How is Lyme Disease Related To Mental Health? – with Dr. Daniel Kinderlehrer


Today on the Gut Health Reset Podcast, we are returning to the topic of Lyme disease, and how it can be connected to mental health. We’ve discussed how certain gut issues can be associated with chronic Lyme disease before, but now we’re exploring how it can also cause depression, anxiety, fatigue, and other neuropsychiatric disorders. 

This episode will explain how Lyme can be a contributing factor in some of these issues, autoimmune conditions, epigenetics, and more with returning guest Dr. Daniel Kinderlehrer! 


We answer these questions:

– Is lyme disease linked to mental health?

– What are PANS and PANDAS?

– What is molecular mimicry and why is it a problem?

– How our environments can affect our epigenetics!

– And more!


Still want to learn more? Schedule with Dr. Barter today!


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About Dr. Kinderlehrer:

Daniel A. Kinderlehrer, MD, is a nationally recognized physician with expertise in the fields of nutrition, allergy, environmental medicine, Lyme disease, and the healing of mind-body-spirit as a unified whole. He co-founded The New England Center for Holistic Medicine in Newbury, Massachusetts, and has taught extensively, including practitioner training courses at the Omega Institute, The National Institute of Behavioral Medicine, and the International Lyme and Associated Diseases Society. He created and organized the Lyme Fundamentals course which is presented annually at the International Lyme and Associated Diseases conferences. He is the author of several review articles in medical journals and the Lyme Times. His integrated medical practice in Denver, Colorado, focuses on the diagnosis and treatment of tick-borne disease. 

You can find him at: 

Get his book at: 

And on Twitter at: 

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Dr. Ann-Marie Barter is a Functional Medicine and Chiropractic Doctor at Alternative Family Medicine & Chiropractic. She is the clinic founder of Alternative Family Medicine & Chiropractic that has two offices: one in Longmont and one in Denver. They treat an array of health conditions overlooked or under-treated by conventional medicine, called the “grey zone”.



Dr. Daniel Kinderlehrer: The epigenetics can be changed from one generation to the next, depending on their nutrition, depending on their mental state. Each generation gets one more bank epigenetic changes in successive generations. It’s like a snowball. We’re seeing more and more and more of this.

Intro: Are you struggling with bloating, gas constipation and fatigue, but don’t know what’s causing these problems? The Gut Health Reset Podcast with Dr. Ann-Marie Barter dives deep into the root causes behind these issues that start in the gut. This podcast will give you the knowledge you need to heal your gut and reset your health.

Dr. Ann-Marie Barter: Today on the Gut Health Reset Podcast, we are covering mental health. We’re covering depression and anxiety and fatigue, which are very common problems that present in practice. A lot of folks struggle with this. We’re also going to go into other disorders such as OCD, suicidal ideations. Bipolar addictions and pants syndrome, as well as eating disorders, specifically anorexia. And we’re going to link these back to Lyme disease and how Lyme can be a contributing factor in some of these issues. Thank you so much for joining us here today on the Gut Health Reset Podcast. I am your host Dr. Ann-Marie Barter, and today I have a returning guest, Dr. Daniel Kinderlehrer. He was on previously talking about gut health and Lyme disease. I’m going to actually put that down below in the comment section so that everybody has access to that because it’s a wonderful episode. He also has written a book called Recovery from Lyme Disease. I’m personally an avid reader. I think the book is great. I’ve probably read it three times, maybe more. It’s an amazing read, especially for anybody that thinks they have Lyme or has been diagnosed with Lyme disease. It’s a great resource. Dr. Daniel Kinderlehrer, M.D., is a nationally recognized physician with expertize in the fields of nutrition, allergy, environmental medicine, Lyme disease and the healing of the body, mind and spirit as a unified whole. He co-founded the New England Center for Holistic Medicine in Massachusetts and has taught extensively including practitioner training courses at the Omega Institute and Nash, the National Institute of Behavioral Medicine, the International Lyme and Associated Diseases Society. He created and organized the Line Fundamentals Course, which is presented annually at the International Lyme and Associated Diseases conferences. He is the author of several review articles in medical journals and Lyme times. His integrative medicine practice in Denver, Colorado, focuses on the diagnosis and treatment of tick borne diseases. Dr Dan Kinderlehrer, thank you so much for coming back on the podcast and sharing your amazing knowledge. We sort of stopped abruptly on your last podcast where we were talking about gut, and we just started getting into some other things associated with mental health conditions. And I wanted to pick back up mental health conditions and live where we had left off. So thank you so much for being here today.

