Chronic Lyme Disease And Stress Psychology Essay

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23 Mar 2015

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This paper examines the infectious disease known as Lyme disease in its chronic stage and the effects on the body when dealing with the stress of living with chronic illness. I have reviewed and analyzed a number of different pieces of literature and studies on the relationship between stress and living with chronic illness, with a particular focus on Chronic Lyme Disease and its devastating effects on a person's physical, emotional, mental, and social aspects of life. Lyme disease is a bacterial infection caused by an organism known as borrelia burgdorgeri, there are also three different variant Lyme co-infections caused by similar microbes, Ehrlichia, Babesia and Bartonella. Borrelia is classified as spirochete, or "corkscrew bacteria," which is in the same family as Syphilis (Makris, K (2011). Out of the Woods.). Lyme disease was discovered in the mid-1970s and now has become the most rampant epidemic in the 21st century. Over 20,000 diagnosed cases are reported annually to the CDC. Estimations suggest well over 300,000 people are infected yearly, yet those are only the positively diagnosed cases, cases of undiagnosed infection are thought to be double of what are reported (Wilson, A. A. (Director). (2008). Under our skin [Documentary]). In this paper I will present different studies and scientific research that support that stress resulting from the broader life context in the involvement of the development and progress of Lyme Disease as well as in the adjustment to chronic illness. Research also suggests supporting evidence association between patient's perception and attitude towards illness and the response of the illness. In this respect after careful research and review of numerous studies I will purpose the devastating effects of living with Chronic Lyme Disease and the possible relationships between life stress, illness-related perceptions, coping, struggle for medical care and the toll that it takes on someone's emotional, psychological, biological and mental wellbeing.

The broad definition of Lyme Disease is defined as infectious illness caused by the spirochete, Borrelia burgdorferi (Bb), technically this is correct, however clinically the illness in chronic form is much more than that. The chronic form of Lyme consists of other factors and takes on an ever more significant role in immune dysfunction, opportunistic infections, co-infections, biological toxins, metabolic and hormonal imbalances, and deconditioning. In general there are three different categories of Lyme Disease: 1) acute, 2) early disseminated 3) Chronic. Acute and Early disseminated stages of Lyme have high success rates, however Chronic Lyme can be very serious if left untreated. Untreated infections will inevitably resurface with tremendous problems of morbidity and difficulty with diagnosis and treatment. An important issue is the definition of "Chronic Lyme Disease." Based on clinical data published by Joseph J Burrascano MD (Burrascano JR., M.D., Joseph J (October 2008). Advanced Topics in Lyme Disease.) I have come to better understand the definition of "Chronic Lyme Disease." Joseph J Burrascano defined Chronic Lyme Disease as the presence of three different criteria: 1) Illness present for at least on year (approximate time when immune breakdown attains clinically significant levels) 2) Have persistent major neurological involvement such as encephalitis/encephalopathy, meningitis, psychosis etc. or active arthritic manifestations. 3) Still have active infection with Borrelia burgdorferi, regardless of prior antibiotic therapy. It is explained that Chronic Lyme disease is an altogether different illness than that of early stage Lyme disease, mainly because of the inhibitory effect on the immune system where the Borrellia Burgdorferi has been documented through in vitro to both inhibit and kill B and T cells, and will decrease the count of CD-57 subset (type of natural killer cells). In a Chronic Lyme patients, due to their inhibited immune defenses, many microbial pathogens that usually are transmitted with the initial Lyme infection can attack and become active enough so that they too add to the features of the illness, whereas people with early stage Lyme can contain and eliminate the microbes by the immune system. Symptoms of Chronic Lyme are similar and comparable to those of Multiple Sclerosis. Early signs and symptoms are aching, flu-like feeling, mild chills, nausea, pain, swelling in joints, low grade fever, headaches, dizziness, sore throat, fatigue, swollen glands, depression, anxiety and brain fog. Chronic symptoms can result from the destruction of one's neurological system, immune/lymphatic system, endocrine system, musculoskeletal system gastrointestinal, heart/circulation, and cardiovascular system which can result in Parkinson's, Bell's Palsy, MS, Bipolar disorder, OCD, hallucinations, heart trouble, pericarditis or valve problems, pneumonia, rheumatoid arthritis, fibromyalgia, migraines, lupus, ALS, chronic pain disorders, memory loss, sleep disorders, confusion, numbness and tingling, chronic fatigue, seizures, shingles, paralysis, and even death (Wilson, A. A. (Director). (2008). Under our skin [Documentary]). After careful analysis of presented scientific medical research done on Chronic Lyme disease it is aparent to me that Chronic Lyme Disease has devastating effects on the body which can lead someone to become extremely depressed and hopeless feeling.

