained therein.

Amino Acid Therapy

Neurotransmitter imbalances are a foremost cause of depression and anxiety in Lyme, mold illness, and other toxicity/infectious conditions. The primary neurotransmitters that regulate mood and cognition (as well as energy and sleep) are dopamine and serotonin, although acetylcholine and GABA also play a role. These tend to be low in people with Lyme, especially dopamine and GABA, although at times there can be excesses, particularly of serotonin, due to metabolic dysfunction.

The amino acid precursors to dopamine are L-phenalalaline and L-tyrosine, and the precursors to serotonin are L-tryptophan and 5-HTP. Therefore, giving patients dopamine and serotonin precursors can be very helpful for mitigating depression. I have also found GPC choline and phosphatidylcholine to impact mood. In addition, the body uses these latter two to make a neurotransmitter that aids in cognition, called acetylcholine, as well as for cellular detoxification and cell membrane repair.

GABA and serotonin precursors can be useful for managing anxiety. However, caution is warranted when prescribing dopamine precursors to people with severe anxiety, as they can exacerbate the condition.

It may also be important for some patients to take methylators along with amino acids, since many with Lyme have methylation issues that prevent them from being able to synthesize and break down neurotransmitters. Some common methylators used for this purpose include methyl B-12, SAM-e, P5P, pyridoxl phosphate and methyl-folate. It’s important to dose these slowly, preferably one at a time, and according to patients’ lab and/or genetic test results.

If you prescribe your patients amino acids and they either feel no differently or feel worse when taking them, consider that methylation problems may be why. The first time I took 5-HTP for sleep, I felt more brain fogged and depressed on it, until I realized that my body needed methylation support. Then, it worked beautifully.

Another consideration when dosing amino acid precursors is to make sure that new amino acid imbalances aren’t created in the body. Serotonin and dopamine must be present in a balanced ratio, for instance; otherwise, patients can feel worse. Doing an amino acid and neurotransmitter panel through labs like Sabre Sciences may be helpful for determining what patients need.

For more information on amino acids and how to use them, see Healthy, Happy and Free. Julia Ross, MA, has also written some good books on amino acid therapy.

Hormone Balancing or Replacement Therapy

Lyme disease causes adrenal and thyroid hormone imbalances, both of which can cause depression and/or anxiety. Hypothyroidism is a foremost cause of depression, and adrenal insufficiency can cause both depression and anxiety, depending on the severity and other factors.

A couple of Lyme-literate doctors have shared with me that their 20, 30, and 40-something year-old female patients with Lyme disease sometimes have a hormonal status that looks similar to that of a woman in menopause.

Therefore, balancing the hormones with adaptogenic herbs such as ashwaghanda and licorice, adrenal and thyroid glandular formulas, and bioidentical hormone replacement therapy is crucial not only for mitigating depression and anxiety but also for helping the body to more effectively overcome disease. Cortisol and thyroid hormones, in particular, are vital for immune function and emotional wellbeing, although low or too-high levels of estrogen, progesterone and testosterone can also profoundly affect the mood, especially in women and men over 35.⁸

Hormone balancing is a complex topic but one that I encourage people with Lyme and their practitioners to explore. One of the most powerful things that I did for my recovery, seven years after I got sick, was to begin taking pregnenolone, DHEA and progesterone for adrenal gland support, along with bio-identical thyroid hormone. I was only 37 years old at the time but wish I had started the therapy much sooner.

Anti-Inflammatory Therapy

I never knew how much inflammation in the brain could cause depression until I experienced it for myself. Inflammation seemed to be a lesser cause of the depression I battled, until at some point later in my healing journey when I was exposed to mold and developed mast cell activation disorder (MCAD). The inflammation created by MCAD and mold illness was profound, and with that, the depression.

I found mast cell stabilizers and H1 histamine receptor blockers, such as the compounded medication ketotifen, to shut down the worst of the depression caused by MCAD. Mold and Lyme-literate Neil Nathan, MD, recommended this to me. In his new book, Toxic, Dr. Nathan also recommends cromolyn sodium, loratadine (Claritin), famotidine (Pepcid), and natural antihistamines like quercetin and HIST DAO and Allqlear to treat MCAD.⁹ A low histamine-diet also may be helpful for some people.