Dr. Daniel Kinderlehrer: Thanks for having me. I’m looking forward to.

Dr. Ann-Marie Barter: All right. So mental health conditions, how is that associated with Lyme disease?

Dr. Daniel Kinderlehrer: OK, I’m really glad you asked. It’s a major, major issue, mostly overlooked, like so much else with Lyme disease. So Lyme is famous for causing arthritis. That’s not one of the main symptoms of Lyme. I think if you going to generalize looking at the big picture of Lyme disease, we would describe it as mainly causing musculoskeletal and neurological complaints. The original investigators, the docs who entered Lyme Connecticut and looked at these kids who had arthritis, they were rheumatologists. And guess what? These kids had neurological complaints, too, but the rheumatologists don’t pick up on that because they go to different conferences than the neurologist and they don’t talk to each other. So it turns out that Lyme disease is is very much a neurological disorder, as well as causing musculoskeletal and other problems. So if I was going to say what are the most common symptoms associated with Lyme disease once it’s in a in a chronic form, I would say fatigue, impaired cognition, headaches, muscle and joint pains, neuropathic pains and sleep disorders and mood disorders.

Dr. Daniel Kinderlehrer: So the most common mood disorder is getting more directly to your question. The most common mood disorders are anxiety, depression and irritability. Now you can imagine if someone presents with those symptoms that basically all of the other symptoms they may have are going to be dismissed or at very least overlooked, like, oh well, this person’s touch distressed or this person has an anxiety disorder, you know, and then they’re sent to a therapist, a psychiatrist, maybe, or just given some medication. But no one’s looking at the whole picture, which is so which is actually part of Western medicine, docs are not trained to look at the whole picture, and they don’t have the time to look at the whole picture. But the mental health symptoms can predominate. And interestingly, it’s often the psychiatrist or the or the psychologist who makes the diagnosis, saying, You know, I think you have an organic disorder. So just described what happened to me when I got Lyme in 1996. And I started off with fever and chills, but it’s fast developed into I can’t sleep at night and anxiety, I mean, nine out of 10 anxiety, 24 seven in now I support impending doom all the time. Later on, when that was complicated by yet another tick borne infection, Bartonella, I developed severe depression on top of panic attacks and I was suicidal. So there’s a long list of mental health conditions associated with Lyme disease, and like I said, these can be predominant. So there’s the anxiety and panic disorders. There’s depression, which can be suicidal. In fact, suicide is the most common cause of death in people with Lyme disease. And there’s bipolar disorder. There’s addiction disorders. There’s actually psychosis with schizophrenic issues. There’s schizoaffective disorder. I’m sure I’m leaving some things out. But suffice it to say, when people have a mental health disorder and there’s no obvious reason why, you know, so for example, someone who is otherwise well balanced, doing well in life and suddenly in their 40s, they develop an anxiety disorder out of the blue without a trigger. Well, that deserves some investigation, right? And the same with, you know, they’re even keeled person. And suddenly they’re irritable. They’re angry a lot, you know, or you know that flying off the handle when they never used to do it, that irritability thing is is very, very common.

Dr. Daniel Kinderlehrer: So those would be the most common the the anxiety, depression, irritability, but it can get much worse. It can become frank psychosis. So one of the one of the something that’s sort of fascinating and and maybe good news in terms of its treat ability. Is I have a sixteen year old patient brought in here by her mom with anorexia nervosa and this young woman refused to eat, she had been inpatient and outpatient. Eating disorder clinics five times was not making any progress, the only way she could. She was getting her calories was through a nasogastric tube that was giving her all her calories because she refused to eat. She had this distorted body image, which so many patients with anorexia nervosa have. You know, she thought she was overweight. She clearly was not overweight and her mother had raised them when she was a child. She lived in upstate New York, which is highly endemic for Lyme disease. Her mother get her tested for line was positive, brought her in to see me. Well, this young woman had four tick borne infections, so she had Lyme disease. She had the bcos. She had mycoplasma pneumonia, and she had Bartonella. Now, the first three of those microbes, she tested positive to Bartonella. She did not test positive two. But first of all, the tests for Bartonella are woefully inadequate. There’s just a high false negative rate, so we’re lost, so we’re often making this diagnosis clinically.

