Dr. Susan B Trachman, Clinical Psychiatrist and Author

Why She Started Looking at Lyme Through the Psychiatric Lens

Mimi MacLean:
Thank you so much for coming on.

Dr. Susan Trachman:
Well I very much appreciate the invitation. Thank you.

Mimi MacLean:
Yeah. So I know your background is psychiatry, that’s what you’re a doctor in, but you’ve kind of focused on treating it by looking at chronic illnesses such as Lyme. And I know, for me, from personal experience from family members, and just being in this community for so long, I don’t think it’s talked enough about when you hear kids who are taking their life or struggling mentally, I’ll say, “Oh, did they have Lyme?” They’re like, “What are you talking about?” And I just feel like that should be one of the first things that people talk about is do they have chronic illness, do they have mold, do they have Lyme? So I guess my question for you is how did you get into this, first of all? How did you decide to take your practice and focus on this part of it?

Dr. Susan Trachman:
Okay, sure. So when I went to medical school, I actually thought I was going to be an OBGYN, because I was always very interested in women’s health. But due to a really unfortunate experience during my clinical rotation in obstetrics, and gynecology for whatever reason, there was a resident who took a distinct dislike to me, and sort of made my life hell. I was like, “No, I don’t think so.” So, I must have had a list of at least a half a dozen specialties that I thought I was going to go into. And I always found human behavior particularly interesting. I was a psychology major as an undergraduate, and when I did my internal medicine clerkship in medical school, I was on the cardiology service, and I had a very nice young attending who at the end of the rotation said to me, “Well what do you want to be when you grow up?”

Dr. Susan Trachman:
And I said, “Well, I think I’m going to be a psychiatrist.” And she looked at me and sighed heavily and said, “Where have we gone wrong?” So I guess that was a compliment. It was kind of a backhanded compliment in that I was guess I was pretty good at internal medicine. And folks who go into internal medicine are very clever people. They like to figure things out, they like to sort pick through all the details, and sort of play detective. But then I was very fortunate because when I did psychiatry, at least where I went to school at the University of Texas, we had a very popular psychology department. And one of the things that I did was in those days we called the consultation liaison, psychiatry. These days we call it psychosomatic medicine, where we would get called by other services in the hospital to go, and consult on their cases that didn’t quite make sense.

Dr. Susan Trachman:
So, in my opinion, we got to see some of the most interesting cases in the hospital. And I thought to myself, this is really interesting because this is being an internist, except we have to think about the brain too. And so I did go into psychiatry, I did my residency at George Washington University, and then I did a fellowship in what is now called psychosomatic medicine, where, again, we were called, this is through Georgetown. So we were called to see all the cases in the hospital, the entire general hospital OBGYN, orthopedic surgery medicine, where they couldn’t quite get a handle on what was going on. So, I became very interested in an area called medically unexplained symptoms, which may sound like, well what is that? I mean, medically unexplained. The truth is they’re all explainable, you just have to know where to look.

Dr. Susan Trachman:
And I think we’ve all probably heard ad nauseam the phrase the mind body connection. But the truth is, if I cut your head off, could you function? And the answer is, I assume you’d say, “Of course not. That’s silly.” So, to think of things in terms of what’s going on in your head, and what’s going on in the rest of your body as separate makes absolutely no sense. And that’s really where I became very interested in this whole idea of medically unexplained symptoms, because up to 40% of patients who are seen in a primary care practice have what are called medically unexplained. That’s a misnomer. They really are explained. They are, however, in excess of what one would expect given whatever kind of laboratory studies, or radiographs are done. Meaning the lab studies might look normal, the MRIs may look normal, the CAT scans may look normal.

Dr. Susan Trachman:
And so the puzzled physician will say, “Well, we don’t really know what’s wrong with you, so we’re going to send you to Dr. X.” And the typical history of someone who will come into my practice is someone who’s been to multiple specialists, all well meaning, who try to fix, or solve the problem. But if you are a specialist, you tend to specialize, and look for things that you can fix within your specialty. So if you’re a cardiologist, you’re going to try to find, maybe there’s a cardiac explanation for this. If you can’t find one, it’s like, “Hmm, we’re going to send you to a rheumatologist.” So ad nauseum, we go on and on and on. These are all well-meaning specialists who try to focus in on their area of expertise, but if it doesn’t fit that area, sometimes patients will walk out of there with the assumption, or the impression that their doctor doesn’t believe them, or that somehow they’re exaggerating, and they’re made to feel like, “Well, it’s all in your head, so go see a psychiatrist”, which is where I come in.

