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As Dr. Richard Bransfield explains in Neuropsychiatric Disease Treatment, “Lyme disease and the immune, biochemical, neurotransmitter, and the neural circuit reactions to [Lyme disease] can cause impairments associated with violence.” [1]
Children with serologic evidence of a tick-borne illness can also develop severe oppositional defiant behaviors, according to Dr. Rosalie Greenberg, a child and adolescent psychiatrist, who runs a private practice in New Jersey.
[bctt tweet=”Lyme disease can trigger extreme oppositional behavior in kids. ” username=”DrDanielCameron”]
Out of 69 youths evaluated at Dr. Greenberg’s practice, 49 (or 2/3) were positive by blood tests for one or more tick-borne illnesses including Lyme disease, Bartonella, Babesia, Ehrlichia and Anaplasmosis.
“I have seen a number of children and adolescents who exhibit significant acute or gradual onset of highly oppositional behaviors often both at home and at school,” she says.
Several examples include:
- Refusal to do class work or homework
- Heightened paranoia or feeling rejected by others
- Increased irritability
- Extreme temper tantrums
- Problems concentrating
- Elevated impulsivity
- Sensory hypersensitivity (sound, touch, smell, taste and/or light)
- Intense emotional lability
Patients also exhibited bouts of rage. “During periods of intense anger over minimal issues, they can appear menacing and threaten to kill a sibling, parent or a friend or state that they want to die themselves,” Greenberg says.
The onset or presentation of the oppositional behavior varied. “Parents describe these behaviors as either a sudden change or a period of worsening of a previous condition, such as attention-deficit hyperactivity disorder or mood 
disorder,” she explains.
In some cases, infections including Borrelia burgdorferi, the bacterial pathogen causing Lyme disease, can induce an immune dysfunction and a condition known as Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). An abnormal immune response triggers various neuropsychiatric symptoms including OCD-like behaviors, tics, mood changes, bouts of rage and aggression.
Dr. Bransfield’s and Dr. Greenberg’s observations will need to be studied further to prove a direct correlation between tick-borne illnesses and aggression and oppositional behaviors. Until then, it would be reasonable to consider a tick-borne illness as a potential underlying cause of extreme oppositional behaviors.
Editor’s note: I have treated both middle and high school students with Lyme disease who exhibited severe oppositional behavior.
Related Articles:
Suicidal behaviors in patients with Lyme and associated diseases
16-year-old boy with Lyme disease presenting as depression
Video: Is Lyme disease an autoimmune disease?
References:
- Bransfield RC. Aggressiveness, violence, homicidality, homicide, and Lyme disease. Neuropsychiatr Dis Treat. 2018;14:693-713.
- Greenberg R. Aggressiveness, violence, homicidality, homicide, and Lyme disease. Neuropsychiatr Dis Treat. 2018;14:1253-1254.
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This is EXACTY what we are dealing with after 3 years of Lyme treatment with abx. The past 3 years since treatment ceased we have gotten to the point where we are considering residential placement. HOW do we help him? Before someone gets seriously hurt and it’s too late?
I am sorry to hear your child remains ill. It sounds like your child is worse again. It is important to follow with doctors to rule other issues. It is also to know if a tick borne illness was adequately treated.
Dr. Greenberg is my son’s doc and quite frankly a superstar! She returned him to us. Her suspicions of tick borne infections were right on. I shudder to think of where we would be now if we hadn’t decided to seek her help. I am thankful every day that we crossed paths because now we are finally treating the CAUSE of this behavior and seeing some improvement.
Can you specify what sr greengergs name is and where she practices? Thanks. Looking for my 5 year old son.
My son was treated for lyme 3 years ago. It was a struggle for anyone to believe he was not cured or better. He had sever headaches and sever stomach pain, complained of numbness, his memory became horrible and lost so much of what he had learned in school. We fought for him to see infectious disease at Mass General Hosp. and he was treated with a longer period of antibiotics. My son started to do much better but still had symptoms about every 6 weeks. Last spring he was put on a preventative for headaches which has also helped a great deal. One of our remaining problem is “His attitude/ittatibility” when he is corrected–for example if something is wrong on his homework and I try to help him correct it, or a teacher tells him something is wrong in school. He feels like the world is against him. People think it is his 12 year attitude but this began when his lyme started at the age of 8. Any thoughts of ways to help him with this.
Doctors are divided on how to approach children with continued issues after treatment. It would be reasonable to include another doctor with experience treating tick borne illness to see if there might be an infection or co-infection.