Dr. Daniel Kinderlehrer: One of the things the Bartonella can do is cause these red lines on the skin they’re referred to as Bartonella Austria. There’s often confused with stretch marks, although they’re in different planes than the stretch marks. And she had these red lines on her thighs, which she interpreted as stretch marks and further evidence that she was overweight, which is really ironic, right? And that was confirmation that she had Bartonella, so she had for tick borne infections. We treated with a year’s worth of antibiotics. Three months of that, she was on intravenous antibiotics. She went into total remission, and it’s four or five years later, and she has had no recurrence of her eating disorder. So I wrote her up and it has been published in a medical journal this past year. It was interesting as I was writing her up, I did all the research I could find on eating disorders and infections. Well, it turns out there’s a whole lot of evidence of eating disorders and infections. Anorexia nervosa is quite serious, as I’m sure you’re aware it’s actually anorexia.

Dr. Daniel Kinderlehrer: Nervosa has the highest mortality of any mental health disorder. So. It’s very important to diagnose and treat, and if there’s an underlying organic issue and it’s not just this psychotic disorder, but rather there’s brain on fire neuroinflammation engendering these distorted self images. It’s obviously crucial to understand that and to treat it appropriately. It turns out that there are viruses that like Epstein-Barr that have been documented as triggering anorexia nervosa. There is only one other case in the literature I could find that Lyme disease triggers anorexia nervosa, and there is a huge population study in Denmark. Denmark, everybody is under the national health care system and there they… There are several large population studies that have come out of that.

Dr. Daniel Kinderlehrer: And over, I don’t know, 10 15 year period where the followed of several hundred thousand people, those people with infections have something like a twenty five percent higher rate of anorexia nervosa than those people who did not have infections. So this is well established in the literature. Something I’m very excited about is we’re about to embark on a study. I’m working with a specialist in eating disorders in Massachusetts. He runs an inpatient clinic with two hundred and fifty patients. Great man. Dr. James Greenblatt is just having a second edition of his book published and online anorexia nervosa. And what we’re going to do is we’re going to be testing these probably 25 patients with anorexia nervosa. And we’re going to test them to these different microbes that I just mentioned, including strep, and we’re going to test them to something called the Cunningham panel.

Dr. Ann-Marie Barter: So many people struggle with bloating, bowel issues, brain fog, fatigue. You might not even have any gut issues, but did you know the cause of it could be food sensitivities or gut infections? What I have done is I have brought a talented functional nutritionist into my practice. We have very similar training in the nutritional world. And her name is Alexis Appleberry. She is awesome. So you can head on over to our website, AltFamMed and have a consultation with her and schedule so that she can help you get to the root cause of your problems.

Dr. Daniel Kinderlehrer: So, so this brings us to a condition called PANS. And I want to get the background.

Dr. Ann-Marie Barter: Yeah, what is PANS? Because I don’t think everybody knows exactly.

Dr. Daniel Kinderlehrer: So here’s the background. In the 1990s, researchers at the National Institute of Mental Health headed by Susan Psuedo they they basically were the first ones to describe a syndrome where kids who are perfectly normal would get a sore throat and they’d get strep and they’d get treated. But then they would fall off a cliff and and develop these severe mood and behavioral disorders. They would develop anxiety disorders, OCD and particular tics depression. They would have impaired cognition. They some sometimes develop bedwetting and sleep disorders and so on. And so that condition was called pandas that stands for pediatric autoimmune neuropsychiatric disease associated with streptococcal infections. Since then, it’s been found that there are multiple microbes that can trigger these infections, including multiple viruses, including the cold, including Epstein-Barr virus, including shingles, that and HIV. And by the way, SARS-CoV-2 it’s been reported. SARS-CoV-2 can also trigger this, as well as as bacterial pathogens, Bartonella and Mycoplasma, which are very, very common tick borne co-infections with Lyme disease.

Dr. Daniel Kinderlehrer: I see it all the time in my patients. Then those us have been well-documented as triggering this syndrome. Since this syndrome can be caused by multiple microbes, they’ve changed the name instead of PANDAS. It’s now PANS.

Dr. Daniel Kinderlehrer: PANS stands for pediatric acute onset neuropsychiatric syndrome. I would really like to have them change the name again. I think it’s a bad name for a couple of reasons. One is that it’s not just the pediatric population in which this occurs. And the other is it’s not always an acute onset like those initial kids with the strep throat, sue fell off a cliff. It can be a stuttering onset or a gradual onset of anxiety, a little social anxiety becoming generalized anxiety, becoming panic attacks and OCD kind of thing. So it’s now been pretty well delineated what’s occurring in these kids, and it’s something called molecular mimicry and for your audience. Just describe what we’re talking about. If if you get a strep throat, you can then develop rheumatic fever if it’s not treated. What’s that about? Well, antibodies to the strep then can attack your heart valve because there’s a structural similarity between the strep bacteria and the cells in the heart. So in a sense, the immune system’s confused. They look alike, and now you hope your own immune system is is actively actively inflaming your heart valves.

