Infections and Mental Health

What is the Cause of Mental Illness?

The Serotonin and Depression Paradigm is Out-of-Date

Old research dating back to the 1960’s says that low serotonin is the cause of depression. A tryptophan-depleted diet was thought to explain depression. The body converts tryptophan into serotonin. It was thought that depression was due to a lack of serotonin, which was only based on a correlative link to depression. But correlation is not causation.

An entire drug class, called Selective Serotonin Reuptake Inhibitors (SSRI), was developed as the solution to depression. These antidepressants were designed to increase serotonin uptake, based on the serotonin theory of depression. 

But now, a recent research review published in July of 2022, found that there is “no consistent evidence of there being an association between serotonin and depression” and that there is “no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations” (Moncrieff et. al., 2022).

In fact, long-term use of SSRI medications may actually lower serotonin levels in the body!  

If it’s not due to low serotonin, what does cause depression? 

Could Microbes & Infections be the Cause of Mental Illness?

Post-infectious onset of mental illness has been observed for many decades. Around 1998, observations of children developing mental health disorders in the weeks or months after strep infection led researchers to look for a possible connection. Case studies of dramatic and sudden onset of OCD and tic disorders in children were seen at the US Institute of Mental Health.

This indicated there is a link between some infections (not just strep) and antibodies against brain tissue. 

The immune system fights off infections. In some infections, the protein structure of the infectious organism may look a lot like brain tissue. So, the immune system inadvertently starts to attack brain structures in the process. If the infection becomes chronic or the autoimmune process continues, changes to brain chemistry and neuroinflammation that result from the brain autoimmunity can cause the onset of mental health disorders. Many types of infections can be linked to brain autoimmunity. 

Dr Miles has first-hand experience with infections as a cause of mental health disorders in the Medicine with Heart clinic. In fact, Dr Miles discovered the connection by accident. He commonly treats people with mold illness, Lyme Disease, Bartonella, Epstein-Barr Virus and other chronic infections. To Dr Miles surprise, treating infections and toxins from mold led many people to report significant improvements in mental health. Severe anxiety, debilitating depression, intense brain fog, food sensitivities and other symptoms were improved and sometimes completely reversed by treating infections. 

Which Infections Can Cause Mental Illness?

Strep

Neuropsychiatric symptoms can appear after strep throat. These include obsessive-compulsive disorder (OCD), tic disorders, eating disorders, anxiety, depression, insomnia, motor or sensory issues and increasing food sensitivities. Symptoms appear after a delay of weeks or even months, as antibodies against brain tissue take time to cause structural damage and neuroinflammation. This can then cause mental health symptoms. The strep bacteria can become chronic and systemic. 

Lyme Disease

Lyme Disease is a bacterial infection, caused by the bacterium Borrelia burgdorferi. Borrelia is spread by a bite from an infected insect, typically the black-legged tick. We have written many blogs on Lyme Disease, starting with What is Lyme Disease? 

Lyme Disease is a complex inflammatory disease with both acute and potentially chronic symptoms. Symptoms include a possible “bullseye” rash, headache, fever and chills, muscle and joint aches and swollen lymph nodes. Lyme Disease can possibly develop into more serious symptoms such as arthritis, neurological or cardiac issues. 

Lyme Disease is the great mimicker; it can look like dozens of other illnesses, and is not completely understood in the medical world.

Lyme Co-Infections

A Lyme Disease co-infection occurs when someone is infected with Lyme and another disease transmitted by the same tick. A tick can carry multiple disease-causing microbes or co-infections in addition to Borrelia. Once bitten, it is possible to contract Lyme and one or even more co-infections simultaneously. 

Co-infections are common, especially in people with chronic Lyme. This is likely why people with chronic Lyme have such severe symptoms.

Co-infections can also be stand-alone. You could be infected with Babesia or Bartonella, for example, without getting Lyme. People may get a co-infection with two pathogens, or even three, although it is rare to have a three-pathogen infection (Kumar M, 2019)  

Potential Lyme co-infections are Bartonella, Anaplasmosis, Babesiosis, Powassan virus, Borrelia miyamotoi (relapsing fever-like illness) and Ehrlichia muris (which causes ehrlichiosis) (Eisen, 2018). 

Mold Toxins

Mold can grow in moist and water-damaged buildings. Mold toxins, or mycotoxins, are biotoxins that can accumulate in the body after mold exposure. They can cause mild to serious illness. 

• The Environmental Protection Agency (EPA) estimates that 25-50% of homes have damp conditions that can lead to mold growth. This may even be a conservative estimate. 
• Other sources say that approximately 50% of buildings are water damaged and have not been remediated properly.
• Approx. 1 in 4 people have a genetic abnormality which prevents mold and other toxins from being detoxified and properly removed from the body.
• For these people, even a single exposure to mold can cause mold toxins to circulate in the body, causing symptoms like fatigue, pain, migraines or headaches and others. 
• Mold is a significant and under-examined issue that contributes to chronic inflammation and illness. 

Viral Infections

A virus can cause illness, inflammation, immune problems and mental health issues. Viruses like Epstein-Barr, herpes simplex virus, chicken pox / shingles and now COVID-19 are common. Everyone gets a viral infection at some time. Most people typically recover with little effect on their lives. But viruses never leave the body; they just become dormant. They can potentially reactivate and become a chronic issue causing symptoms. A virus can also lead to mental health issues in the weeks or months after infection.