Dr. Susan Trachman:
So, that’s why that’s the title of my blog. It’s not just in your head because your head is connected to the rest of your body. So, in the course of writing a book, which I’ve done over the course of the past year, I have done research on a lot of these areas of called medically unexplained symptoms. Lyme is not medically unexplained. You can explain it very well. However, the presentation of Lyme may look very, very different depending upon where in the course of the illness the person is being seen. And one of my favorite authors, Amy Tan, tells a very interesting story, and I don’t know if you’re familiar with her history. Amy Tan went to a wedding in upstate New York years ago and she, after attending the wedding, she noticed some kind of a lesion on, I believe it was on her leg, but she didn’t make much of it because it didn’t look like what we called the target lesion of Lyme disease.

Dr. Susan Trachman:
It looked like a little black spot. She thought it was a spider bite. To make the story short, she felt flu-like for about a week after, but then it got better. So she didn’t really pursue it, but things didn’t get better. So she started to develop other symptoms. She started to develop joint pain. She started becoming short of breath, she started having difficulty focusing, and concentrating. And again, she pursued this line of specialists, much like what I just described and was told, “Yeah, there’s really nothing wrong with you”, until her blood sugar dropped so low that her internist was very scared, and had to hospitalize her. So at the time they did an MRI and it came back with multiple lesions, unexplained lesions. And she said, “Well, what is that?” And her doctor at the time said to her, “Well, that’s normal for someone your age”, except that she was 49 at the time.

Mimi MacLean:
And the lesions were on her brain?

Dr. Susan Trachman:
Yeah. So, she’s told this is normal for someone your age. Well that’s not normal for anyone, particularly for someone with her level of cognitive ability at the age of 49. So, unfortunately, this goes on and on, she’s getting worse. It got to the point where she started having seizures, she started to hallucinate, and believed she saw like poodles hanging upside down. Her two dogs were talking to her. Finally, she saw someone, and she told them the story, “I had been there, could I possibly have Lyme?” All along, she’d been told, “No, no, no, you can’t have Lyme, you live in California.” She said, “I attended a wedding in upstate New York.” And they’re like, “Nah, you don’t have it. You didn’t have the rash, blah, blah blah.” Well, finally, this specialist determined that we need to do some testing, and see if in fact you either do, or did.

Dr. Susan Trachman:
And she did. She was treated with antibiotics, and the acute symptoms got better. But unfortunately she had been suffering from it for so long that some of the symptoms and some of the residual was not reversible. To this day, she still has seizures. To this day, she has crippling arthritis, thank goodness she can still think because she still writes books that I love. But she is my sort of classic story of someone who is, here’s someone who’s well known who can have access to excellent medical care. And even the excellent medical care that she attempted to obtain didn’t think about Lyme disease because you don’t have the classic symptoms. The problem is, like I said earlier, it depends upon when you’re seen, in other words, up to 30 to 40% of people who have Lyme who’ve been infected by a tick, never have a target lesion, the bullseye.

Dr. Susan Trachman:
And if you’re tested too early, your test may not come up positive. So they’ll say, “Well, you have a negative”, the first test is an ELISA test. “Oh, your ELISA test is negative. We don’t have to pursue anything else.” What I recommend is if you’re still having symptoms, and it’s been more than two to three weeks, and you’re not getting better, go in, and have another one because your ELISA test may then turn positive, at which point your doctor should order what’s called a western blot, which is much more specific for Lyme because the treatment is very simple. It’s a course of antibiotics and most people are well.

What Does a Psychiatric Treatment for Someone with Lyme Look Like?

Mimi MacLean:
Oh geez. I mean it’s like what do you do? So when you have someone, you have a new patient that comes to see you, and they’re here because they think they have bipolar, or they think they have anxiety, or depression, or suicidal tendencies, is your immediate go to, I think most psychiatrists, because everybody probably who is listening to this podcast, has been told at one point or another to go see a psychiatrist, because they’re [inaudible 00:11:39] it up. that’s pretty much the common thing because everyone thinks, you want to be sick and that’s what you’re trying to do. But that’s not the case. So, if someone comes to you and is like, “Hey, I have suicidal thoughts, I’m depressed”, do you automatically say, “Okay, let’s test for X, Y and Z.” If it’s your vitamin D, or whatever. I don’t know if it’s Lyme, if it’s mold, or do you treat them first? How does your process typically work?