Many different studies lend insight to the role of stress on patients with chronic illness. It is observed that stress also may affect the progression of infection and infectious disease. Research findings have continuously demonstrated a significant role that stress has in bacterial, viral and fungal infection, leading one to conclude that stress is a significant factor in susceptibility, severity, and progression of disease and illness. A growing body of evidence indicates that stress can make arthritis pain worst

by increasing sensitivity to pain, reducing coping efforts, and possibly affecting the process of inflammation itself, these direct effects occur through neuroendocrine responses to stress. Stress plays a huge role in chronic illness. Stress is defined as the physical or mental response to demands from the environment, the events that led up to these demands, or the individual's perception of these demands. Reach indicates that between 70-80% of health related disease and illness may be precipitated or aggravated by stress. Stress affects the immune system in many ways by affecting biological processes. When a person perceives stress, the sympathetic division of the autonomic nervous system rouses the person from a resting state by stimulating the sympathetic nervous system and producing hormones. The pituitary gland releases ACTH, which in turn affects the adrenal cortex. Glucocorticoid release prepares the body to resist the stress and cope with injury by the release of cortisol, however if the body is constantly under attack, it will remain in a constant state of high alarm resulting in severe damages to the body. This is what happens when a person is living with chronic disease. One study that I reviewed was an example of how stress results from broader life context is involved in the development and progress of many diseases as well as in the adjustment to chronic illness (Karademas, E. C., Karamvakalis, N., & Zarogiannos, A. (2009). Life context and the experience of chronic illness: is the stress of life associated with illness perceptions and coping?) In this study conducted by Karademas and colleagues, they examined the possible relationships between life stress and chronic illness related perceptions, coping and behaviors. Findings suggested that stress resulting from life context is involved in the development and progress of many diseases, adjustment to chronic Illness and associated with the specific ways in which patients perceived and respond to illness. The study hypothesizes that Chronic Illness can be a very aversive experiences that may impact almost every aspect of a person's life. Also it conveyed reports that people evaluate and react to significant stressors based on their previous experiences and after considering the broader context of their life. The study illustrated a Cross-sectional design where participants completed measures regarding life stress, illness perception, illness related coping and restriction imposed by the illness. Participants consisted of 101 chronically ill outpatients with a mean age 51 years old and a mean time elapsed since initial diagnosis was 12 years. Results suggested that life stress was associated with certain illness perceptions (personal control over illness, illness consequence, and perceived severity of illness) and illness-related coping strategies such as different ways of coping. Results concurred that life stress was positively related to consequences and negatively related to personal and treatment control. Higher levels of life stress were associated with perception of worst consequences and less control over the illness. However, results show that life conditions of the illness put a greater burden on patients and as a result they evaluate the impact of their illness as more severe and control over it as less feasible. After analyzing the results of this study, I believe that it fully supports my hypothesis of how stress affects chronically Ill people and how it can perpetuate their progress and degree of suffrage.