SOT
We started Lyme treatment 2 years ago with a Lyme specialist for our 9 year old child with Lyme-induced PANS, and saw great improvement on many fronts. However, the rage episodes you are describing here (extreme to the point of looking neuropsychiatric) are still happening sometimes and seem to be coming back periodically. It is very discouraging to witness, and very difficult to deal with. Which makes us think the 2 year treatment didn’t touch them the root cause of these rages at all. Is it safe to assume so? Do you believe such rages can be fully eradicated with the correct treatment? Many thanks
HI Anna – when researching for my 10 year told, your message is exactly what we experience with our daughter (She has babesia, bartonella and Lyme) We are one year into lyme treatment but the rages periodically, come back some days are worse than others. I was just wondering how your child is doing and if you have any experiences you can share? I’m sorry you are going through this too, it’s so hard.
I have had children in my practice with the same issues. Check out one of their stories on my website https://danielcameronmd.com/videos-lyme-disease-profiles/
Hi-my son was almost 6yo when he was treated for Lyme this past summer. Is there any connection between time of suspected exposure to tick-borne illness and drastic shifts in mood/reactive behavior? I had attributed this shift to his age however they happened at the same time. Or is the behavior something that occurs much later and this is more of a coincidence? Thank you for your research and time.
I find mood/behavior issues can occur quite early in my Lyme disease patients.
It i unfortunate, that over 30years have passed since I was first treated for Lyme disease. My symptoms ranged from mild to torturous.
The unthinkable is to see a parent’s worst nightmare. Seeing their child in suffer.
I have seen horrible symptoms displayed in children,
many parents resigned themselves to accepting that their child would not ever recover.
Dr. Cameron as well as a select few treating physicians, have not given up on their patients.
Don’t accept that your child will never be the same,.
Look forward to what they can accomplish. Many individuals look back on a life that they believe they should be experiencing.
Life is to be lived; sometimes with major accomplishments and most of the time acknowledging baby steps.
Believe in them, I have seen recovery after many years especially in children.
Do these issues accur if Lyme is caught early? Our son is 6 and is not experiencing any symptoms other than the rash. If Lyme is treated early can this be avoided?
I often have patients in my practice who do well after early treatment. I have them return for followup in month and as needed.
Hi! I have a 5 year old who was diagnosed with lymes last year. Before it was diagnosed we bad multiple doctors visits, even met with a therapist because of my daughter’s out of nowhere serious freak outs. They did a month long treatment, and did not send us to infectious diseases because shes pediatric and the last western blotch test came back negative. For about a month after treatment everybody was saying my daughter was back to normal but then we started kindergarten. It’s now daily fits, refusing to log back in to class, and usually ends in me being hit, headbutted, kicked or scratched. I’m at my ends and shes at hers, but her peds doctor seems like this behavior isnt because of the lymes even tho we did not experience it until after she was bitten by a tick. I dont know where to go or what to do. Any advice would be great. Thanks!
I have seen Lyme disease patients with similar behaviors. I have seen more problems in children than adults. I have had to refer to other doctors to rule out other causes. I do not take care of children that young.
Dr minkoff in Clearwater Florida SAVED MY LIFE and my 10 year old son from Lyme babesia bartonella and Rocky Mountain spotted fever. Best clinic ever!
My daughter was diagnosed with Lyme after many doctors said no cause she had no sign of tick bite. She had many symptoms and was treated by holistic dr. Most symptoms were reduced but sleep disturbance, hot flashes,migraines etc.continue. She was more argumentative, aggressive by had mood swings at time of diagnosis but I presumed this was due to physical discomfort and frustration of finding treatment and her age.. she is now 21 and I notice she coninues to have unpredic table sporadic mood swings which are now making it hard to have contact with her. Where can I take her to diagnose and treat these emotional symptoms. She’s in therapy but clinician doesn’t factor lyme in and presumes her anger and rage are experience based.
I find it difficult to be sure Lyme disease has resolved. I have had adolescents and young adults with persistent psychiatric symptoms with their Lyme disease. I typically recommend a reevaluation by a doctor familiar with neuropsychiatric aspects of Lyme disease along with her psychiatrist. Call my office at 914 666 4665 if you have any questions.
My son has been diagnosed with Lymes and Bell’s palsy. He is also ADHD. After the Lymes his mood swing are terrible. He has made horrible threats he is only five. He did a round of antibiotics to treat Lymes. Does the ODD and mood swings get better?
I have patients in my practice who have persistent OCD and mood swings who have resolved these symptoms with additional treatment or change in treatment. I also advise that they see other doctors for other conditions.
My daughter is 34 and was diagnosed FINALLY with Lyme disease two years ago. she has probably been sick since she was 15. She also has Bipolar 1. Her bipolar is controlled well with medication and she is treating Lyme with bee venom therapy – she has been doing that for 6 months and feels somewhat better – (20%) this is a miracle in some ways, but she still gets reactions (herxes). The challenge is mostly her neuro symptoms, especially frustration and anger. She is an extraordinary young woman, talented, generous, compassionate. I can understand her frustration, and it is hard to live with. Just sharing and hoping someone might have some coping suggestions. Patience, I know. But it’s hard. We Iive in Canada and there are few Lyme Doctors here – the ones we’ve seen, she doesn’t trust – we have spent thousands on homeopathic remedies that make her sicker. Bee venom is the only thing that seems to be helping right now. Her diet is antihistamine and she is very observant.