Dr. Susan Trachman:
Well, I think that you basically have to rule things out before you rule them in. And so one of the other things I do besides seeing patients is I teach medical students, and residents, and fellows, and I used to prepare people for their psychiatry oral boards when we used to have oral boards. And so I’d give them, they’d have to interview a patient, I’d give them an oral exam. And I would fail them immediately on their oral exam, their practice exam if they arrived at a diagnosis. Because you can’t arrive at a diagnosis until you consider all the facts. Let’s say someone comes in, they have no prior history of any kind of psychiatric illness, there’s no family history of psychiatric illness, there’s no recent events that might contribute to something. Now some people are still depressed even in spite of that. However, I’ll also ask for other things.

Dr. Susan Trachman:
For example, when’s the last time you had a physical exam? When’s the last time you had any laboratory studies? Do you have any physical symptoms? I mean, basically, I will go through a typical what an internist would do except doing a physical exam. Unless I need to listen to their heart or their lungs, and I will. But do you have this medical problem? Do you have this? Do you have this? Do you this? Because there are so many medical illnesses that can present with psychiatric symptoms, and they’re so common I can’t tell you the amount of time I’ve diagnosed thyroid disease in someone who comes in and is depressed or is anxious. And you treat the thyroid disease and their symptoms go away.

Dr. Susan Trachman:
However, if someone says to me, I had this weird rash, and then it went away, and I’m also having joint pain, and my next question is, “Have you traveled? Where have you been on vacation recently? Have you ever been bitten by a tick?” Because those are things I think about and certainly not the only thing I think about. But you can’t be so narrow in your focus because if you are, you’ll miss something. If you don’t look, you’re not going to find it. And that’s why I think all these well-meaning specialists who see folks with medically unexplained symptoms sometimes miss it, because they’re zeroing in too narrowly on their area of expertise in hopes of fixing the problem.

Mimi MacLean:
Well, out of your patients, what would you say, what percentage that come in that you would say become explainable? Like it’s from the thyroid, or from Lyme, or for something?

Dr. Susan Trachman:
A lot of what I see are just, you’re kind of garden variety, someone’s depressed. Physically, they’re fine, they have no physical symptoms, they’ve had a significant loss, or they’ve moved across country, or they just had a baby, and they have postpartum depression. I mean you have to look at it within the context of their life. I guess that would be a good way of explaining it is before making a diagnosis, you have to think about what they’re describing to you within the context of their life. So like I said, even when I teach medical students, I mean the first thing I tell them is, before you even lay hands on anyone, just listen. Because if you listen carefully, more often than not the patient’s going to tell you what’s going on.

Dr. Susan Trachman:
They’re not going to tell you what the diagnosis is, but they’re going to tell you what’s going on. Because think about it, they know their bodies more better than you do. They know their history better than you do. But like I said, if you’re too narrow in your focus, more often than not you’re going to miss something. I like to tell people start broadly, and then narrow it in. And if you’ve ruled everything else out, they have your garden variety, depression or anxiety, treat it. They get better.

Mimi MacLean:
Right. And what would you say besides the thyroid, how often do you either see Lyme, or what other diseases do you see?

Dr. Susan Trachman:
It depends. I mean I see a lot of them. I have a lot of patients who have autoimmune disorders, and one of the reasons is that autoimmune disorders often present with psychiatric symptoms, or have coexisting psychiatric symptoms. An example would be lupus, for example. So some people have mild cases of lupus, some people have more significant cases of lupus. Someone who’s having a lupus flare very well may get psychiatric symptoms because it can cause what’s called encephalopathy, and where they basically they can hallucinate. It’s rare that you see something like that. Sometimes you see the results of a patient being treated for their autoimmune disease. So, let’s just say someone’s having a flare of an autoimmune disease, and their rheumatologist puts them on a steroid, which is often the first line treatment. That alone can cause psychiatric symptoms. I’ve had patients before I had met them who were hospitalized in the psych unit because they looked like they had bipolar disorder when in fact they were just manic from a high dose of prednisone.

