Is There an Association Between Lyme Disease and Suicidality?

Robert Bransfield, MD, DLFAPA, private practice, Psychiatry, in Red Bank, New Jersey, explains the potential correlation between Lyme and associated diseases and suicidality.

Interview Transcript (modified slightly for readability):

"If we look at the association between suicide in Lyme and associated diseases, for many years, when we would be in a room full of physicians, we would say, ‘Well, what’s the most common cause of death from Lyme disease?’ And there was a strong consensus that it was suicide. Now, some people would die from opioid overdoses that would occur, sometimes different neurological conditions or heart problems but suicide, by far, was the main cause.

When I gave a lecture recently, I asked, ‘How many of you in the audience know someone with Lyme disease who committed suicide?’ and two-thirds of the people in that room raised their hands; there were a couple of hundred people in the audience. So, it is the major cause, but it doesn’t occur immediately after someone has a bullseye rash; it’s usually several years later, and it’s a correlation, it’s been observed.

I can explain it by the physiology; just like other chronic infections, and we see it with HIV, hepatitis C, other chronic infections where there’s persistent inflammation, we can see a correlation with suicide, so it makes sense. And when we look through the medical literature, we can see that there are quite a few journal articles describing case reports. So, in looking at that, I went through a number of my old charts, and I went through 253 charts and found that a high percentage of those, 43%, had a history of being suicidal at some point.

Now, I realize that this is not representative of all patients with Lyme disease because these were the patients who went to a psychiatrist, so there were more patients who had psychiatric symptoms. But looking at other statistics, they range from 18%, some were higher—like 30%, 37%, a couple of studies, so it does seem like there is a strong correlation that occurs.

And if we try to explain it, you can explain it partly by the physiology of the biochemistry and how it affects the brain, but another explanation is that Lyme patients often feel that they have a disease that would be categorized as an invisible disability, and it’s hard for them to understand what’s happening to them. They do not get so much support from family, friends, doctors, and health care assistants, because it’s hard for people to understand it, and people look at them and they say, ‘Well, you have two arms, two legs; you seem okay. And so, there isn’t the validation, and often, there’s a frustration, and that doesn’t help. There’s a feeling of alienation in addition to the pathophysiological process. So, we do see that, and I see this frequently—people struggling with suicidal thoughts.

Another part of it is that you often see that Lyme and associated diseases are associated with a lot of psychiatric symptoms that progress years later in the course of the illness. And the additive effect of all of these symptoms can contribute to suicidality in some people. Certainly not everybody, but there is a certain population that has it, and a population that does not have that.”