Bacterial infections typically are fully eliminated from the body and completely resolve. Exceptions to this rule are Lyme and Bartonella. A virus, Borrelia or Bartonella can be re-activated in the body at any time. 

Stress is a common trigger for reactivation. The immune system gets overwhelmed and the virus can become active again. Constant stress can leave the immune system too weak to fight the virus off. It can potentially develop into a chronic underlying viral infection. Other bacterial/ parasitic infections, mold toxins or toxic metals can all trigger latent viral infections to reactivate. Other viruses like COVID-19 may reactivate dormant viruses like Epstein-Barr Virus. 

Chronic viral infections can cause:

• Unexplained symptoms and flare-ups
• Inflammation and pain
• Fatigue and/or insomnia
• Autoantibodies that can lead to autoimmunity
• Brain antibodies that can lead to neuroinflammation and mental health issues

What are the Effects of Chronic Infection?

Chronic infections, autoimmunity, chronic inflammation and psychosocial stress can affect mental health, possibly triggering schizophrenia, autism spectrum disorder, bipolar disorder and depression (Pape K, 2019). 

Chronic infections can worsen the severity of Lyme Disease or mold illness. Or Lyme or mold illness can worsen infections already present in the body. What came first can be difficult to identify. Lyme, mold and chronic infections may induce brain autoimmunity, causing or worsening neuroinflammation. 

Some infections produce toxins. The cell walls of gram-negative bacteria contain lipopolysaccharides (LPS). LPS are an endotoxin and raise pro-inflammatory cytokines. These toxins worsen the inflammatory process and can contribute to health issues.

• One study found that any history of hospitalization for infection is associated with a 62% increased risk of later developing a mood disorder, such as depression and bipolar disorder (Benros ME, 2013)6
• Autoimmunity, a condition where the immune system attacks itself, can be triggered by infection and may contribute to mental disorders. A history of an autoimmune disorder increases the risk of a future mood disorder by 45% (Benros ME, 2013).6

Unfortunately, infections from bacteria (Lyme & co-infections), viruses (EBV, herpes simplex, COVID-19 & others) or biotoxins (mold) can be overlooked by doctors. If this happens, symptoms will persist because the infection is not treated. This can quickly become a chronic problem affecting overall health. 

Chronic underlying infection is one of the first potential root causes we look for in our Functional Medicine clinic, alongside gut dysregulation, hormonal imbalance, nutrient deficiencies, detoxification issues and others.

How exactly does Infection Cause Mental Illness? (Pape K, 2019):

• Pro-inflammatory cytokines of the immune system are part of the ‘cytokine theory of depression’. Inflammatory proteins, or cytokines, circulate in the bloodstream and cross the blood brain barrier. This leads to neuroinflammation. Source(s) of the inflammatory cytokines can be infections and toxins.
• Molecular mimicry (which happens in autoimmunity)
• Autoantibodies (also involved in autoimmunity)
• Self-reactive T-cells (immune system cells)
• Disturbance to the blood-brain barrier (which protects the brain from toxins) 
• Microglial cells are immune cells which make up 10% of cells in the brain (Augusto-Oliveira M, 2019). They can be activated and cause inflammation in the brain. Activated microglia cells and neuroinflammation can cause depressive symptoms.
• Neuroinflammation negatively affects brain health. Depression, anxiety, autism, dementia, schizophrenia, ADD, ALS, MS, Alzheimer’s and Parkinson’s are all inflammatory diseases of the brain.

What are Other Causes of Systemic Inflammation?

Other things, apart from infections and toxins, can cause inflammatory cytokines, neuroinflammation and systemic inflammation:

• Some foods and nutrient imbalances may increase inflammation. A key one is excessive omega-6 polyunsaturated fatty acids from industrial seed oils like corn oil, soy oil, peanut oil, sunflower oil, safflower oil, etc. These are pro-inflammatory. This is especially true if omega-3 (EPA and DHA from fish) is too low.
• Gut dysbiosis is linked to depression and inflammation. The vagal nerve connection between the brain and gut can sense and send gut bacteria signals to the brain and induce brain disorders including depression. Equally, intestinal permeability, or leaky gut, can cause gram-negative bacteria to circulate into the blood stream and cause systemic inflammation.

Summary

• Mental health issues in the US are on the rise. Current medical solutions are not effective. 
• The symptoms of mental health illness and illness from chronic infection ate strikingly similar. This is because an infection – from Lyme, mold, a Lyme co-infection or a virus – can trigger a mental illness.
• The infection can cause brain autoimmunity, neuroinflammation and other effects that can lead to mental illness, like depression, anxiety and others.
• In our Medicine with Heart clinic, we systematically check for infection as a root cause of illness and help people to improve both physical and mental health issues using a Functional Medicine approach to treatment. 

In our clinic, we are experts at identifying root causes of chronic and mental illnesses. We regularly diagnose and treat hard-to-diagnose conditions like mold illness, chronic Lyme Disease, Lyme co-infections and others. Once treated, we see vast improvements in our patients mental and overall health. In addition, we are Lyme-literate doctors. We help people to address the root causes of illness and improve their health, with both natural and pharmaceutical approaches, depending on the individual case. 

** Please stay tuned for our next Blog!  **