Mimi MacLean:
Wow.

Dr. Susan Trachman:
I have a guy now that I’ve seen only not that long, he’s very well educated, professional man in his fifties. He’s physically in good shape, saw him early on in the pandemic, he was very, very depressed, had never been depressed before, and he believed that things were not going well in his legal practice, there were other issues going on, and his internist had already started him on an antidepressant, which he was tolerating. And I was like, “Okay, that makes sense. Your internist has worked you up, there’s no physical symptoms, fine. Let’s just see how you’re doing.” Didn’t see him for a while. My colleague here happens to see his wife who then called me and said, “My husband is acting really weird, I don’t know what it is, can you see him again?” I was like, “Yeah, of course.”

Dr. Susan Trachman:
They came in together and she’s describing symptoms that are absolutely consistent with bipolar disorder, but the guy’s in his fifties, and it doesn’t usually present in his fifties, late teens, early twenties, right? So, I thought, “Okay, maybe you have late onset bipolar disorder. I doubt it. But being on an antidepressant, if we don’t know that you had this predisposition, maybe that’s what caused it. Stop the antidepressant, let’s see how you do.” He got worse. Until recently, within the past two months, I, and his wife insisted that he get an MRI of his brain. He’s got all kinds of lesions.

Mimi MacLean:
So do you think it’s from the Lyme?

Dr. Susan Trachman:
We don’t know what it is. His internist is supposed to work him up. I think he’s probably had small strokes, and if you have a multitude of small strokes, the combined effect can do lots of things, and make you look depressed. They can make you look manic, they can make you look demented. They can do lots of things. So you have to go in there with an error of being a detective. Meaning don’t assume that you know what it is, if you know what it is, you’re probably going to be wrong.

Mimi MacLean:
Okay. So, why do you think, I think you’re a rare doctor, I don’t think most psychiatrist think this way.

Dr. Susan Trachman:
There are some of us who do, though.

Mimi MacLean:
There are some, I can name a couple, but most of them I don’t think are. For example, especially now with, well of course because the lockdowns, and everything with the teens. But the [inaudible 00:19:04] teen suicide rates going through the roof, and of course it’s because of social media, and also being locked down with the pandemic, and all that. But I do think there is a big part of, I think a lot more people have mold, parasites, Lyme that are causing them to have psychiatric, but why is that not something that they’re… That’s just an easy like, “Hey, let’s check your vitamin D. Let’s check to make sure you don’t have mold. Let’s check to make sure you don’t have parasites.” Why is that not part of a normal workup before you go put them on heavy duty pharmaceutical drugs?

Dr. Susan Trachman:
Because I can’t answer for everybody, but I think that no one’s going to think about parasites as first line, I don’t think. I think even an internist, unless someone’s coming in, and they’ve got some abnormality in their blood work, or they’ve got gastrointestinal disorder is going to start thinking about parasites. However, I went to medical school at the University of Texas, and we saw weird stuff because we saw a lot of people coming across all different borders. I think I saw the only case of central nervous system Cysticercosis that any of my friends have ever seen. And you probably say, “Well, what is that?” It’s a form of snails. It’s a parasite that likes to travel to the brain, and that’s why that person was psychotic, but that’s a way outlier.

Mimi MacLean:
No, but I do think a lot of us have more parasites than we think because everyone travels and…

Dr. Susan Trachman:
That’s the key. I mean, but again, that’s part of taking a good history. So, if you take a good history, part of taking a good history is where have you traveled recently? Where have you traveled in the past six months? Where have you traveled before you developed the onset of these symptoms? Because then you know what to zero it in on. I mean if you’ve traveled to a place that’s endemic for let’s say Giardia, because the water’s contaminated, okay, you’re going to look for that. If I went to the beach in Connecticut, I’d be looking at Lyme because that’s where it was first diagnosed in children, because ticks are endemic. But as the deer population has migrated to all these different places, so have the ticks that carry Lyme disease. But again, I think even your primary care doctor’s not going to think about zebras, they’re going to think about horses first. So, I don’t think it’s anybody’s fault, but if you’re not getting the result that you think you should, given what you believe is appropriate treatment, then I think you need to go back, and reconsider the diagnosis.