Dr. Daniel Kinderlehrer: And that’s rheumatic fever. So it’s an autoimmune illness, but it’s also an infection. And we call that molecular mimicry because there is some confusion there, you know, in terms of our own cells mimicking these bacteria, that’s what happens in kids with pans, except instead of our immune systems attacking our heart out there now attacking our brain. We are talking about brain on fire. We are talking about all sorts of issues associated with that, adding that include, in particular, aberrations in dopamine transmission. And we think that that is is probably at the crux of what is causing all of these neuropsychiatric symptoms and these kids. It’s bad. I mean, severe anxiety, panic disorders, OCD and anorexia nervosa. So the the two primary symptoms in the case definition of pans is OCD or and or anorexia nervosa. And then two of seven other symptoms. But they’re the ones we’ve talked about. Excuse me. So there’s anxiety and panic attacks, depression, irritability, anger, oppositional disorders, cognitive decline, tics and and other somatic issues, including the bedwetting and sleep disorders and so on. But the two primary symptoms and manifestations are OCD and or anorexia nervosa. So, you know, this basically pulls together what we’re seeing in terms of infection, autoimmunity and mental health issues and in particular, coming back to my 16 year old patient with anorexia nervosa. She probably happens. She would actually fit the criteria for using the case definition criteria. Even though we didn’t do the test. The test is is the Cunningham panel. I promise to get back to that.

Dr. Daniel Kinderlehrer: The Cunningham panel measures anti-New Ronel antibodies. So what we’re talking about is that there are bacteria that are at that hour. Immune systems react to and that those antibodies, in turn, attack brain and nervous tissue, and they stimulate an enzyme that impacts dopamine transmission. And we see all of these neuroscientists use these are very, very challenging syndromes for the kids, for anyone around them. They’re challenging to treat. Once people get these inflammatory disorders, they often have inflammation elsewhere in the body. So they might have, you know, the muscle aches and the joint pains and chest pain and and and neuropathy. Although those tend to be overwhelmed by the neuropsychiatric symptoms, you know, if you’re having panic attacks, you don’t care if your foot hurts and. And, you know, just like chronic Lyme disease, doctors don’t believe it. I have so many patients who say, you know, they ask their doctor about their pediatrician in particular, can we test our kid to Pam’s? Oh, I don’t believe in pants. I mean, I should not be surprised anymore. But you know, I didn’t know pants was a faith based issue. You know, I thought it was a medical science issue. Why did they think it’s an appropriate response to say, I don’t believe in that, but that’s it’s really a sad fact. There are only a few of us in this state who are actively diagnosing and treating it.

Dr. Daniel Kinderlehrer: And I, we have a lot of patients. It’s often not easy to treat at all. The primary treatment is antibiotics. But then there are all these other sensitivities that happen once the body’s inflamed. So these kids develop food sensitivities and and then those foods in turn trigger more neuroinflammation and make them nuts. So. I have kids who who dairy and eggs and gluten and yeast and corn, if they have it. Oh my God. The lid comes off. You know, we’ve got a Chernobyl meltdown. And you know, and these kids can be violent. I mean, you know, stories of the father usually having to hold the kid to stop the kid from destroying the house and or destroying their sibling.

Dr. Daniel Kinderlehrer: You know, these are really, really serious disorders. So we’re seeing more and more of this. And and we did a study, you know, after after I saw that young woman with anorexia nervosa, I had a doctor sitting in with me at three Cogan. I always had doctors sitting in with me, right? And this is Dr Nancy Brown, who is in Louisville, Colorado. And I said to Nancy, I said, Wouldn’t it be great if we could test a cohort of patients with anorexia nervosa and see how many of them have tick borne infections? And she said, Well, you know, I’m the medical director at a residential treatment center for adolescents with mental health disorders. And we got permission to do an investigation there. And I think this is really important now. This they did not have patients with eating disorders, they were not equipped for that.

