Can Lyme Disease Cause Depression, Rage, or Suicidal Thoughts?
Research has linked Lyme disease to depression, irritability, and suicidal thoughts.
Neuropsychiatric symptoms may occur in some patients with Lyme and associated diseases.
New or worsening psychiatric symptoms require prompt medical evaluation.
Neuropsychiatric symptoms have been described in Lyme disease for decades. Researchers have reported depression, irritability, cognitive dysfunction, mood changes, and, in some cases, suicidal thoughts among patients with Lyme disease and associated tick-borne illnesses.
Psychiatric symptoms can have many causes, and their presence does not necessarily mean that Lyme disease is responsible. However, several studies have examined the association between Lyme disease and psychiatric or neurologic manifestations.
If you or someone you know is experiencing suicidal thoughts, call or text 988 in the United States or Canada. If there is immediate danger, call 911 or your local emergency services, or go to the nearest emergency department.
Can Lyme Disease Cause Rage or Explosive Anger?
In a 1990 report, Logigian and colleagues described severe irritability in patients with chronic neurologic Lyme disease. Eight patients experienced excessive daytime sleepiness, and seven experienced severe irritability.
According to the authors, these patients “became angry over circumstances that previously caused only minor annoyance.”[1]
Patients may describe sudden anger, low frustration tolerance, emotional outbursts, or mood swings. These symptoms may occur alongside fatigue, sleep disturbances, pain, and cognitive dysfunction.
Neuropsychiatric Symptoms Reported in Lyme Disease
In 1994, Fallon and Nields reviewed neuropsychiatric manifestations associated with Lyme disease. Published reports included depression, panic attacks, cognitive impairment, paranoia, mood instability, and other psychiatric presentations.[2]
These reports do not establish that Lyme disease was the cause of every psychiatric symptom. However, they highlight the complexity of neurologic and psychiatric symptoms reported in some patients.
Large Study Found Increased Mental Health Risks After Lyme Disease
A nationwide Danish cohort study published in 2021 examined nearly 7 million people, including almost 13,000 individuals diagnosed with Lyme borreliosis in a hospital setting.[3]
Compared with people without a recorded Lyme disease diagnosis, patients with Lyme borreliosis had a:
- 28% higher rate of mental disorders
- 42% higher rate of affective disorders, including depression and bipolar disorder
- Twofold higher rate of suicide attempts
- 75% higher rate of death by suicide
The investigators excluded patients with a history of mental illness or suicidal behavior before their Lyme disease diagnosis. The increased risk was greatest during the first year after diagnosis and was higher among patients with more than one episode of Lyme disease.[3]
These findings demonstrate an association at the population level but do not mean that most people with Lyme disease will develop serious psychiatric symptoms. Approximately 7% of patients with hospital-diagnosed Lyme disease were subsequently diagnosed with a mental disorder in a hospital setting.
Bransfield Study Examined Suicide Risk
Psychiatrist Robert Bransfield reported observations from a clinical cohort of 253 patients with Lyme disease and associated tick-borne illnesses.[4]
- 43% reported suicidal thoughts or behaviors
- 32% were suicidal but not homicidal
- 11% were both suicidal and homicidal
- No patients were homicidal without also being suicidal
- 25% experienced explosive anger without being suicidal or homicidal
- 10% reported depression before infection
- 97% reported depression after infection
- Patients were ill for an average of 8.4 years before diagnosis and treatment
Because this was a selected clinical cohort rather than a population-based study, these percentages should not be interpreted as the prevalence of psychiatric symptoms among all patients with Lyme disease.
Bransfield described a broad spectrum of symptoms, including explosive anger, intrusive thoughts, sudden mood swings, paranoia, dissociation, hallucinations, panic, anxiety, chronic pain, depression, and post-traumatic stress symptoms.[4]
Can Lyme Disease Cause Depression?
Depression is among the most frequently reported psychiatric symptoms in Lyme disease studies. The Danish population study found an increased rate of affective disorders following hospital-diagnosed Lyme borreliosis.[3] Depression was also frequently reported in Bransfield’s selected clinical cohort.[4]
Depression may occur alongside fatigue, pain, sleep disruption, cognitive dysfunction, and other chronic symptoms that affect quality of life. The physical and emotional burden of a prolonged illness may also contribute to depression.
For more information, see Neuropsychiatric Lyme Disease and Brain Fog and Lyme Disease.
Sleep Problems May Contribute to Mood Symptoms
Sleep disturbances are common in patients with neurologic Lyme disease and may contribute to irritability, depression, fatigue, and cognitive dysfunction.
Logigian and colleagues reported excessive daytime sleepiness in several patients with chronic neurologic Lyme disease.[1]
Learn more about Lyme Disease Sleep Disorders and Persistent Lyme Disease Symptoms.
