21

Jul

Is Lyme Disease Diagnoses Leading To Rise In Suicides?

By the time Andrew Potgieter learned why he had been so sick for so many years, he had become an invalid.

In 2005, the native of South Africa had moved to New Jersey and was working as a day-laborer and gardener. One day, while working in Monmouth County, N.Y., he came home covered in ticks. Lyme disease is rare in South Africa, so Potgieter did not think about the potential danger.

It wasn’t until 2014, after years of misdiagnoses and deteriorating mental and physical health, that he finally got his first dose of antibiotics targeting the bacteria coursing through his body.

What came next was worse — a series of extreme flu-like symptoms, known as a Jarisch-Herxheimer reaction, that spike when the bacteria begin to die.

“Everything was painful,” said Mark Sluscavage, Potgieter’s fiance and a resident of West Milford, N.J. “And it was unrelenting.”

So was the anxiety.

“It gave him anxiety he never had,” Sluscavage said. “He had all sorts of social anxieties and intrusive memories.”

On Aug. 22, 2015, Potgieter put an end to his suffering. He committed suicide at age 41.

His suicide is emblematic of a trend in Lyme disease cases that often is overlooked, according to a recent paper authored by a New Jersey psychiatrist.

The report, published last month in the peer-reviewed journal Neuropsychiatric Disease and Treatment, suggests that suicidal thoughts in patients with Lyme and other associated diseases may provide context for the thousands of unexplained suicides in the United States each year.

More than 44,000 people took their own lives in 2015, the most recent year for which data from the Centers for Disease Control and Prevention are available. The rate of 13.3 suicides per 100,000 people was the highest since 1986.

The paper’s author, New Jersey-based psychiatrist Dr. Robert Bransfield, estimates that as many as 1,200 of those suicides — as well as more than 14,000 incidents of self-harm and 31,000 suicide attempts — may be attributed to Lyme and associated diseases each year.

“It’s a constant action that comes up and isn’t adequately addressed in the scientific literature,” Bransfield said. “… Failure to adequately diagnose, failure to adequately treat and the progression of the disease over a span of many years often leads to suicide.”

Bransfield suggests the risk is greater among veterans and outdoor workers who are more likely to be exposed to ticks.

Dr. Brian Fallon, a psychiatrist who was not involved in the study and is the director of the Lyme and Tick-borne Diseases Research Center at Columbia University, said patients with Lyme disease are known to suffer from depression, a well-established indicator of suicidal thoughts.

He said that while the idea that Lyme and suicide could be linked may not be novel, “it certainly is important for clinicians to recognize that some of their patients, particularly those who are depressed, might be having suicidal thoughts.”

Fallon raised questions about Bransfield’s estimates of the number of cases. Bransfield, who has frequently spoken and written about Lyme, based his calculations on reviews of his own patients, many of whom have battled the disease.

Since no comparison group was used as a control, Fallon said, Bransfield’s patient group could result in a biased sample.

“What we need is a high quality, epidemiological, random-sampling study to address this question,” Fallon said, “using standardized psychiatric measures and a standardized way of diagnosing Lyme disease.”