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Integrative Psychiatry

Lyme Disease and Psychiatric Disorders with Daniel Kinderlehrer, MD

Did you know that there are two categories on how to recognize Lyme disease? Let’s watch Dr. Daniel Kinderlehrer talk about this and how to also consider Lyme Disease complex in all of your patients.


In general, we’re talking about two categories.

One is the people with a prior history of acute Lyme disease. So, they presented with, you know, maybe a known tick bite and a rash and they were diagnosed with Lyme disease, they were treated with a course of ten days to three weeks of antibiotics. And either they continued to be symptomatic, or after having gone into remission, now they have a recurrence of symptoms. And this recurrence can be weeks, months or even years after treatment. In other words, the infection goes dormant, but comes back later in the form of chronic symptoms. These people are referred to as having post treatment Lyme disease syndrome or PTLDS.

There’s another category, and that’s people who have no prior knowledge of acute Lyme disease. They never saw a tick, they never saw a rash, but they developed chronic symptoms. I can tell you that that category is much larger than the former category. These people just develop chronic symptoms and are labeled or mislabeled with numerous ICD code diagnoses that are simply misdiagnoses, and among them often are significant psychiatric diagnoses.

Four Central Points: Pattern recognition is essential in diagnosis

Lyme disease complex often presents as a psychiatric illness with major mood disorders, accompanied by physical symptoms. The pattern recognition is essential in diagnosis.

What is this onset of neuropsychiatric complaints and what is it accompanied by? Testing for Lyme disease? Not straightforward. The diagnosis of a chronic infection with Lyme is still not generally accepted by mainstream medicine despite overwhelming evidence.

Lyme endemic areas: Lyme disease has been reported in all 50 states

Lyme disease has been reported in all fifty states, there is no state immune from Lyme disease. But there are areas where it’s much more likely to get it than others. And these are basically states with higher humidity and/or doctors who are more aware and capable of making the diagnosis. So, the Northeast, but that includes the Mid-Atlantic states, and it doesn’t actually doesn’t stop at the Mason-Dixon line. You can keep on going south to Delaware, Maryland, Virginia, and so on. So, areas with high humidity, that includes the Great Lakes states, that includes the Pacific Northwest. At least 50% of my patients are actually from Colorado, and at least 5% of my patients got it in Colorado.

What’s the Pathophysiology?

This is quite interesting. It’s not what we normally think. When we normally think of infections, we think of microbes invading cells and tissue. These microbes in general do not attack our hardware, they don’t invade cells, but rather they attack software. They result in dysregulation of our systems that are supposed to keep us in homeostasis, like our nervous system.

Consider Lyme Disease Complex in all of your patients with:
Chronic anxiety
Chronic depression
Bipolar illness

Consider Lyme disease complex in your patients with anxiety, depression, perhaps a bipolar presentation, but often a lot of irritability, rage or ODD in kids, along with these other symptoms – fatigue, impaired cognition, pain syndromes, sleep problems. And then if you want to really start to narrow it, the likelihood if they have treatment resistance, why isn’t this person getting better?

Frederick Barrett is a cognitive neuroscientist with training in behavioral pharmacology, and the Associate Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Dr. Barrett has been conducting psychedelic research at Johns Hopkins University since 2013, and his research in healthy participants and in patients with mood and substance use disorders focuses on the psychological and neurological mechanisms underlying the enduring therapeutic and other effects of psychedelic drugs. In 2017, he received an NIH “R03” grant as Principal Investigator to investigate biological mechanisms of psilocybin effects, the first federally funded research since the 1970s administering a classic psychedelic to people with psychedelic effects as the primary focus. He has developed measures of subjective effects of psychedelic drugs, and has also published first-in-human studies characterizing the acute and enduring effects of psilocybin on the brain. He is currently leading clinical trials to investigate the use of psilocybin to treat patients with major depressive disorder and co-occurring alcohol use disorder, and he is leading a number of ongoing studies aimed at better understanding the psychological, biological, and neural mechanisms underlying therapeutic efficacy of psychedelic drugs.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.