Can Lyme Disease Increase Suicide Risk?
Psychiatric symptoms may complicate Lyme disease
Depression and suicidality may be underrecognized
Recognition and treatment may improve outcomes
Lyme disease suicide risk remains a difficult and controversial topic, but psychiatrists and clinicians have argued that psychiatric manifestations associated with Lyme disease deserve greater recognition. Neuropsychiatric symptoms including depression, anxiety, cognitive changes, irritability, and suicidality have been described in case reports and observational studies.
Questions such as “can Lyme disease cause suicidal thoughts?” and “can Lyme disease affect mental health?” are increasingly discussed by patients and clinicians.
Psychiatric symptoms can overlap with manifestations discussed in neuropsychiatric Lyme disease, brain fog and cognitive dysfunction, and broader discussions surrounding persistent Lyme disease symptoms.
Bransfield’s colleagues from Howard University, Rush University Medical Center, and the University of North Dakota agreed with his assessment, stating, “We would like to applaud the author for conducting such an important study by performing a comprehensive assessment of suicide and its association with Lyme-associated diseases (LADs).” [2]
Published reports describe psychiatric symptoms in Lyme disease
In their article “Suicidal and homicidal tendencies after Lyme disease: an ignored problem,” three psychiatrists summarized case reports supporting Bransfield’s concerns.
One report described a 44-year-old man without previous psychiatric history who presented after a third suicide attempt and was later diagnosed with Borrelia infection. One month of intravenous ceftriaxone reportedly improved mental status and resolved suicidal ideation. [3]
Another publication noted that psychiatric manifestations can occur during both acute and later stages of Lyme borreliosis, with depression among the most frequently reported symptoms. [4]
A separate report described two patients who developed severe depression and suicidal behaviors after treatment, with evidence suggesting persistent Lyme borreliosis remained present in both cases. [5]
How might Lyme disease affect mental health?
Researchers have proposed several explanations for psychiatric manifestations in Lyme disease, including neuroinflammation, sleep disruption, autonomic dysfunction, chronic pain, immune activation, cognitive dysfunction, and the psychological burden associated with prolonged illness.
No single mechanism explains all presentations, and symptoms may overlap with manifestations described in autonomic dysfunction and Lyme disease, fatigue and sleep disruption, and other neurologic complications.
In one highlighted case, patient A reportedly became suicidal, violent, and physically assaultive. Another patient followed over three decades experienced severe suicidal thoughts and intrusive violent images which improved following treatment. The authors described treatment as “clearly life saving.” [2]
Questions that remain unanswered
Bransfield raises several important questions: [6]
- Why do only some patients develop psychiatric symptoms or suicidality?
- What mechanisms contribute to psychiatric manifestations?
- What diagnostic and treatment approaches are most effective?
- How many patients are affected and to what degree?
Frequently Asked Questions
Can Lyme disease cause suicidal thoughts?
Case reports and observational studies describe suicidality in some patients with Lyme-associated illnesses, though determining causation remains challenging.
Can Lyme disease cause depression?
Depression has been described in both acute and persistent Lyme disease settings, although symptoms may have multiple contributing factors.
Are psychiatric symptoms common in Lyme disease?
Depression, anxiety, sleep disruption, irritability, cognitive dysfunction, and mood changes have all been reported in patients with Lyme disease.
What psychiatric symptoms have been reported?
Published reports describe depression, intrusive thoughts, panic symptoms, emotional lability, irritability, cognitive dysfunction, and suicidality.
Clinical Takeaway
Psychiatric symptoms associated with Lyme disease remain difficult to study and interpret. Published reports suggest that some patients experience significant neuropsychiatric manifestations, while important questions remain regarding mechanisms, prevalence, and treatment.
Clinicians should consider psychiatric symptoms within the broader neurologic and systemic context of Lyme disease while maintaining appropriate psychiatric evaluation and support.
Mental Health Support
Depression, hopelessness, and suicidal thoughts deserve prompt attention regardless of the underlying cause. Anyone feeling unsafe or experiencing thoughts of self-harm should seek immediate support from a healthcare professional, emergency services, or crisis resources.
In the United States, calling or texting 988 connects individuals to the Suicide & Crisis Lifeline.
Related Articles
Neuropsychiatric Lyme disease
Brain fog and anxiety in Lyme disease
Autonomic dysfunction in Lyme disease
Persistent Lyme disease symptoms
References
- Bransfield RC. Suicide and Lyme and associated diseases. Neuropsychiatr Dis Treat. 2017;13:1575-1587.
- Munir A, Aadil M, Rehan Khan A. Suicidal and homicidal tendencies after Lyme disease: an ignored problem. Neuropsychiatr Dis Treat. 2017;13:2069-2071.
- Banerjee R, Liu JJ, Minhas HM. Lyme neuroborreliosis presenting with alexithymia and suicide attempts. J Clin Psychiatry. 2013;74(10):981.
