In the last two years, since my plea appeared in a letter in the July 3, 1998, issue for psychiatric recognition of the epidemic of mental illness caused by tick-borne disease, the situation has escalated to a dangerous degree.

In my small solo psychiatric practice, nearly every new patient has positive evidence of infectious disease of the brain resulting in serious cognitive and emotional damage. Since I have begun to do SPECT scans to pick up Lyme brain inflammation, I have diagnosed and am treating the psychological sequelae in at least 12 previously unsuspected cases of encephalitis or cerebral vasculitis. Most of the patients have positive PCRs for the DNA from Lyme, babesiosis, and/or ehrlichiosis.

All infected persons seen in my office appear to have the typical, usual emotional problems that I have been used to treating for decades. One difference is that people have not found reasonable answers to explain multiple physical problems. Both the mental and the physical symptoms are reversible if treated quickly enough and for a sufficient length of time. For example, panic or rage attacks may resolve totally with the help of antimicrobials, needing only initial treatment with psychotropics. Unfortunately, the vast majority of these infected patients is not being treated at all because of the failure, by psychiatrists and other physicians, to diagnose tick-borne encephalopathy in time or at all.

My appeals to authorities in public health and at APA have not brought forth visible proactivism against this unprecedented epidemic originating in our own backyards. Disseminated Lyme disease is a neuropsychiatric disease with the emphasis on the latter; it is not primarily an articular disease, as is widely believed. Unfortunately, APA’s published literature is asymmetrically preoccupied with the chemistry of the brain and economic challenges to APA’s membership instead of the overwhelming threat of this epidemic.

Home is burning, and APA is fiddling. Official psychiatry seems to be out of touch with reality.

Virginia T. Sherr, M.D.

Holland, Pa.