Dr. Daniel Kinderlehrer: But all of them were DSM five, diagnosed with major depressive disorder. Most of them had generalized anxiety disorder. Many of them had made suicide attempts, serious suicide attempts, cutting and so on. They did not have any known organic disorders, but they were too sick to hack it at home to go to school. And so they were in this residential facility, actually right here in Estes Park. So we got permission and we took 10 kids at random and we tested them and the this is what came out of the testing if we use strict criteria. Six out of 10 had evidence of exposure to tick borne pathogens. If we use more liberal criteria that a doctor like myself would use that a line literate medical doctor. Nine out of 10 had exposure to tick borne infections, but nine out of 10 were significantly positive. The Cunningham panels. That is, nine out of 10 had had autoimmune encephalopathy. That’s a technical term. Seven. Allopathy is, you know, that’s just that’s that’s some pathology of the brain. You know, there’s something wrong with the brain. So encephalopathy or encephalitis, the inflammation of the brain and autoimmune encephalitis. And no wonder, you know, they had such severe mental health issues, this was not because they hated their mother or didn’t fit in with their friends at home.

Dr. Daniel Kinderlehrer: You know, these kids had fire on the brain. And no one’s no one is diagnosing it. As we all know, the incidence of mental health disorders. In all, age groups is going up, but particularly in in youngsters and adolescents, and here we have this 10 kids chosen at random with serious mental health disorders. Nine out of 10 of them with evidence of tick borne infections and autoimmune encephalitis. Well, you know, it’s it’s a very small study. We don’t have any controls. It was hard for me to get that published for just those reasons. It is published now and and now we are doing finally that anorexia nervosa study and we will have a larger cohort and we’re going to have a control population. So I’m trusting that will be easy to get this one published. But but just think of the potential of how big an issue this could be because you know, what we’re seeing is in the past hundred years a real change in our health and I mean, both physical and mental health. You know, they don’t even separate those two.

Dr. Daniel Kinderlehrer: There have been so many changes in the human condition and in the western world, in the United States in particular. So just think about it when we’re talking about wholesale changes in our diet with, among other things, the sugar in our diet going up like the like a reverse avalanche here and but also nutrient depletion because of soil depletion and so on, we’ve turned to having tons more carbs. That’s really since the since the 70s or so. And now we have all this diabetes and obesity that we didn’t have before then people don’t remember. But a lot of other things have changed. Look at all the additives they’re putting.

Dr. Daniel Kinderlehrer: You know, you read the ingredients in a processed food and you can’t pronounce that for them. And then think of the hundreds, hundreds of thousands of xeno biotic agents, chemicals that we’ve never. The human condition has never been exposed to these before. It’s I mean, you can’t find anywhere on the planet now where you’re not exposed to these things, so it’s not just pesticides and herbicides, but you know you go inside and everyone’s got air fresheners and outgassing from the carpet in the paint with all that formaldehyde. But like I said, hundreds of thousands of these, we have no idea what the toxicities. But what we do know is that they have the capacity to change epigenetics. So I’m going to describe what that is free for the people who are listening. While our genes generally don’t change except over millennia with so-called natural selection. There are proteins that sit on our genes and they turn the genes on and off and the epigenome. Excuse me, the epigenetics can be changed from one generation to the next, depending on their nutrition, depending on their mental state, depending on on the chemical exposure and its. So each generation gets one more bank of epigenetic changes. They’re not. We’re not born with a clean slate.

Dr. Daniel Kinderlehrer: But but then in successive generations, it’s like a snowball. We’re seeing more and more and more of this. And I just want to mention one other huge change in the human condition, which is the breakdown of extended families and community, the breakdown in safety, real safety. You know, now, as you know, we’ve gone from that to nuclear families more, more and more single parent families. So no parent families, you know, people living on the street. I mean, we didn’t, you know, when I was a kid growing up, we didn’t have homeless.

Dr. Daniel Kinderlehrer: There may have been down on the other side of the railroad tracks some alcoholic and junkies that I never saw them. Now they’re on every street corner. You know what the hell’s going on here? And I won’t get into a whole political tangent about that one, although we should, maybe. But. But the point is that that affects our nervous systems and that that affects our metabolism, that affects, that is actually passed on to the next generation. PTSD can be inherited. I mean, it’s crazy, right? But but when you add all that up. What we’re seeing is an epidemic of a lot of illnesses.

Dr. Ann-Marie Barter: Thank you so much for being here and sharing your knowledge. I mean, always, you just have a plethora of knowledge. You’re always learning more every time I talk to you. So it’s pretty amazing. It was amazing to hear you speak today. So thank you so much for being here.

Dr. Daniel Kinderlehrer: Thanks for having me. I really enjoyed it.

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