As I was looking at the weekend edition of the New Jersey Star Ledger , a major newspaper in my state, on Sunday, March 5, 2022 I was struck by an exceptionally lengthy article entitled, “Saving Charlie.”1 Reporter Adam Clark chronicled the struggles of a highly suicidal teenager and his family’s ongoing efforts to get him proper help. Sadly, this 16-year-old was obsessively preoccupied with ending his life which resulted in at least seven serious suicide attempts over the previous two years. The article highlighted how the mental health crisis in this state is getting worse and better interv ..read more

Many scientists and physicians agree that there are important issues concerning present Lyme disease (LD) testing. In this post I will address how the commercial testing cleared by the Food and Drug Administration and approved by the Centers for Disease Control and Prevention (CDC) results in under-identification of the number of individuals, especially children, suffering from LD. First let’s review the recommended testing to confirm exposure to Borrelia Burgdorferi (BB), the bacteria that causes LD. Testing consists of two parts or “tiers.” Results of these two tests depend upon the ability ..read more

The association of Lyme disease (LD) and mental illness has been an area of hot debate among medical professionals for a number of years. A new study published in the American Journal of Psychiatry by Fallon et al. that reviewed a database of nearly 7 million people in Denmark helps shed some light on this issue. A record review of over 12,000 individuals diagnosed with LD in a hospital related program, were compared to a control group without this diagnosis. The group of individuals who had LD had a 28% higher rate of mental disorders and double the risk of attempted suicide. There was also ..read more

I live and work in New Jersey, a Lyme endemic area, which also has the distinction of having a very high rate of youth diagnosed with Autistic Spectrum Disorders (ASD). The most recent statistics indicate that as many as 1 out of 32 children may be affected by some form of the disorder. Included under the heading of ASD are: Autism, Asperger’s Syndrome and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS.) In general, these terms are used to describe and differentiate a group of individuals who share difficulties with social, emotional and communication skills which can poten ..read more

Part 2- Pediatric Mood Disorders and Tick-borne Illness In my previous blog I discussed the overlap of symptoms shared by Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS), Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Bipolar Disorder (PBD). PANDAS occurs following a Group A Strep infection and is a category under the larger grouping of PANS. In most cases the cause of PANS is unknown but potential triggers include infections, metabolic disturbances and other causes of inflammatory reactions. In the majority of cases the c ..read more

Part 1- The beginning of the road: PANDAS, PANS and Pediatric Bipolar Disorder There is no question that the rate of pediatric mental illness has increased in the last twenty to thirty years. This includes autism, attention-deficit hyperactivity disorder (ADHD), depression, pediatric bipolar disorder, as well as anxiety disorders. Studies indicate that half of adult mental illness begins by age 14. Successful early intervention may decrease the persistence of symptoms into adulthood which takes a significant emotional, social and economic toll on people throughout the world. In recent decades ..read more

I recently logged onto the virtual Inflammatory Brain Disorders Conference presented by The Foundation for Children with Neuroimmune Disorders and wanted to share some of my thoughts with you. Lecturers from the United States and abroad spoke on diagnostic and therapeutic approaches to these disorders. Overall, I found the conference to be quite informative. I am writing because a few remarks interested me. #1. A hot topic in psychiatry and neurology these days is autoimmune encephalopathy. The National Institutes of Health defines autoimmune encephalitis as “a group of conditions that occur w ..read more

Being a doctor who works with children, the idea of maternal-fetal transmission of Lyme or any other tick-borne illness is very disturbing. There has been a lot of denial about this issue in the medical literature, but in 2020 the Centers for Disease Control and Prevention acknowledged that congenital transmission is possible but “rare.” Personally, I find it very hard to accept that maternal-fetal Lyme transmission is an unusual occurrence. I’ve diagnosed at least five cases of probable congenital Lyme while evaluating a child for possible psychiatric illness. On only one occasion was the mot ..read more

Those involved in the world of tick-borne illnesses quickly come to learn that the ,Borrelia ,bacteria that is responsible for Lyme disease, as well as tick-borne relapsing fever and other illnesses, frequently live alongside other organisms inside deer ticks. Although transmission of the ,Bartonella, species of bacteria by ticks is still questioned by some, increasing evidence points to it being an important player in zoonotic infections (those transmitted from animals to people), and a potentially significant cause of human illness. Until eight or nine years ago if you asked me about ,Barton ..read more

As we appear to be gaining more control over the SARS-CoV-2 virus I worry about the risk of another problem. Most of us have spent the last year feeling like hibernating bears because of the restrictions the pandemic has placed on our lifestyles and freedoms. I can say for myself that I am excited to be able to go outside in the sunlight, walk around the neighborhood with my girlfriends, and break bread with family members whose thoughtful, funny and somewhat oppositional banter I have so missed. Finally spring has sprung and we are all excited to go outside and see each other as well as to en ..read more