Prior trauma may worsen symptom severity of Lyme disease


Lyme disease can lead to severe symptoms in some individuals. In their study, “Psychological factors in the prediction of Lyme disease course,” Mustafiz and colleagues examined whether prior trauma may worsen the severity of symptoms for Lyme disease. [1]

The authors cited earlier research by Solomon and colleagues on the role of prior trauma in Lyme disease.²  “The investigators noted that patients who reported a higher number of lifetime traumatic events (i.e., a higher trauma score) at initial presentation were more likely to report a painful, disabling symptom course at follow-up.”

Mustafiz and colleagues described the history of prior trauma in 60 individuals with Post-Treatment Lyme Disease Syndrome (PTLDS). Twenty-five patients met the criteria for highly probable PTLDS and 35 for definite PTLDS.

PTLDS is a term used to describe individuals who fail initial treatment for Lyme disease and remain ill with impaired cognitive function, pain, fatigue, and poor function.

The history of trauma life events was assessed by The Trauma History Screen (THS). “This self-report assesses exposure to 14 types of high-magnitude stressor events that could be traumatic (e.g., natural disasters, sexual or physical abuse, military trauma, loss of a loved one),” wrote the authors.²

They observed that prior trauma may worsen symptom severity of Lyme disease on every measure except for pain and fatigue. “A greater number of traumatic events were significantly associated with greater symptom severity on the scales of mood (stress, depression, and anxiety), cognition, multisystem symptom burden, and functional status (mental and physical), but not on measures of pain and fatigue,” wrote the authors.

“The investigators concluded that traumatic psychologic experiences predating disease onset may play an important etiologic role in symptom severity for chronic conditions like Lyme disease.”¹

The impact of prior trauma on the symptom severity of Lyme disease was modest. Therefore, the authors suspected that other factors were responsible for the symptom severity of Lyme disease. “These factors range from characteristics of the Borrelia strain to the biological characteristics and clinical history of the human host.”

Editor’s note: Some doctors have used PTLDS for individuals with Lyme disease who remain ill despite antibiotic treatment. I have not used the term PTLDS until they have a validated test to rule out a persistent infection.


  1. Mustafiz F, Moeller J, Kuvaldina M, Bennett C, Fallon BA. Persistent Symptoms, Lyme Disease, and Prior Trauma. J Nerv Ment Dis. May 1 2022;210(5):359-364. doi:10.1097/NMD.0000000000001452
  2. Solomon SP, Hilton E, Weinschel BS, Pollack S, Grolnick E. Psychological factors in the prediction of Lyme disease course. Arthritis Care Res. Oct 1998;11(5):419-26. doi:10.1002/art.1790110514

12 Replies to "Prior trauma may worsen symptom severity of Lyme disease"

  • Ellen Stone
    05/23/2022 (10:47 am)

    Lyme disease attacks areas of the body that have been previously injured. I disagree with the finding of not worsening the pain or fatigue. People who have trauma have a much higher pain threshold,therefore they judge pain differently than those without significant trauma. The scale of 1 to 10 doesn’t work accurately for those who have suffered excruciating pain. You can’t compare the pain of a toothache with the pain of torturous beatings. The pain scale is subjective.
    Also,people who have suffered significant trauma have had to power through their fatigue in order to have any semblance of a normal life,so reporting on that factor is also skewed.

  • Suzanne Meub
    05/23/2022 (8:09 am)

    I was parenting 6 children through high school and college after my husband died in 2011. I had lost my father, my husband, my mother, and infant granddaughter ,Ella Lee. Lyme hit me like a runaway train . In the end, severe sepsis almost took my life but cured the Lyme.and confections. As I read the stories in the Facebook from people with the worst Lyme symptoms, the number of folks had stories like mine. The worse the trauma, the worse and more persistent the symptoms of Lyme and coinfections.

    • Tina
      05/23/2022 (12:23 pm)

      Oh my the challenges you endured ❣️
      Thankful Lyme is cured.
      Oh m struggling with Lyme and mold.
      May I asked how yours was cured?

    • Laurie
      05/26/2022 (1:09 am)

      Suzanne Meub, how were you healed? Was it massive antibiotics? I’m so sorry for your tragic losses❤️

  • SaraBeth Yassin
    05/23/2022 (7:45 am)

    Thank you for speaking about this subject. I recently got diagnosed with PTLDS. I never knew why it was so hard for me to leave my house, etc…Even though I am better after three years of ABX treatment, Lyme Disease did a number on my psychology.

  • Jacqui butterworth
    05/23/2022 (4:33 am)

    Same old story life is a trauma for everyone

  • Deb Antanitis
    05/22/2022 (9:19 pm)

    Hmm I’m confused. They say trauma made a difference in long-term severity of symptoms. Then just below the blue box you state just the opposite. I don’t think we can tie it to one thing like trauma. holistically …body, mind and spirit are all interconnected. To study one aspect in only 60 patients when there are thousands of Lyme patients to study makes the results questionable.

    • Dr. Daniel Cameron
      05/23/2022 (11:00 am)

      The author was not so supportive of trauma in their closing statement. They suspect other factors were also important. I find prior trauma quite important in my patient.

      • Shelley D.
        06/18/2022 (8:33 am)

        I hear you on this. We all know that Lyme, especially if it goes into PTLDS is enough on its OWN to cause trauma, add life and the daily stressors, especially in our current world,the lyme flare ups could happen. I feel this is happening to me a lot lately. Having this forum to be able to connect and read about others experiences has been helping me a lot, like a form of therapy in a way.
        Thank you Dr. Cameron and all for this blog!

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