Table 13.

Anxiety is not well studied in the medical literature as a symptom of TBDs, but is shown to be present with LD. TBRF is also associated with anxiety.

Sixty-seven percent of LD patients report having anxiety.	[114]
Neurological psychiatric symptoms develop gradually in patients with Lyme borreliosis (LB) and include anxiety disorders, such as panic disorders, social anxiety, general anxiety, and other anxiety disorders.	[67,119]
Anxiety is a clinical feature of bartonella, which is often recognized as a co-infection of Lyme disease.	[120]
TBRF can produce psychiatric symptoms, including anxiety, and patients should be monitored for anxiety during treatment.	[46]
“A higher level of risk to self and others is associated with multiple symptoms developing after acquiring [Lyme and Associated Diseases] LAD, in particular, explosive anger, intrusive images, sudden mood swings, paranoia, dissociative episodes, hallucinations, disinhibition, panic disorder, rapid cycling bipolar, depersonalization, social anxiety disorder, substance abuse, hypervigilance, generalized anxiety disorder, genital-urinary symptoms, chronic pain, anhedonia, depression, low frustration tolerance, and posttraumatic stress disorder”.	[121]
The CDC does not recognize anxiety as a symptom of any tick-borne disease.	[27]