- Juchnowicz D, Rudnik I, Czernikiewicz A, Zajkowska J, Pancewicz SA. Mental disorders in the course of Lyme borreliosis and tick borne encephalitis. Przegl Epidemiol. 2002;56 Suppl 1:37-50.
- Fallon BA, Schwartzberg M, Bransfield R, et al. Late-stage neuropsychiatric Lyme borreliosis. Differential diagnosis and treatment. Psychosomatics. 1995;36(3):295-300.
- Bransfield RC. Author’s reply. Neuropsychiatr Dis Treat. 2017;13:2071.
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Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Thank you for speaking about Lyme Suicide. It is my mission to raise awareness and prevent this from happening. https://www.eventbrite.com/e/conference-on-neurological-tick-infections-mental-illness-suicide-prevention-tickets-35080930006?aff=es2
You have an outstanding faculty. The goal is great “This educational summit is a 1-1/2 day program for physicians and nurses on the diagnosis and treatment of neurological tick infections ( i.e.: Borellia Burdorferi, Bartonella etc.) which lead to cognitive impairments, mental illness and ideations of suicide/violence.”
This is very real. It haplened to me. I attempted suicide three times and almost succeeded twice. Doctors misdiagnosed and mistreated me. It was the most painful and scariest part of my life. I estimate I went undiagnosed for at least 7 years. I was losing my mind and my life and knew I was in a struggle for my life. I am one of the lucky who remember the tick bite and how things went downhill after it. I found a Lyme doctor and within a couple of month the depression was gone after taking antibiotics. It has taken longer for other symptoms to slowly get better but having the depression clear was the first step in having my life return to what it once was. Anyone older who is depressed and has never had depression before should be evaluated for a medical problem thag may be the cause of the depression. My depression was treatment resistant. That should have been a sign to the doctors.
If someone has Chronic Lyme disease and they begin to experience suicidal thought, should they go to their Lyme doctor or a psychiatrist for help?
It remains important to seek immediate help if you have suicidal thoughts. It is important to use of 911 or the emergency room if your doctor is not available. It also is important to consider an assessment for a tick borne illness as part of any evaluation.
I wish this article came out sooner. 5/1/17, my husband who we called Tommy tick, or Tommy tick magnet shot himself. He had been treated for Lyme’s disease. He was a hunter and woodsman. He loved the outdoors, but always managed to find a tick on him. After a beautiful trip to Aruba, we came home Saturday, and on Sunday his behavior was delusional. I did not know what to do, or what was wrong. That night, he shot himself. I truly believe his suicide was tick disease related. Please bring this to the forefront so that there is enough awareness.
Sorry to hear your loss.
My family adopted a stray cat when I was small & I got scratched then developed cat scratch fever from it. After three neurosurgeries for bartonella cysts, I attempted suicide twice. This was decades ago. It was a very dark time bc I didn’t have a diagnosis yet and my family didn’t understand the severity of suffering or how to offer any validation or support. As I was in my early 30s with few answers there was a lot of pressure to settle down marry and have kids but each time I got close the symptoms would push people away. Had numerous hospitalizations with no answers. My family came to think of me as a failure when I bounced from relationship to relationship unable to get traction with health family or career. Even though I worked my way up to top positions in journalism in Washington & Hollywood the disease always caused me to crash again and to lose everything. After surgeries left me with neuropathy the pain led me to seek pain meds or mmj. My family then labeled me an addict. This illness takes everything. Yet I wake up every day with hope to heal & be of service. It keeps me going. Sadly it’s now decades later and my family still feels terribly drained by this horrible illness (Lyme) & the poor politics and sad lack of support or awareness. StIll we press on in faith. Thanks for all you do to shed light Dr. Cameron.
Too late for me – I developed horrendous constant visual disturbances accompanied by an inexplicable feeling of horror and absolute dread for 2 years after contracting lyme disease. Even though I was one of the lucky few who received an NHS diagnosis, doctors still insisted my symptoms were psychosomatic and were on the verge of sectioning me under the mental health act. The thought of being institutionalised while suffering these horrendous symptoms and the accompanying neuropsychiatric anxiety and dread from my inflamed, infected brain pushed me over the edge and I made a last minute, panic-driven suicide attempt by jumping off a bridge. Amonth of ceftriaxone while I was in hospital with numerous broken bones restored my sanity, although I still battle with other aspects of the disease. The repercussions of feel as if they have destroyed my sense of self, well-being and body image to the point that my PTSD and distress is so great I cannot even try to treat the Lyme properly. I have had 6 years of constant trauma and despair since with no end in sight. I still cannot believe that a disease that was discovered as far back as the 60s has been so neglected, so weirdly politicised and still so poorly handled by medical authorities around the world. The amount ruined lives is staggering.