As Dr. Richard Bransfield explains in Neuropsychiatric Disease Treatment, “Lyme disease and the immune, biochemical, neurotransmitter, and the neural circuit reactions to [Lyme disease] can cause impairments associated with violence.” [1]
Children with serologic evidence of a tick-borne illness can also develop severe oppositional defiant behaviors, according to Dr. Rosalie Greenberg, a child and adolescent psychiatrist, who runs a private practice in New Jersey.
[bctt tweet=”Lyme disease can trigger extreme oppositional behavior in kids. ” username=”DrDanielCameron”]
Out of 69 youths evaluated at Dr. Greenberg’s practice, 49 (or 2/3) were positive by blood tests for one or more tick-borne illnesses including Lyme disease, Bartonella, Babesia, Ehrlichia and Anaplasmosis.
“I have seen a number of children and adolescents who exhibit significant acute or gradual onset of highly oppositional behaviors often both at home and at school,” she says.
Several examples include:
- Refusal to do class work or homework
- Heightened paranoia or feeling rejected by others
- Increased irritability
- Extreme temper tantrums
- Problems concentrating
- Elevated impulsivity
- Sensory hypersensitivity (sound, touch, smell, taste and/or light)
- Intense emotional lability
Patients also exhibited bouts of rage. “During periods of intense anger over minimal issues, they can appear menacing and threaten to kill a sibling, parent or a friend or state that they want to die themselves,” Greenberg says.
The onset or presentation of the oppositional behavior varied. “Parents describe these behaviors as either a sudden change or a period of worsening of a previous condition, such as attention-deficit hyperactivity disorder or mood 
disorder,” she explains.
In some cases, infections including Borrelia burgdorferi, the bacterial pathogen causing Lyme disease, can induce an immune dysfunction and a condition known as Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). An abnormal immune response triggers various neuropsychiatric symptoms including OCD-like behaviors, tics, mood changes, bouts of rage and aggression.
Dr. Bransfield’s and Dr. Greenberg’s observations will need to be studied further to prove a direct correlation between tick-borne illnesses and aggression and oppositional behaviors. Until then, it would be reasonable to consider a tick-borne illness as a potential underlying cause of extreme oppositional behaviors.
Editor’s note: I have treated both middle and high school students with Lyme disease who exhibited severe oppositional behavior.
Related Articles:
Suicidal behaviors in patients with Lyme and associated diseases
16-year-old boy with Lyme disease presenting as depression
Video: Is Lyme disease an autoimmune disease?
References:
- Bransfield RC. Aggressiveness, violence, homicidality, homicide, and Lyme disease. Neuropsychiatr Dis Treat. 2018;14:693-713.
- Greenberg R. Aggressiveness, violence, homicidality, homicide, and Lyme disease. Neuropsychiatr Dis Treat. 2018;14:1253-1254.
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