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Much gratitude to all who took the time to participate in Anna Satalino's study.

1. Study: “Personality Traits, Perceived Stress, and Coping Styles in Patients with Chronic Lyme Disease and Fibromyalgia by Anna Satalino, MS”

Summary of the Research Results by the author: Anna Satalino, MS   anna.satalino@yahoo.com

Chronic Lyme disease (CLD) and fibromyalgia syndrome (FMS) have developed into widespread epidemics. Diagnosis and treatment of these diseases remain areas of controversy. Studies examining personality and coping styles in FMS have provided mixed results. A deficiency in the current literature remains regarding stress, personality, and coping styles in CLD and FMS. The purpose of this study was to examine personality traits, perceived stress, and coping styles in patients with CLD and FMS and to assess whether common patterns exist. The biopsychosocial model provides the theoretical basis of this study as it models the important interaction between the mind and body. Using a quasi-experimental design, 105 women with CLD or FMS, and 31 healthy women completed a demographics survey, the NEO Five Factor Inventory (NEO-FFI), the Toronto Alexithymia Scale (TAS-20), the Brief COPE, and the Perceived Stress Scale (PSS). It was hypothesized that both CLD and FMS groups would report significantly higher levels of perceived stress (PSS), neuroticism and conscientiousness  (NEO- FFI), difficulty identifying feelings (TAS-20), behavioral disengagement, self-distraction, and self-blame (COPE) than the controls. Tukey post hoc findings supported hypothesized relationships among perceived stress and negative emotions relating to neuroticism, difficulty identifying feelings, and coping methods such as behavioral disengagement and self distraction in those with CLD and FMS. Social change implications of this study include providing a better understanding of the mind-body connection in CLD and FMS, more favorable treatment outcomes, and improved quality of life. These findings demonstrate the importance of a multidisciplinary approach to disease.

If anyone who participated is interested and would like to email Ms Satalino for more info: anna.satalino@yahoo.com 

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Anna Satalino's article:

2. Article: Brief Overview of Depression, Herxheimer Reaction, and Treatment; Suggestions in Lyme Disease Patients by Anna Satalino, MS

     Depression from Lyme disease can be caused by a multitude of factors including predisposed genetic history, direct physical dysfunctions seen in Lyme disease, indirect effects of having an illness that effects multiple body systems, one’s support system, financial impact, medical misinformation, social stigma of having Lyme disease and other factors. Depression is the most common psychiatric syndrome in Lyme disease and although depression is common in any chronic illness, it is more prevalent in Lyme patients than in most other chronic illnesses. Levels of depression may vary from simply experiencing uncomfortable feelings of doom, or experiencing a more sustained version, even to the point of gross debilitation. In a study of sero-positive Lyme patients conducted by Dr. Fallon, 85% experienced sleep disturbances; 94% experienced extreme fatigue; 84% suffered from irritability and agitation; 24% had worked through suicidal plans, while many more admitted to suicidal thoughts; 83% had difficulty with concentration and memory and most patients reported a significant loss of libido and interest in other aspects of their lives. Most of the patients commented on the guilt they felt for the length of time they were ill; for the physical, mental, and financial toll their illness was taking on their families; and for not being able to “will” themselves well. The physical and psychological presentations of Lyme affect a patient’s whole family. Bransfield (2008) noted that once depression or other psychiatric syndromes occur with Lyme disease, treating them effectively improves other Lyme disease symptoms as well and prevents the development of more severe conse­quences, such as suicide.

     Suicidal risk is increased in Lyme patients due to illness impairments. However, suicidal tendencies associated with Lyme disease follow a somewhat different pattern than is seen in other suicidal patients. Suicide is difficult to foresee in Lyme patients. Some attempts are very determined and serious and although a few attempts may be planned in advance, most are of an impul­sive nature (Bransfield, 2008).

     While patients are undergoing their antibiotic therapy it is common to experience a ‘Jarisch Herxheimer Reaction’ (healing crisis) in which both physical and psychological symptoms may increase in intensity. Dr. Bock (1999) described the Jarisch Herxheimer reaction as an exaggeration of symptoms (which is due to the spirochetes reaction to being destroyed, similar to what occurs in case of syphilis). In Lyme disease, this Herxheimer-like reaction can be quite prolonged-lasting a few days or longer-and can be frightening to patients who are expecting a resolution, not a worsening, of their symptoms. The reaction can sometimes be difficult to distinguish from an allergic reaction to the medicine, a distinction with obvious and crucial treatment implications. Both suicidal and homicidal tendencies can be part of a Jarisch-Herxheimer reaction.

     Antidepressants can treat depression and suicidal tendencies in adjunct with psychotherapy. It has been demonstrated that anti depressants increase natural killer cells and aid the immune functioning in other ways as well. It is important to treat the mind and body in Lyme disease and a mental health professional trained in the area of chronic physical disease can assist through therapeutic protocols that have proven effective such as meditation and relaxation exercises, exercise and nutrition, biofeedback, effective coping skills, and helping patients follow and adhere to treatment regimens.    

     It is crucial to keep the lines of communication open, especially with someone with Lyme and tick related diseases. The patient and family should report any concerning changes in behavioral and/or physical symptoms to their physician and therapist. There is a 24 hour crisis hotline available to those that are feeling despair, suicidal, or just need to talk about what they are experiencing; The hotline is called Response and the number is: (631) 751-7500,so utilize this service if you need to, this is what they are there for J

What to do for Children -  

• Encourage children to discuss their thoughts and feelings. Many kids find it helpful to keep a journal or to draw as a way of expressing their emotions.
• Pay attention to changes in the child’s mood and activity level. When irritability, sadness, and/or decreased interest in activities last for several days, it is important to talk to your child about what is happening. It is a good idea to have a mental health evaluation from a Lyme Literate Mental Health Professional.
• If you are not sure how your child is feeling, ask!! Children learn from watching adults who openly discuss their own thoughts and feelings.
• In children that are suicidal, medication may be needed in adjunct to therapy.   

Bock, S. (1999). The integrative treatment of Lyme disease. Retrieved January 3, 2008, from http://www.Rhinebackhealth.com

Bransfield, R. (2008). Lyme, depression, and suicide. Retrieved January 3, 2008, from http://www.lymealliance.org/bransfield/bransfield_3.php

Fallon, B., & Nields, J. (1994). Lyme disease: A neuropsychiatric illness. Retrieved January 8, 2008, from http://www.jersey.net/~joebur/introfal.htm  

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