Mimi MacLean:
Yeah, right, exactly. I just wish there’s a way we can get the message out. Just high schools, and kids that are struggling, because it could just be an easier fix of supplements, or minerals, or treating whatever their chronic illness could be.

Dr. Susan Trachman:
There are more practitioners that are going into what are called… More medical students actually are going into what’s called integrative medicine. And I think the folks that are legitimate are great. What I worry about, quite honestly, are some of these characters who are making a lot of money off of unsuspecting patients who just want to get better, who have these quote Lyme literate practices. Some of them are legitimate, but some of them are not. And the danger is these practitioners who believe that people have what’s called chronic Lyme disease, and they want to put them on antibiotics long term that causes more harm than good. I mean there are people who have what’s called post-treatment Lyme syndrome, but that is different than telling someone they have chronic Lyme disease, because chronic Lyme disease implies that you’re continually infected by this thing that’s not going away. So you should always take antibiotics.

Dr. Susan Trachman:
Well, what’s going to set you up for all kinds of problems long term. There is a real diagnosis, and this is where a lot of the debate has gone back, and forth among different specialists within medicine about is there such a thing as post-treatment Lyme syndrome? Yeah, there really is. These folks are not making it up, and they’re suffering, and unfortunately there’s not a quote cure for that. We can treat the symptoms of post-treatment, Lyme disease, but to have someone believe that they have Lyme for the rest of their life is a mistake, and could lead to some serious consequences.

Mimi MacLean:
well, if you have someone you find out that has Lyme, and you tell them to go get the three weeks of antibiotics, whatever, and they’re not getting better, where do you send them? Where would you tell them to go next?

Dr. Susan Trachman:
Well, first I want to see what the lab work looks like. I want to know when in the course of the illness they got their first test, which is an ELISA. That’s kind of the screening test, which is non-specific. If that came back negative initially, and I’m still suspecting that they have Lyme, I’ll wait a few weeks and have them do it again. It’s still negative, then we have to look for something else. If it comes back positive, then we want to get a confirmation with a western blot, and have them treated with a first line course of antibiotics. If they get better after that, great. If they don’t get better after that, then the question is what else do they have? So then we might be talking about post-treatment Lyme syndrome, and no one really knows what causes that, but there’s a general belief that it’s not due to continuing infection with the Lyme bacteria itself.

Dr. Susan Trachman:
However, it may be the case that being infected, depending upon when you got your treatment, what kind of treatment you got, it may set you up for some type of an autoimmune process, which we haven’t really named yet, because it kind of triggered your immune system to go after the bad guys. But your immune system is taking on too forceful a response to the bad guys and may actually be attacking some of your own healthy cells. And that’s what we really don’t know. That’s what a lot of the research, hopefully, will be on because again, we do not have an absolute treatment for that. You treat the symptoms. So if someone, for example is having persistent insomnia, we treat the insomnia. If someone is having chronic joint pain, there are some antidepressants that work beautifully to treat pain as well as mood disorders. So, then we treat symptomatically. But it’s definitely a challenging area.

Mimi MacLean:
Yeah, it is. And you know what> I’ve done it all. So I’ve been on the long-term antibiotics, which almost killed me.

Dr. Susan Trachman:
Yeah, well like I said, it can do sometimes more harm than good.

Mimi MacLean:
Yeah, and I think I’ve learned now that the joint pain, for me, it’s chronic kind of comes and goes, but I manage it through lifestyle choices, definitely what I eat, and drink. That’s like totally, I feel like that is something. But I do agree with you. I feel like I tell people if you’ve already kind of gun done the standard, what you’re supposed to do for Lyme and you’re not getting better, there’s something else going on. You either have a parasite, you have mold, you have continual mold exposure, stress, whatever. Your limbic system is incomplete, like it’s still on, it’s turned on. You got to figure out how to turn it off because it’s still thinks it has the Lyme.

Mimi MacLean:
And I like to use the analogy, it’s like it’s almost like having termites, and so the termites came into your body, you killed the termites, but it left damage. And so what is it left? What damage is it left? And figuring out where that damage is and why. But I also have learned, and I don’t know if you’ve seen this where, this is my observation is, even if you killed the Lyme, there’s like a 60 day cycle. So they may come back if you didn’t catch them. Like you might have to catch it twice before… I have found that I feel really good and then six months later it comes back, and I think it’s because I didn’t catch those eggs.