A second study that I analyzed was called "A Qualitative Approach to Understanding Patients Diagnosis of Lyme Disease." This study was very informative and conclusive to my personal experiences with living with Chronic Lyme disease and the effects of stress that daily life has on people living with chronic Illness. The purpose of this study was to explore the lived experiences of becoming diagnosed with Lyme disease. Drew and Hewitt used a qualitative phenomenological study to investing the experience of becoming diagnosed with the disease. In the study, 10 participants diagnosed with Lyme disease were interviewed and tape-recorded. The tapes and interviews were then transcribed and coded into key words or phrases that were similar and extracted from each participant's interview. They then analyzed data and concluded five themes that emerged from the interviews. The themes were 1) Frustration from the illness, 2) long road of diagnosis where patients endured multiple diagnostic tests and were seen by numerous health care providers before being correctly diagnosed. 3) Participants voiced financial stress and everyday life stressor that they couldn't complete due to their health condition. 4) they expressed the need for self-advocacy and felt validation when diagnosis. 5) Patents voiced a sense of hopelessness towards treatment and future with living with chronic Lyme disease (Drew, D., & Hewitt, H. (2006). A qualitative approach to understanding patients' diagnosis of Lyme disease.). Through analyzing this study I can relate many of the findings to my chronic illness of Lyme Disease and the stress that it has had on my life. I also believe that many of these findings about stress and Chronic Lyme disease are also similar to other findings related to a variety of different chronic Illnesses.

A third study that I analyzed was very interesting to me and I found myself having related to it very intensely. The study was conducted by Lamia P. Barakat and Ericka L. Wodka from Drexel University in Philadelphia PA. The study analyzed the relationship of posttraumatic stress symptoms in college students with a chronic illness. The study searched to find if there was a relationship between posttraumatic stress responses in college students who had experienced traumatic life events, including the diagnosis and ongoing demands of chronic illness. Post-traumatic stress disorder is a mental health condition that's triggered by a terrifying event. Symptoms of post-traumatic stress disorder include flashbacks of the event, nightmares and severe anxiety, as well as uncontrollable thoughts of the events. Posttraumatic stress disorder is commonly found in war veterans and people who have been involved in a horrific life changing event, but studies and evidence also show that it is found in people with chronic illness. In Barakat and Wodka's study, examination of posttraumatic stress response in youth who experience moderate to severe health-related traumatic stressors was focused on life-threatening, chronic disease, acute events such as accidents or surgeries or hospital visits from illness and trauma related to the treatment of their chronic disease. The study included participants comprised of students in the east coast of the USA. All students gave informed consent completed the measures for which they were eligible. The measure were given in two different parts, part 1 included being at least 18 years of age and eligibility of part 2 required that the participant endorsed have experienced a major life event or chronic illness. All participants met both requirements and there were a total of 195 participants. The participants were measured with, The Life Experiences Survey (LES) (Sarason, Johnson and Siegel, 1978) which consisted 46 life events and changed and participants were asked to experience the event and rated the event from negative to positive impact on a 7-point Likert scale. The Chronic Illness Appraisal Scale was also used in order to assess perceptions of illness-specific threat. Questions on the questionnaire were similar to "I could die from my illness," and "My treatments are severe." The Life Orientation Test was developed to measure a dispositional outlook of favorable versus unfavorable outcomes for oneself (Scheier & Carver, 1985) This test measured the generalized optimistic-pessimistic outlook in a 12 item test presenting states such as "I always look on the bright side of things." The last measurements were the Posttraumatic Diagnostic Scale created by Foa, Chashman, Jaycox and Perry in 1997. The scale was used to measure posttraumatic stress symptoms in response to chronic illness or a life event selected from the Life Experience Survey. The survey had five parts: Part A assessed frequency of symptoms in the past month from Part B criteria of re-experiencing. Part C measured avoidance and numbing and Part D measures arousal from the life events, and part F measures the impact on nine areas of functioning using yes/no questions. Findings documented the presence of posttraumatic stress symptoms among college students with chronic illness and highlighted the role of anxiety and perceived threat in the development of symptoms. Results indicated that the percentage of participants meeting each of the criteria for PTSD was as follows: 41% met A criteria (life threatening illness), 57.4% met Criteria B of re-experiencing symptoms, 31% met criteria C of avoidance, numbing symptoms, 49.2% met the D Criteria of arousal of symptoms and 63.9% met criteria F of interference with functioning. Three students out of 195 students met the full criteria for PTSD (4.9%). These findings suggest that symptoms of PTSD are present in college students with chronic illness. Even though the rate of PTSD diagnosis was low, more than half the sample met the criteria for the re-experiencing symptoms and for significant interference with functioning in everyday life. It also shows that nearly half of the sample met criteria for the arousal symptom. This study was incredible for me to read because I have always suspected that I have had related PTSD symptoms from the tragic illness of Lyme. I still cringe at the mention of "surgery" and have flashbacks of times from when I was extremely ill due to treatment, which has made me apprehensive when continuing treatment. This study shows the importance of understanding subclinical posttraumatic stress responses of young adults to chronic illness that may be persistence and thereby impacting these young adults wellbeing. This study is solid evidence that PTSD of chronic illness effects student's ability to meet their goals and maintain their quality of life.

