It’s All In Your Head. …Or is it?
A Physician’s Perspective
Guest post: Dr. Elena Frid, MD
This week, we feature a guest post from Dr. Elena Frid, a board-certified NYC neurologist and specialist in Lyme disease and other vector-borne diseases. Dr. Frid has been recognized by her peers and patients for her innovative diagnostic methods and treatment regiments for a wide array of complex neuro-Lyme manifestations which often mimic other illnesses including multiple sclerosis (MS), Attention Deficit Hyperactivity Disorder (ADHD), various learning disabilities, Autism, Arthritis, Lupus, Alzheimer’s, Dementia, Parkinsons, anxiety/depression, intractable headaches, dizziness, insomnia, obsessive-compulsive disorder (OCD) behavior, ticks and many more. Here, she shares her perspective on the complexities of treating these complex illnesses.
Over the years, I have seen numerous patients who complain of many neurologic and psychiatric conditions. Often, when a patient complains of more than one or two problems, many physicians can get overwhelmed. It is difficult to treat a patient who seems to have a multitude of problems that, at first glance, may not appear to be related. Part of the issue is that medicine is moving in the direction of treating symptoms, and not the underlying cause of the problem.
When I see a patient who is complaining of headaches, insomnia, depression, anxiety, dizziness, concentration issues, brain fog, memory disturbance, visual problems, or other, I start with an extensive history. I want to know: When did these symptoms first appear? How long have they been going on? Did they all start at the same time? Are medications helping any of the symptoms? What was done by other doctors to work up these complaints (tests? treatments?)?
Often, what I hear back is that test results were negative, medications seem not to be working, symptoms have persisted for months or years, and the condition is either not going away or getting worse. Frequently, these patients have received a psychiatric diagnosis and the bulk of their symptoms are being “managed” by their psychiatrist. In my practice, which primarily deals with neurologic manifestations of Lyme and associated illnesses, I see a great deal of these patients. My experience, and the use of a number of tests (such as MRI, Brain SPECT/PET scan, LP, blood work, EEG, VNG, and neurocognitive assessment), has led me to believe that many of these patients are suffering from Infections Induced Autoimmune Encephalitis [IIAE].
Essentially, Infections Induced Autoimmune Encephalitis [IIAE] is an inflammation of one’s brain due to a break in the blood-brain barrier that produces a form of Encephalitis manifesting all of the symptoms I just described (headaches, declining memory, insomnia, depression, anxiety, brain fog, etc.) These symptoms are not only resistant to psychiatric medications but in some cases will worsen and cause patients to have trouble tolerating the medicines due to an increase in the excitatory neurotransmitters induced by the medication.
Identifying the causes of one’s symptoms is critical and determining an appropriate treatment protocol is dependent on an accurate assessment which requires deep investigation using cutting edge diagnostic technology and expert clinical experience. Once the cause is successfully identified and treated, the symptoms almost always resolve.
You speak here about symptoms being misdiagnosed as psychiatric conditions but there are also many cases of symptoms wrongly attributed to other physical illnesses like MS, Rheumatoid Arthritis, Lupus, etc. Can you comment on the challenges of distinguishing among these diseases?
The challenge in distinguishing between infections-induced and idiopathic immune disorders listed above is that you really need a proper and thorough medical/physical history and diagnostic testing. In my practice, I use my clinical expertise as well as specialty labs and cutting-edge medical technology to arrive at a diagnosis. Lyme disease and associated disorders often mimic and can cause symptoms of Lupus, MS, RA, Alzheimer’s disease and many other conditions. The treatment and management of patients who have Lyme induced disorders would be vastly different than if one had the same conditions for an unknown/idiopathic reason. Therefore, I urge everyone to seek a specialist who would be able to decipher the cause of your symptoms so that a potential cure can be attained.
What can patients do to ensure they get proper diagnosis and treatment?
I recommend for patients to obtain expert opinion from physicians who are well versed in Lyme as well as Autoimmune Neurology. Patients need to know that one needs to identify all the offending pathogens and disease processes and treat them all at the same time to get proper long-lasting results. Often, patients are treated symptomatically or treated for one infectious, inflammatory, or autoimmune process at a time. Results are attained only when the patient is treated for everything that is going on with them all at once.
Any other words of wisdom for the Lyme community and/or all those outdoor enthusiasts wary of encountering ticks and Lyme disease in their activities?
People need to understand that protecting oneself is important. For example, they need to consider wearing long sleeves and Permethrin-embedded clothing when doing outdoor activities, including playing/working in one’s yard, playground, or soccer field. Checking for ticks after an outdoor activity is absolutely important. Also, it is important to know that the earlier we are able to identify Lyme and associated diseases in a patient, the higher chance of preventing/avoiding long term symptoms. Therefore, seeing a Lyme-literate physician who can order proper diagnostic tests and start appropriate treatment is crucial.
Here, in this talk with Fox5 News, Dr. Frid explains her focus on Lyme.
In another upcoming post, Dr. Frid will talk about the risks of self-diagnosis and the importance of and tactics for building a successful partnership with your care provider. Do you have other questions for her? Comment below.
You can also follow Dr. Frid on Instagram @drelenafrid
Visit her website www.elenafridmd.com
And watch her YouTube channel Lyme Talk with Dr. Frid