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Justin Bieber’s Reveal Shows Why Lyme Disease Is Often Misdiagnosed

Share on PinterestThe singer revealed he’s received a diagnosis of Lyme disease. He’s bringing attention to the condition’s persistent symptoms that can affect physical and mental health — even after treatment with antibiotics. Getty Images

  • Singer Justin Bieber revealed he recently received a diagnosis of Lyme disease.
  • Lyme disease is a tick-borne illness that can cause fever, rash, joint pain, fatigue, and neurological problems.
  • Another common symptom people with Lyme disease experience is depression, which can appear both before, and linger long after, the illness is treated.
  • This can result in delayed diagnosis of Lyme disease for those who are already living with depression or other mental health conditions.

Singer Justin Bieber revealed last week that he recently received a diagnosis of Lyme disease, a tick-borne illness that can cause fever, rash, joint pain, fatigue, and neurological problems.

Bieber, 25, shared the news in an Instagram post, where he addressed comments people have recently made about his appearance. He also said in the post that he has a “serious case of mono” that’s affected his brain function, energy, and overall health.

TMZ reports that Bieber’s Lyme disease caused depression and other symptoms, and that it went undiagnosed for much of last year.

Lyme disease is one of the most common tick-borne diseases in the United States. The bacterium Borrelia burgdorferi mainly causes it.

The Centers for Disease Control and Prevention (CDC) estimates 30,000 Americans contract it each year.

Many, but not all, people with B. burgdorferi develop a circular rash — which sometimes appears as a “bullseye” — within 3 to 30 days after being bitten by a tick carrying this bacterium.

Without prompt treatment, the bacterium can migrate from the bite area to other areas of the body, in particular the nervous system, heart, and joints.

This can lead to a range of persistent symptoms, including fatigue, night sweats, stiff neck, headache, disrupted sleep, and depression. These symptoms can last for months or years.

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Some studies estimate that 10 to 20 percent of people still experience symptoms even after treatment with standard antibiotics. This condition is sometimes known as post-treatment Lyme disease syndrome (PTLDS).

Symptoms like fatigue, depression, anxiety, and brain fog aren’t unique to Lyme disease. But studies have found that 8 to 45 percent of people with PTLDS have depression.

Dr. John Aucott, director of the Johns Hopkins Lyme Disease Research Center in Baltimore, says depression among people with PTLDS tends to be mild to moderate in severity, with major depression uncommon.

In a 2017 study in Frontiers in Medicine, Aucott and his colleagues found that people with well-documented PTLDS had higher levels of depression — along with fatigue, pain, and poor sleep quality — than healthy participants.

Although major depression is less common in people with PTLDS, those with moderate to severe depression have a greater risk for suicidal thoughts.

Complicating matters, it’s not always easy for doctors to tell the difference between depressive symptoms that occur with Lyme disease and major depressive disorder.

“Our recent symptom survey could not distinguish Lyme and depression,” Aucott said. “Especially the vegetative symptoms, such as fatigue, sleep disruption, etc.”

However, one study found that people with PTLDS have more difficulty with memory-related tasks compared to people with major depression. And these memory problems can occur alongside language and attention difficulties.

So, do people with Lyme disease have depression because they have a chronic illness, or because of changes to their brain caused by the disease?

“We think both mechanisms are likely,” Aucott said.

In particular, researchers have been looking at inflammation caused by infection with B. burgdorferi as a possible cause of Lyme symptoms like fatigue and brain fog.

Aucott and his colleagues recently used PET imaging to scan the brains of 12 people with PTLDS.

They found higher levels of a protein called translocator protein (TSPO) in eight different regions of the participants’ brains compared to the brains of healthy people. This protein is a marker for brain inflammation.

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Although the results will need to be replicated in larger studies, they fit with other research linking chronic inflammation with depression.

For Allie Cashel, president and co-founder of Suffering the Silence, an online community for people living with chronic illness and disability, the link between the long-term symptoms of Lyme disease — or any chronic illness — and mental health makes sense.

“When somebody is sick for a long period of time, their mental health is going to suffer,” Cashel said. “If someone is mentally ill for a long period of time, their physical health is likely going to suffer as well.”

For people with PTLDS, it can take years — and several doctors — before they finally get a diagnosis of Lyme disease.

People who are bitten by a tick may not even realize it. Or they may not develop the characteristic Lyme rash.

Also, years can pass between a tick bite and when people show up at their doctor’s office with symptoms like fatigue or brain fog.

When they do, their doctor may make a diagnosis of another condition, like depression or anxiety. While this can provide the clarity of having a definite condition, it may not bring relief of their symptoms.

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