A patient presented with neuropsychiatric Lyme disease. She had been misdiagnosed for over 10 years. Now 27 years old, she was unable to take care of herself and is living with her parents. Some of her symptoms included depression, anxiety, OCD, and insomnia. She was seeing a Lyme specialist and undergoing treatment, but she was not gaining the ground her LLMD expected to see. Lyme co-infections, such as Bartonella, Babesia, and Erlichia, can have psychiatric manifestations. These manifestations include self harming, suicidal tendencies, and Lyme psychosis, which this patient presented with as well.
As I began talking with her and hearing her story, other symptoms came to light that were not Lyme related; internal dialogues, losing track of time, intrusive dreams, being known by different names with different groups of people. With enough evidence, I was able to diagnose her with Dissociative Identity Disorder stemming from a background of childhood related abuse and trauma.
I began treatment with getting history and building trust. As the trust was developed, my patient was able to open up more about her background. These sessions could be difficult, and often times in the week following, she would seem to have set backs in Lyme treatment or experience more DID symptoms.
I began to work with her using components of Cognitive Behavioral Therapy. During these sessions, we would talk about the weeks stresses and at the end of the sessions, we would place the anxiety, unknowns, worries and fears into a box to be held safe until the next session. This allowed the patient a way to not hold onto and struggle with the stressors throughout the week. Instead she was able to focus more on self care. Then at the next session, we could reopen the box to place in new events, and feelings, and to re-frame other stressors placed in the box previously.
Many times patients are unaware of the toll that trauma or other stressors take on their physical health. This allows the Lyme infection to gain ground when the body's immune system is in a constant state of fight or flight. Stress hormones have been found to inhibit the production of cytokines, the agents of the immune system that respond to danger. This causes these cells to overreact and create an inflammatory response that is over the top, often creating a greater problem than the original danger. Unresolved emotional issues and negative emotional patterns can put a huge stress on the immune system. Clearing these emotional issues can be highly beneficial in releasing the immune system from suppression. The body maintains this fight or flight mode by pumping the body with adrenaline and other stress hormones. While short term exposure allows the body to do tremendous things, long term exposure is detrimental to your health.
Discussing the emotional issues was very helpful to the patient. It allowed her to come out of a constant state of fight or flight.
Another technique that I recommended to my patient was Fascial Counterstrain, which allows the blood to flow back into the brain and calms the parasympathetic nerve. With the parasympathetic nerve inflamed, the body is unable to relax as easily or as quickly as it should. In a sense, the inflamed nerve acts like a stopped up drain slowing the release of the tension and stress. With the Fascial Counterstrain, the parasympathetic nerve was able to be calmed and soothed. Without its overreaction, the patient was able to talk about and work through the childhood traumas more easily and with fewer reactions.
As I worked with my patient to confront the emotional stresses from current events, and from past trauma, she was able to more easily handle life events. As she was able to handle events better, less stress came from having fewer setbacks. As she had less stress, her body was able to devote more energy into fighting the Lyme and other co-infections. This feedback of reducing stressors freed up the person as a whole to gain traction in healing physically and emotionally.
Katie Chandler, MSW
Lyme Literate Counselor