As you can see, the impact of chronic illness on someone's life can be devastating to every aspect of their life. Stress that comes from living with a chronic illness can come from the struggles of everyday life, medication hassles, treatment hassles, and struggles from living with a chronic disease. Lyme disease has become a huge part of my life and my own experience and research has shown me that progressed chronic cases of Lyme are situations that propel people into a state of emotional crisis. Stress that is caused by a person in an emotional crisis and chronic illness can have a devastating effect on the person's health and wellbeing and can affect the progression of the disease. I have come to realize that when a traumatic life event such as being diagnosed with a chronic illness happens to people it forces them to change every aspect of their lives and can result in devastating effects and increased levels of stress. People with chronic illness experience more stress by the illness than people without chronic illness. The intensity of stress created by chronic illness can be different for everyone and relates to the person's perception of the chronic illness, their ways of coping with the illness, the severity of their prognosis, the struggle for medical care and the toll that is takes on their emotion, psychological, biological and mental wellbeing. In conclusion after carefully analyzing multiple studies and research I have been able to relate to findings of certain studies and their links to stress. I do believe that having a chronic illness makes a person stronger on every level of their being. Dealing with the levels of stress that come from the chronic illness forces people to make radical shifts in their lives. I believe that those individuals that cope with those changes have so much to offer the world and those who are working hardest and have the most altruistic attitudes can be hit hardest by illness as they tent to push themselves so hard with little self-recognition. I believe that the hardest hurdle to dealing with a chronic illness is yielding to its demands or levels of stress. For me, I wanted to hold onto and maintain the "me" I thought I was, the values I felt to be important and the marks of success I was raised to honor. However my illness and the stress from my illness opened my eyes to some other important lessons and those lessons cannot be taught without going through something like chronic illness. Lyme taught me to stop, center myself and listen within to just what it is I need and truly love within my life. I believe that even with the stresses of chronic illness, greatness can come from its burdens. As painful as illness can be sometimes, it has forced me to find inner values and gifts within my life that I never knew were out there.

I truly applaud and admire each and every one out there that struggle with chronic illness and disease for their tenacity, bravery and inner strength. As presented in this paper it is clear how much stress and chronic illness can have a devastating effect on someone's life, however, I have come to realize how grateful I am for the deep inner knowledge and appreciation I have for life. Throughout my illness even though it is a constant struggle every day, I was able to discover things about myself, humankind, chronic illness and the power of patients, hope and faith. In the beginning of my illness I thought it was a curse, but now I realize that chronic illness has opened my life up to a purpose that I would never have imagined before having this illness. My overall self and wellbeing has reached new heights, and I could not be more grateful.



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