Some patients describe it as a type of “brain fog.” It’s a state of mind where things are hard to remember and it takes longer to process what you read and think. It mimics the visibility that comes with the morning fog, where things are hard to see, hard to perceive, hidden behind a mental cloudiness that can result in a chronic change in mental status. While “brain fog” might not be a professionally supported medical diagnosis, it is often a word used to help describe the cognitive problems that come with long-term exposure to Lyme disease. The technical term for it is “Lyme neuroborreliosis” and this happens when Lyme disease creates inflammation in your brain. Lyme neuroborreliosis is a general umbrella term for the cognitive and neurological symptoms that persist when Lyme disease progresses. Neuroborreliosis symptoms are diverse, including trouble recalling specific words, memory issues, and even problems with processing information. It may even involve problems walking, headaches (migraines), balance issues and numbness or tingling in your skin. It is important to understand that chronic Lyme disease can also include psychiatric issues. Problems with mood changes, irritability, increased feelings of depression and sudden personality changes can all occur when Lyme disease invades your brain. Recognition of these psychiatric changes is important because they can all be signs of Lyme disease that get ignored. And because many Lyme disease symptoms mimic other illnesses, it is difficult for medical practitioners to pinpoint what may be causing your symptoms. Lyme impacts and affects each person differently, so there are no set of symptoms every Lyme person experiences. While some people report only the traditional symptom of joint pain, headaches, fever and a bull’s-eye rash, others may feel less obvious symptoms such as fatigue, brain fog, dizziness, wandering joint or muscle pain or short-term memory loss. The wide variety of symptoms are partially explained that there are many ways Lyme disease can affect your body, but also may be due to the presence of coinfections. Coinfections are other microbes that can be transmitted through a tick bite, such as Bartonella, Babesia, Anaplasma, Ehrlichia, Mycoplasma, Rickettsia and others. Some of what causes symptoms after a tick bite may be due to Lyme disease in combination with another infection. Evidence suggests up to 30% of people who get Lyme disease also have a coinfection and it is difficult to tell what Lyme disease causes versus what is caused by another organism. Therefore, it is important to get thorough testing to try and help you and your doctor find out what is making you sick. Lyme disease is a complex, multi-system problem that mimics so many other conditions, it often gets missed. Unfortunately, this means millions of people around the world either get misdiagnosed as having something else or gets no diagnosis at all. Either way, it means lack of proper treatment and worsening of their symptoms. Depending on the strength of your immune system, Lyme disease symptoms could show up to 12 hours after the first tick bite or it could take years. There is nothing in our current testing that tells us anything about timing and when you may have been bitten by a Lyme-carrying tick. It’s no secret that the sooner you find out you have Lyme disease, the better. Early treatment means less likelihood of having long-term health problems, including mental and cognitive issues. Consider the possibility of Lyme disease if your symptoms are persistent and every test seems to keep coming back negative. I recommend you work with a provider who uses a lab that does more comprehensive tick-borne testing that your regular local reference lab. I’ve seen plenty of people who have a negative test with their local lab and then we find out they have Lyme disease when they get better testing. Lyme disease is a clinical diagnosis, which means it’s based on your symptoms plus your risk of tick exposure. The lab test only confirms what we suspect, but a negative test does no rule out the possibility of having Lyme disease. Although Lyme itself can be tricky to detect, your symptoms are not. Feeling better is everyone’s right and knowing how to identify and treat it is just as important and is your first step to feeling well again.