Dr. Susan Trachman:
Or could you have been re-exposed because you can get it more than once. And particularly of where you live, like I said, you live in a very high endemic area.

Mimi MacLean:
Right. Or they’re also saying, right, it’s like how else can you get it besides being bit? Like is can you get it sexually? Can you get it through, I don’t know.

Dr. Susan Trachman:
As far as I know, the only way you can get it is through a tick that’s been infected with the actual bacteria.

Mimi MacLean:
Because they’re saying it’s part of the syphilis family, so is it? I don’t know.

Dr. Susan Trachman:
Well, it is in that it’s caused by the same type of bacteria. They’re called spirochetes, and they used to call syphilis the great imitator because, again, when you were presented to a physician, depending upon when you presented it could look like anything. And now we call Lyme, at least I did in my article, the great imitator because again, it can look like anything depending upon when in the course of the illness you’re seeing.

Mimi MacLean:
Yeah. So, I mean much to talk about, and the problem is we’re they’re not talking about it. It’s almost like the banned topic. It’s like I wish there was just more discussion and they’re starting to, and they start to have the congressional committee. But even that, it’s just not being talked about enough as far as where is it really coming from? All we know is it’s exploding, right? That it’s an epidemic.

Dr. Susan Trachman:
It is. I mean I think the last statistics I read was about a half a million people a year will be infected with Lyme disease. But in general someone says I had Lyme, okay, no big deal, because they don’t think of it as a life-threatening illness. It can become a life-threatening illness if it’s not treated. I mean you can end up with permanent heart disease, and joint problems, and skin issues, and cognitive issues. I mean, like I said, Amy Tan still has seizures, so yeah, it’s not going to kill you immediately, but if it’s neglected it can cause a lot of damage.

Mimi MacLean:
People have said it could be from ALS could be on the rise because of that, or I don’t know if that’s true, but that’s what I’ve read. So, what else have we not covered, what you would like to cover?

Dr. Susan Trachman:
Well, I just want to follow up on something that you said, which I think is probably a great idea and hopefully is publicized more. You talked about managing your symptoms through lifestyle, and we all know that anytime you’ve been infected with anything, whether it’s a staph infection, or it’s a parasite or whatever, your body amounts an immune response, that’s what it’s supposed to do. It fights off the bad guys. And that leads to a process called inflammation, which causes a lot of the symptoms that we have when we get sick. Fever, body aches, gastrointestinal issues like with COVID for example, the same kind of thing. However, if you do have some type of a chronic illness that we know, or we believe is related to inflammation like yourself, there are things you can do. For example, exercise is great. It really decreases pain, and inflammation.

Mimi MacLean:
Which is easier said to done when you’re not feeling well.

Dr. Susan Trachman:
No, I gotcha. No, I understand. And what I say to my patients, I don’t want you to go out, and run a marathon, I just want you to get up and move for 20 minutes a day. Can you do that? Most of they say yes. Food choices, so there are, as you probably know, a list of anti-inflammatory foods, and there are a list of inflammatory foods. If you can change your diet, not that you have to suddenly become vegetarian, but if you can incorporate more of what we call the anti-inflammatory foods, it will probably be helpful. You could add a probiotic. If you don’t like some of the anti-inflammatory foods like the fermented foods, kimchi and sauerkraut, yogurt’s great. It’ll take care of a lot of stuff. Getting enough sleep, critically important for everybody, but particularly for folks who have chronic illness, and then limiting your alcohol because alcohol can actually cause, or worsen inflammation. Nothing wrong with having if you want to, unless you shouldn’t the glass of wine every once in a while. But people have even moderate alcohol consumption maybe contributing to worsening of their inflammatory disease.

Mimi MacLean:
I agree. I mean when I was at that worst part, I couldn’t drink at all. I had one drink, I would be in bed for a week. Now that I’m feeling better, I can have, but it has to be vodka. I can’t have wine. It has to be something very, like vodka and soda, or something like that, club soda, or something. But yeah, that is a trigger. You kind of learn your triggers, gluten, sugar, whatever, but when you don’t feel well, right? You want to have all the bad stuff.

