Year: 2017 Source: Neuropsychiatric Disease and Treatment. (2017). 13, 1575-1583. SIEC No: 20170364

Purpose: The aim of this paper is to investigate the association between suicide and Lyme
and associated diseases (LAD). No journal article has previously performed a comprehensive
assessment of this subject.
Introduction: Multiple case reports and other references demonstrate a causal association
between suicidal risk and LAD. Suicide risk is greater in outdoor workers and veterans, both
with greater LAD exposure. Multiple studies demonstrate many infections and the associated
proinflammatory cytokines, inflammatory-mediated metabolic changes, and quinolinic acid and
glutamate changes alter neural circuits which increase suicidality. A similar pathophysiology
occurs in LAD.
Method: A retrospective chart review and epidemiological calculations were performed.
Results: LAD contributed to suicidality, and sometimes homicidality, in individuals who
were not suicidal before infection. A higher level of risk to self and others is associated with
multiple symptoms developing after acquiring LAD, in particular, explosive anger, intrusive
images, sudden mood swings, paranoia, dissociative episodes, hallucinations, disinhibition,
panic disorder, rapid cycling bipolar, depersonalization, social anxiety disorder, substance
abuse, hypervigilance, generalized anxiety disorder, genital–urinary symptoms, chronic pain,
anhedonia, depression, low frustration tolerance, and posttraumatic stress disorder. Negative
attitudes about LAD from family, friends, doctors, and the health care system may also contribute
to suicide risk. By indirect calculations, it is estimated there are possibly over 1,200 LAD
suicides in the US per year.
Conclusion: Suicidality seen in LAD contributes to causing a significant number of previously
unexplained suicides and is associated with immune-mediated and metabolic changes resulting
in psychiatric and other symptoms which are possibly intensified by negative attitudes about
LAD from others. Some LAD suicides are associated with being overwhelmed by multiple
debilitating symptoms, and others are impulsive, bizarre, and unpredictable. Greater understanding
and a direct method of acquiring LAD suicide statistics is needed. It is suggested that
medical examiners, the Centers for Disease Control and Prevention, and other epidemiological
organizations proactively evaluate the association between LAD and suicide