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by Jennifer Crystal

Every few months, Jennifer Crystal devotes a column to answering your questions. Here she answers some questions she recently received. Do you have a question for Jennifer? Email her at jennifercrystalwriter@gmail.com.

Can antibiotics help neurological symptoms? Which antibiotics did you take?

Yes. My neurological symptoms such as sleep disturbances, muscle twitches, brain fog, migraine headaches, and difficulty with word retrieval all improved after months of antibiotics. At first, many of these symptoms worsened, as the spirochetes (Lyme bacteria) burrowed deeper into my nervous system to evade the antibiotics. But eventually all my symptoms lessened to a degree where I could function again. Complementary therapies such as neurofeedback and integrative manual therapy also helped, but they couldn’t have killed the bacteria in my brain on their own. That required antibiotics.

A good Lyme Literate Medical Doctor (LLMD) will be able to to determine whether your tick-borne infections—you can get multiple infections from a single tick bite—have crossed the blood-brain barrier, and, if so, what antibiotics will be best for you. Unfortunately there is no set protocol because every Lyme case is different. Many factors enter into treatment decisions.  

Your treatment will depend among other things on how long you’ve been ill, how long you went undiagnosed, which bodily systems are affected, how you respond to treatment, and whether you have other tick-borne diseases in addition to Lyme. Length of treatment varies per patient. I wish I could give you a magic protocol, but there’s no such thing. Only an LLMD can clinically assess your particular case and provide you with an individualized care regimen.

How long did you stay on antibiotics after relapse?

I’m still on them. I’m on a much lower, maintenance-level dose, which I usually take six days a week. When I experienced a flare-up of symptoms earlier this summer, I increased the antibiotics to seven days a week, and doing so fixed the issue. More than a decade after relapse, antibiotics are still helping me.

They are also not hurting me, at least in any tangible way that my doctors can determine. We don’t know what the long-term effects might be, but I have blood work drawn every other month, and so far everything is fine. I take probiotics and stick to a gluten-free, low-sugar diet, which has staved off any yeast infections. I have not become resistant to antibiotics; when I get a sinus infection, I take an antibiotic in a different family than the one I’m on, and the infection clears up just fine.

But this is just my personal experience. I’ve met lots of chronic patients who have gone off antibiotics after relapse and have done well for awhile—maybe six months, maybe a year—and then they eventually relapse. I’ve met others who do well pulsing antibiotics—going off them for a bit, then going back on, then going off again. Still others have switched to only herbal tinctures, and some do a mix of both low-dose antibiotics and herbal tinctures. Only you and your LLMD can determine the course of action that’s best for you. It usually takes some trial and error to figure it out.

Is Lyme disease a mental health issue?

Lyme disease can affect mental health, but it is not exclusively a mental health issue. That is to say, a Lyme diagnosis is not synonymous with a diagnosis of a mental health problem such as bipolar disorder or schizophrenia. Rather, the tick-borne infection causes symptoms that affect one’s mental health. Patients can present with bipolar or schizophrenic behavior, but those behaviors may be an effect of neurological Lyme, and usually not a sign that mental illnesses are the root cause. A competent Lyme literate psychiatrist should be able to tell the difference between a primary mental health diagnosis and a secondary one caused by one or more tick-borne infections.

But be aware, Lyme can impact mental health in many ways. Patients can become irritable and angry, or experience sudden mood swings. Many Lyme patients suffer from anxiety or depression, again as secondary effects of one or more primary tick-borne infections. All of these symptoms may be signs that the central nervous system has been affected.

In summary, Lyme can cause mental health issues, but these are symptoms and usually not core mental health issues. Lyme affects patients physically, neurologically, mentally, and emotionally. It is a full-body illness that should not be too rigidly categorized into its constituent parts.


Jennifer Crystal


Opinions expressed by contributors are their own. Jennifer Crystal is a writer and educator in Boston. Her work has appeared in local and national publications including Harvard Health Publishing and The Boston Globe. As a GLA columnist for over six years, her work on GLA.org has received mention in publications such as The New Yorker, weatherchannel.com, CQ Researcher, and ProHealth.com. Jennifer is a patient advocate who has dealt with chronic illness, including Lyme and other tick-borne infections. Her memoir, One Tick Stopped the Clock, is forthcoming from Legacy Book Press in September 2024. Ten percent of proceeds from the book will go to Global Lyme Alliance. Contact her via email below.

Email: lymewarriorjennifercrystal@gmail.com