Depression in Lyme Disease Patients: A Common but Overlooked Symptom

Depression is a frequent but often underrecognized feature of Lyme disease.

Zomer and colleagues found that approximately 1 in 5 patients referred to a tertiary Lyme center in the Netherlands were diagnosed with both Lyme disease and depression.

Findings from the Study

The study evaluated patients seen at the Lyme Center Apeldoorn between 2008 and 2014 using the Beck Depression Inventory II (BDI-II), a screening tool for depressive symptoms.

The prevalence of moderate to severe depressive symptoms was similar in patients with clinical Lyme disease regardless of serologic status (19.3% in seropositive patients vs 20.9% in seronegative patients).

These findings suggest that depressive symptoms are common among patients evaluated for Lyme disease, independent of laboratory confirmation.

Interpreting the Results

The authors noted an important limitation: the study was not designed to determine whether depression developed before or after Lyme disease.

This distinction is clinically relevant. Depression may arise as part of the illness itself, from neuroinflammation or neurologic involvement, or as a response to prolonged symptoms and functional impairment.

For a broader neurologic context, see Neurologic Lyme disease.

Implications for Clinical Care

The authors recommend screening patients with suspected Lyme disease for depressive symptoms.

Identifying depression early may allow for appropriate psychological support alongside medical treatment.

This approach reflects a more comprehensive model of care, particularly for patients with persistent symptoms. For more on this, see Post-Treatment Lyme Disease Syndrome (PTLDS).

Clinical Takeaway

Depression is common in patients evaluated for Lyme disease and should be considered as part of the clinical picture. Screening and supportive care may improve overall outcomes.

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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