Dr. Susan Trachman:
You want comfort food when you don’t feel good, you really do. And I think, in the short term it’s probably okay, but I think in the long term, if you want to try to manage some of your symptoms, behaviorally, as well as if you need to or choose to take medication, lifestyle changes make a big difference. I mean, meditation has been proven to be very, very helpful. Yoga’s really great. Even in people who have chronic fatigue syndrome, who can’t do kind of very active exercise because they get worse if they do, yoga’s great. There’s a whole school of practice called mindfulness training. It was originated by a doctor at the University of Massachusetts named Jon Kabat-Zinn. And there is an abundance of literature on how helpful this is to treat serious medical illness, heart disease, cancer, pulmonary disease, autoimmune disorders. So there are alternative, I want to say alternative, not in the sense that they’re wacky, and out there because they’re not. But we can incorporate not just medicine into the treatment of someone who has a chronic disease.

Mimi MacLean:
No, it’s true. I mean, you said kind of like when you don’t feel well, if you’re watching a funny TV show, a comedy show for half an hour, you’re like, “Oh, I didn’t even notice. I forgot that I didn’t feel well.” It’s because it’s distracting. It’s just distracting [inaudible 00:32:34] Getting outside. Water, I mean, I’d definitely tell people, it’s like if you’re not pooping, drinking water, the basics, sleeping, you’re not going to get better. You got to get back to the basics.

Dr. Susan Trachman:
Right. I don’t know how you feel about animals, but pet therapy has also been proven to be extremely helpful for people who have chronic illness.

Mimi MacLean:
Well, first of all, you got to get out bed to feed them.

Dr. Susan Trachman:
You do have to get out of bed to feed them. You have to get out of bed to let them out. Therapy pets are wonderful and some people say, “Well, I’m allergic, I can’t.” That’s fine. You know, could have a fish. I’m not kidding. There is data.

Mimi MacLean:
That’s true. My fish, when I come up to feed her, she literally almost jumps out the water. I’m like, oh my gosh.

Dr. Susan Trachman:
But you see how happy you get even when you talk about your fish, and you’re not going to go pet a fish, but you have some type of connection to this other creature and it’s very, very helpful.

Mimi MacLean:
It’s so true. And it’s funny how even dogs, they know you don’t feel well. Like sit right there. They don’t leave your side. It’s just weird how they know. This has been amazing. So can you tell us again where the best place to find you if they want to sign up for your newsletter?

Dr. Susan Trachman:
My website is www.susanbtrachmanmd.com. I have a blog on psychologytoday.com. It’s called, It’s Not Just in Your Head. And there is an article on Lyme disease on that blog.

Mimi MacLean:
Okay, great. This has been amazing, Dr. Trachman.

Dr. Susan Trachman:
I so much enjoyed it.

Mimi MacLean:
I know this is great, and I’m so appreciative for what you’re doing, because I do think it is an area that needs to be talked about enough, and I’ve been kind of noodling around what to do with my podcast going forward. I’m like, I want to make something bigger with this. And I feel like that’s my area getting the message out, especially every time I hear somebody who’s taking their life, especially a younger kid, I’m like, maybe it’s the social media. Maybe it’s being locked up, but maybe it was like Lyme, or mold, or something that could’ve just been the basic, or not enough vitamin D, or enough minerals. Something that could’ve just been, because when you hear it come out of left field, you’re like, “What?”

Dr. Susan Trachman:
Right. Well, it’s always a tragedy.

Mimi MacLean:
If you just save one life, or at least one that’s struggling to get better without years, and years of medication. But thank you so much.

Dr. Susan Trachman:
Well, thank you for having me. I very much enjoyed it.

Mimi MacLean:
Okay, take care.

Dr. Susan Trachman:
All right. You do the same.

Mimi MacLean:
Bye-bye. Each week I will bring you different voices from the wellness community so that they can share how they help their clients heal. You will come away with tips, and strategies to help you get your life back. Thank you so much for coming on and I am so happy you are here. Subscribe now, and tune in next week. If you want to learn how I detox, and you want to check out my detox for Lyme checklist, go to Lyme360.com/detoxchecklist. You can also join our community at Lyme 360 Warriors on Facebook and let’s heal together. Thank you.