Children May Also Experience Psychiatric Symptoms
Tager and colleagues conducted a controlled study of cognitive and psychiatric symptoms in children with chronic Lyme disease.[5]
According to data discussed by Bransfield, 41% of children with Lyme disease in the study had reported suicidal thoughts and 11% had made suicidal gestures.[4,5] The study was small, so these percentages should not be generalized to all children with Lyme disease.
Nevertheless, the findings underscore the importance of promptly evaluating new emotional, behavioral, or cognitive symptoms in children experiencing a persistent illness.
How Might Lyme Disease Affect Mental Health?
Researchers have proposed several possible pathways that could contribute to psychiatric symptoms, including:
- Inflammation and immune activation
- Neurologic involvement
- Metabolic changes affecting brain function
- Chronic pain and disrupted sleep
- The emotional burden of prolonged or disabling symptoms
Bransfield noted that chronic infections and their associated inflammatory processes have been linked to an increased risk of suicidal behavior.[4] Additional research is needed to clarify the biological and psychological pathways involved.
Clinical Perspective
Psychiatric symptoms associated with Lyme disease remain challenging to evaluate. Depression, anxiety, irritability, cognitive dysfunction, sleep disturbances, and emotional dysregulation may have multiple contributing factors.
Clinicians should assess both medical and psychiatric explanations when a patient develops new or worsening neuropsychiatric symptoms during or after a tick-borne illness. Psychiatric evaluation should complement—not replace—an appropriate medical evaluation.
Frequently Asked Questions
Can Lyme disease cause depression?
Population-based and clinical studies have found an association between Lyme disease and depression or other affective disorders.[3,4] Depression can have multiple causes, so each patient requires an individualized medical and psychiatric evaluation.
Can Lyme disease cause rage or anger?
Severe irritability, low frustration tolerance, and explosive anger have been reported in some patients with chronic neurologic Lyme disease and associated tick-borne illnesses.[1,4] These symptoms are not specific to Lyme disease and may have other causes.
Can Lyme disease cause suicidal thoughts?
Studies have reported an association between Lyme disease and suicidal thoughts, suicide attempts, and death by suicide.[3,4] Suicidal thoughts require immediate attention regardless of their suspected cause.
Can children with Lyme disease experience psychiatric symptoms?
Cognitive, emotional, and behavioral symptoms have been reported in some children with chronic Lyme disease.[5] Any child experiencing suicidal thoughts, major behavioral changes, or severe depression should receive prompt professional evaluation.
Do psychiatric symptoms prove that someone has Lyme disease?
No. Depression, anxiety, anger, cognitive problems, and mood changes have many possible causes. These symptoms alone cannot diagnose Lyme disease.
Clinical Takeaway
Studies have reported depression, irritability, rage, cognitive dysfunction, and suicidal thoughts in some patients with Lyme disease and associated tick-borne illnesses. Although these symptoms may have multiple causes, clinicians should recognize that neuropsychiatric manifestations can occur alongside other features of Lyme disease.
New or worsening psychiatric symptoms should be taken seriously and evaluated promptly. Suicidal thoughts require immediate professional assistance.
Related Articles
- Neuropsychiatric Lyme Disease
- Brain Fog and Lyme Disease
- Lyme Disease Sleep Disorders
- Persistent Lyme Disease Symptoms
Important Safety Information
If you or someone you know is experiencing suicidal thoughts, call or text 988 in the United States or Canada. If there is immediate danger, call 911 or your local emergency services, or go to the nearest emergency department.
This information is for educational purposes and does not constitute medical advice, diagnosis, or treatment.
References
- Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease. N Engl J Med. 1990;323(21):1438–1444.
- Fallon BA, Nields JA. Lyme disease: a neuropsychiatric illness. Am J Psychiatry. 1994;151(11):1571–1583.
- Fallon BA, Madsen T, Erlangsen A, et al. Lyme borreliosis and associations with mental disorders and suicidal behavior: a nationwide Danish cohort study. Am J Psychiatry. 2021;178(10):921–931.
- Bransfield RC. Suicide and Lyme and associated diseases. Neuropsychiatr Dis Treat. 2017;13:1575–1587.
- Tager FA, Fallon BA, Keilp J, Rissenberg M, Jones CR, Liebowitz MR. A controlled study of cognitive deficits in children with chronic Lyme disease. J Neuropsychiatry Clin Neurosci. 2001;13(4):500–507.
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
Three thumbs up Dr. C. Way to go!!! Thanks for writing this and thanks more for caring about the patients. Amazing you are!
This article is Spot On. I did not know what anhedonia was until I looked it up today as an “Inability to experience pleasure”. This describes how I felt for 10 years as well as most of the other symptoms mentioned. These suicides are so sad…and so preventable. Thank you.
While all the articles and research are very encouraging, the resources for where to get help is still very
difficult to find. Wish more information as to how to get connected with physicians who ARE aware and specialize in chronic lyme symptoms was available.
any luck on finding this information?