Inflammation in the brain can also be quelled at times by taking omega-3 essential fatty acids, intravenous phosphatidylcholine, cannabinoids (CBD and CBN) and natural herbal anti-inflammatories like Chinese Skullcap. I have even found licorice to provide some benefit. Brain retraining is another powerful tool for reducing inflammation, at least based on anecdotal evidence, which is now substantial.

Blood Sugar Support

Blood sugar dysregulation is also common in those with Lyme and related co-conditions and has been found to cause or exacerbate depression. Hypoglycemia, for instance, is an oft-unrecognized cause of depression. There are several ways to support proper blood sugar balance.

The first and most logical way is by prescribing patients a diet that emphasizes healthy fats and proteins, and which is relatively low in carbohydrates. Paleo, The Plant Paradox, GAPS, or ketogenic are a few such diets. Encouraging patients to have a bedtime snack can help those with hypoglycemia or unstable blood sugar to sleep longer and more deeply.

Intermittent fasting can be helpful for lowering insulin levels and bringing high blood sugar back into the normal range, but I believe fasting can also make blood sugar imbalances worse in the long run for some people. This is because fasting causes the body to release adrenaline, and in people who battle adrenal fatigue, fasting may exacerbate this condition. The more exhausted the adrenal glands, the worse blood sugar imbalances may become, perpetuating a vicious cycle.

I’ve done weeks-long vegetable and juice fasts and always ended up weaker and more compromised at the end. Fasting has tremendous benefits, but it’s not for everyone. Even a 16-hour fast can be difficult for a person with adrenal insufficiency, which is many people with Lyme.

On another note, natural substances such as chromium, cinnamon, and berberine have been found to help the body utilize glucose. In one study, berberine was found to be just as effective as the diabetes drug metformin for lowering insulin and blood sugar.¹⁰

Mitochondrial Support

The mitochondria, or the cell’s energy powerhouses, are often compromised in people with Lyme and depression. Indeed, one study found that people with depression had significantly fewer mitochondria, or energy producing organelles, than those who weren’t depressed.¹¹ In another study, elderly women with good cognitive function were found to have greater numbers of mitochondria than those with poor cognitive function associated with depression.¹²

Nutrients that facilitate mitochondrial health and provide energy to the cells include coenzyme Q10 and acetyl-L-carnitine. Both of these nutrients also have mood-enhancing properties, due to their ability to reduce oxidative stress and toxicity in the neurons and improve energy within the cells. Studies have shown CoQ10 levels to be significantly lower in people who are depressed or have chronic fatigue.¹³ Consequently, CoQ10 can improve symptoms of depression. And, in another study, acetyl-L-carnitine was found to alleviate chronic depression.¹⁴

Gut-Healing Diets and Supplements

Brain function has been intimately linked to gut health, and vice versa. Certain gastrointestinal bacteria have been found to influence mood,¹⁵ and most neurotransmitters are made in the gut. Therefore, optimizing gut health is important for healing from depression and anxiety.

In Healthy Happy and Free I cite some gut bacteria that have been linked to emotional health and probiotics that may be helpful for improving mood. However, healing the gut, through a gut-healing diet like Plant Paradox or Gut and Psychology Syndrome (GAPS), and gut-healing products like Restore™, are just as important. This is a complex topic, so the information here is just a starting point for further research.

In summary, treating depression and anxiety in patients with Lyme disease and common co-conditions like mold toxicity is vital since mental and emotional health play a foremost role in recovery. Proper treatment enables patients to feel and function better while undergoing antimicrobial therapy, make wiser decisions, stick with their treatment plan, and remain hopeful and encouraged throughout their healing journey. Healing from depression and anxiety is possible—I have done it, and I had a severe case of both conditions. And if I can do it, I believe anyone can. So if you are a health care provider, please encourage your patients to believe that healing is possible for them, too!