Your daughter’s story did not include an antibiotics for Lyme disease or other tick borne infections. Sometimes treatment for babesia has been overlooked.
I have a 12 year old grandson who has been diagnosed with ADHD, ODD, Anxiety, and 2E. Behavioral problems began as early as 3 or 4 years and have gotten worse the older he gets. Is it possible that unknowingly he had lyme disease as a child that was never treated which could be causing the problems he is having? His parents have worked very hard at trying to find the right help for him, to no avail and especially because finding mental health treatment is beginning to feel like next to impossible.
I have patients with ADHD, OCD and anxiety who have benefits from antibiotics. I have some patient with Lyme and ADHD, OCD and anxiety
My grandson got Lyme and was treated at once with antibiotics. I now wonder if it was erased few years later at 9 yrs exhibited violent outbursts and anxiety, could not go to school for few months and after overload of antibiotics seems better until another violent outburst, has been hospitalized couple of times but getting better, tested negative for Lyme and is now 12 and still struggling??
I have seen patients of mine with tick borne illnesses with rage.
This sounds just like what we are dealing with! My son 15 months ago got LD. And he changed. He is/was so smart. But now he struggles daily. School has become hell for him. He won’t listen, he gets angry over the simplest tasks, he isn’t violent towards others but in class he will throw desks and chairs away from others. He’s now recently starting to run out of the school. He’s only 8. He sometimes almost seems like he blacks out in his fits of rage like he don’t know what’s going on. He struggles to do his school work, when he used to do it no problem. He’s always been advanced academically until he got LD now he can’t barely think enough to put it on paper. He don’t sleep well. He does this weird thing with his neck since the LD, almost like a tick habit. The Dr just wants to say he has ODD. He cries to me that he don’t understand why he’s so angry and he feels broken, that he wishes he could kill himself some way, unless he can hurry up and feel better. My heart breaks for him, I’m on wait lists to get him evaluated but I’m sure they won’t diagnose him right. I’m trying everything no one just believes me it’s from LD. I wish there was a medicine and test to help show and regulate what he’s feeling and going through.
I have children in my practice with the same presentation. I advise those patients to include an evaluation with experience treating Lyme disease.
We don’t have any lyme disease speacilist in our area. And unfortunately the closet one is 2hrs away from us and medical won’t cover it and it can get very costly I’m told. I’m just at loss. I am seeing his pediatrician again today begging her for help. But Dr’s just don’t want to even acknowledge it’s side affects from lymes. They don’t believe there are long term side effects like this, they act like I’m making it up and talking out my ass. But I’m still waiting on an evaluation with a psychiatrist to do an evaluation on him but I feel like that will also be missed diagnosed. Do you have any suggestions on which way I sure ask these people on how to evaluate and treat him?
I have not been very successful in urging doctors to take chronic manifestations of Lyme disease seriously. You may have to pay out of pocket. You may save money by using local labs and using your prescription or GoodRx.
Hello. My daughter (5 years old) was diagnosed with Lyme disease over the summer. The pediatrician treated it with a month long antiobitic but this winter she’s been exhibiting a lot of behavioral problems at school. How do I know if she’s still suffering effects of the lyme? What steps should I take to look into this further?
I advise my patients to include a doctor experienced in treating Lyme disease to their team of doctors.
Hello all sadly I hate to become part of this community but my 3 yr old grandson was found with a tick on him less then a month ago. I removed the tick myself and reported it to his mother immediately. About a week after finding the unwanted guest she took him to the doctor who prescribed antibiotics. When following up with my daughter she informed me that the doctor didn’t do any actual testing for the strain of the Lyme disease and really didn’t have a whole lot of feedback regarding what to do in the future and what sort of side effects that we should be on the look out for? Today was the first day he has been back in my care and “WOW” is all can say. I am having difficulty with getting him to follow simple commands, or to remember what I asked him to do to get what he was wanting? He was reported to have a physical outburst towards a close family friend and couldn’t explain why! Any suggestions that can be funneled my way, really want to assist my daughter who is losing her patience with a plan to deal with such a huge burden, that started with such a small interaction. Is the antibiotic something he will have to take for years?? What test should she request to know the strain of Lyme he is being affected by? If you know what strain that you are affected by does that assist in treatment efforts?
I am sorry to hear your grandson is having problems. The tests for Lyme and co-infections are not as reliable as I would like. I have to rely on clinical judgement to determine the best tests and treatment strategies. I also have to rule out other illnesses. I don’t treat younger children. All the best.