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May was Mental Health Awareness Month. It is a month to lift the stigma around mental illness. Mental illness and mental health look different for everyone. Our struggles and our successes are our own, but researchers are learning more about mental health and the causes of neuropsychiatric disorders, including infectious disease.
Rapidly Changing Concepts of Wellness and Neuropsychiatric Disorders
Emotional, psychological, and social well-being are all part of mental health. Keeping an eye out for these aspects of health can inform how a person interacts with the world around them. Just like physical health, everyone’s mental health baseline looks different. For some people, mental illness is deeply intertwined with their mental health.
Mental illness is a diagnosable disorder or disability that often affects everyday life. Depression, anxiety disorders, bipolar affective disorder, obsessive-compulsive disorder, post-traumatic stress disorder, schizophrenia, and more are all examples of mental illnesses.
For a long time, these conditions were little researched. As mentioned in our post on the history of Alzheimer’s disease, research subjects were often the poor. Their illnesses were usually defined from the perspective of their physicians rather than from their own perspectives.
There has been a recent push to redefine how the mental health conversation is being held. Celebrities and athletes have come forward to discuss their struggles with depression, anxiety, bipolar disorder, and more. The resulting buzz about mental illness has served to center the experience of the patient, to destigmatize mental illness, and to highlight the importance of mental health.
At the same time, more research on the causes of mental wellness and mental illness is being conducted. Researchers are learning more about how mental health can be affected by life events, environmental factors, immunology, genetics, and even pathogens.
Pathogens as a Cause of Mental Illness
The idea that pathogens can lead to mental health events is not controversial. Infections that cause encephalitis or meningitis often trigger psychiatric diagnoses. Central nervous system inflammatory disorders such as Multiple Sclerosis, itself associated with Epstein-Barr virus infection, are also associated with psychiatric diagnoses.
A study of one million medical records in Denmark found that children who had an infection requiring hospitalization had an 84% increased risk of a psychiatric diagnosis as an adult and were 42% more likely to be prescribed a medication with a psychiatric indication.
Researchers at Galaxy Diagnostics have been involved in important research furthering the understanding of how Bartonella species infection in particular may be a cause of mental illness.
Bartonella Species Infection and Mental Illness
A 2021 study conducted by researchers at the University of North Carolina at Chapel Hill and North Carolina State University, including Galaxy Diagnostics scientists, explored the potential connection between neurological disorders like schizophrenia and Bartonella spp infections. This study of 30 individuals included 17 who were diagnosed with schizophrenia/schizoaffective disorder. The other 13 were the control group and exhibited no signs or diagnosis of these disorders.
Blood and serum were collected on two separate days in a week time frame. Serum was used to run immunofluorescent assays that looked for exposure to different Bartonella species utilizing antibodies and antigens. The blood samples were used in molecular assays that looked for evidence of Bartonella DNA. This direct detection method was used in conjunction with the patented Bartonella Alphaproteobacteria Growth Medium (BAPGM) used at Galaxy Diagnostics.
The results of the research study show that a Bartonella spp infection was more common in the individuals with schizophrenia/schizoaffective disorder. You can read more about this study and next steps for research here.
Bartonella henselae and Mental Illness Case Study
In 2015, a high school-aged boy suddenly began to struggle with mental health issues. In the span of three months, the child went from a social, active, high-achieving student to a deeply troubled individual who could no longer attend school. He presented signs of obsessive-compulsive behavior, delusions, and suicidal ideation. After years going between home care with his mother and hospitalizations, physicians did not have an answer to the onset of his mental illness.
In 2017, the boy was diagnosed with Pediatric Acute-onset Neuropsychiatric Syndrome, or PANS. PANS occurs when children suddenly present signs of obsessive-compulsive behavior which may include food restriction. Food restriction itself is also a diagnostic criteria. The behavioral change presents suddenly and may be combined with symptoms of depression, irritability, and anxiety.
At this point, there had been no progression in the boy’s symptoms. Doctors had explored a pathogenic cause using two-tier testing to look for potential exposure to Lyme disease. The results came back negative. Other pathogenic causes were explored when a clinician identified “cutaneous ‘stretchmark like’ lesions” on the child’s body.
Neurobartonellosis was suggested as a potential cause of illness. The boy’s family entered him into a research study at NC State University that included Galaxy Diagnostics scientists. The study focused on identifying and confirming Bartonella species in blood and serum using immunofluorescent assay serology and enriched sample polymerase chain reaction (PCR). Participation in the study by Galaxy Diagnostics scientists led to a diagnosis of Bartonella henselae infection. After treatment with antibiotics, the boy was able to stop taking antipsychotic medications and resume attending school.
Conclusion
Mental wellness and mental illness have a complex mix of causes as well as complex presentations that may be interpreted in different ways by different clinicians as well as different patients. With complexity layered on complexity, there are many directions for further research to go. One of those directions is further study of how pathogens may be causes of mental illness and what treatments can lead to wellness.
References
Lashnits, E. et al. (2021). Schizophrenia and Bartonella spp infection: A pilot case-control study. Vector-Borne and Zoonotic Diseases, 21(6). https://doi.org/10.1089/vbz.2020.2729 https://www.liebertpub.com/doi/10.1089/vbz.2020.2729?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed
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AdvantageCare Health Centers. (2021, October 7). Celebrities raise mental health awareness by sharing personal experiences. https://advantagecaredtc.org/celebrity-mental-health-awareness/
U.S. Department of Health & Human Services. (2022, February 28). What is mental health? https://www.mentalhealth.gov/basics/what-is-mental-health
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Better Health Channel. (2015, September 18). Types of mental health issues and illnesses. https://www.betterhealth.vic.gov.au/health/servicesandsupport/types-of-mental-health-issues-and-illnesses
Disability Benefits Help. (n.d.). Mental disorders and Social Security Disability. https://www.disability-benefits-help.org/disabling-conditions/mental-disorders#:~:text=Is%20Mental%20Illness%20a%20Disability,for%20Social%20Security%20disability%20benefits.
National Institute of Mental Health. (2022, January). Mental illness. https://www.nimh.nih.gov/health/statistics/mental-illness
National Alliance on Mental Illness. (n.d.). Mental Health Awareness Month. https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Awareness-Month
Breitschwerdt, E. B. et al. (2019). Bartonella henselae bloodstream infection in a boy with Pediatric Acute-Onset Neuropsychiatric Syndrome. Journal of Central Nervous System Disease, 11. https://doi.org/10.1177/1179573519832014 https://journals.sagepub.com/doi/10.1177/1179573519832014