For decades, mental illness has been framed as a chemical imbalance in the brain. But what if those chemical shifts are not the root cause—but the body’s alarm system trying to signal deeper inflammation?
A new study by Dr. Rosalie Greenberg, provisionally accepted in Frontiers in Psychiatry, adds striking evidence to this growing conversation. Her research suggests that, for some children diagnosed with mood disorders, the story begins not in the brain, but in the immune system.
A Closer Look at the Study
Dr. Greenberg’s retrospective chart review examined 37 children and adolescents diagnosed with pediatric bipolar disorder in a New Jersey private practice—an area where tick-borne infections are common.
When she screened for pathogens such as Borrelia burgdorferi (Lyme), Bartonella, Babesia, Mycoplasma pneumoniae, and Group A strep, she found something remarkable:
92% of patients showed laboratory evidence of infection exposure.
81% met both clinical and laboratory criteria for active tick-borne illness.
Breakdown:
- Babesia – 51%
- Bartonella – 49%
- Mycoplasma pneumoniae – 38%
- Borrelia burgdorferi – 22%
- Group A Streptococcus – 19%
The study cannot prove causation, but it points to a truth many clinicians in root-cause medicine have long suspected: psychiatric symptoms can be the first visible sign of an infection-associated inflammatory disorder.
How Microbes Disrupt the Mind
These microbes don’t just linger in the bloodstream—they hijack the immune and metabolic systems that the brain depends on. Four main mechanisms link infection to psychiatric symptoms:
1. Neuroinflammation
Pathogens such as Bartonella, Borrelia, and Babesia activate microglia, the brain’s immune cells. When microglia remain chronically “switched on,” they release inflammatory cytokines that disrupt serotonin, dopamine, and glutamate balance—key regulators of mood, focus, and emotional stability.
2. Molecular Mimicry and Autoimmunity
Some bacterial proteins resemble human tissue. In susceptible individuals, the immune system starts attacking its own neural structures—a phenomenon known as autoimmune cross-reactivity.
This mechanism is well established in PANS/PANDAS, where infection-triggered autoantibodies target the basal ganglia, producing OCD-like and mood symptoms. Similar pathways may operate in certain bipolar or depressive presentations.
3. Mitochondrial and Metabolic Stress
When infection is chronic, mitochondria divert resources toward defense rather than energy production. The resulting ATP deficit produces fatigue, poor concentration, and an inability to regulate emotion—symptoms often mistaken for primary psychiatric illness.
4. Cerebral Folate Deficiency (CFD)
Autoantibodies against the folate receptor alpha (FRA)—sometimes triggered by infection—can block folate transport across the blood–brain barrier.
Low brain folate disrupts methylation, neurotransmitter synthesis, and myelination, leading to irritability, anxiety, sleep issues, and cognitive changes.
Addressing CFD through folinic acid (leucovorin) supplementation often brings measurable improvements once the underlying immune trigger is managed.
Clinical Observations in Practice
In my own work with children and adolescents, I’ve seen patterns that mirror Dr. Greenberg’s findings.
Young patients diagnosed with anxiety, mood instability, or rage episodes often later test positive for infections such as Bartonella, Babesia, or Mycoplasma.
When these infections are identified and properly treated—alongside nutrient repletion and nervous-system support—the psychiatric symptoms frequently ease.
It’s a reminder that the brain’s distress can be a signal of an inflamed or dysregulated immune system, not merely a standalone psychiatric disease.
How Treatment Evolves When Infection Is Considered
Approaching these cases through a whole-person lens often involves several overlapping steps:
- Identify and treat the infectious drivers
- Comprehensive testing for Borrelia, Bartonella, Babesia, Mycoplasma, and related pathogens
- Use of antimicrobial or immune-modulating therapies as appropriate
- Comprehensive testing for Borrelia, Bartonella, Babesia, Mycoplasma, and related pathogens
- Calm the immune and inflammatory cascade
- Address oxidative stress and cytokine imbalance
- Support detox pathways (sauna, Epsom-salt baths, binders, hydration)
- Address oxidative stress and cytokine imbalance
- Repair and nourish the nervous system
- Replete folate, B12, zinc, magnesium, and omega-3s
- Consider folinic acid or leucovorin if cerebral folate deficiency is suspected
- Replete folate, B12, zinc, magnesium, and omega-3s
- Regulate the stress and limbic systems
- Gentle breathing, mindfulness, and nervous-system retraining (e.g., Primal Trust, DNRS)
- Restore circadian rhythm and sleep quality
- Gentle breathing, mindfulness, and nervous-system retraining (e.g., Primal Trust, DNRS)
As inflammation quiets and the brain’s chemistry normalizes, many children experience steadier mood, better focus, and improved emotional flexibility.
Why This Matters
When a child develops sudden mood instability, anxiety, or cognitive decline, it’s easy to assume a purely psychiatric cause. But when infections like Bartonella or Babesia are silently driving immune chaos, psychotropic medication alone cannot resolve the problem.
Recognizing the infection-immune-neurotransmitter connection allows for true root-cause care—addressing both biology and psychology together.
The Bigger Picture
Dr. Greenberg’s work—and similar clinical observations from integrative and functional practices—underscore a simple truth: the mind and immune system are inseparable.
Psychiatric symptoms are often the body’s earliest signal that inflammation has reached the nervous system.
When we treat those signals as data rather than defects, the path toward genuine healing becomes clearer.
Closing Reflection
“Sometimes the earliest sign of infection isn’t fever or fatigue—it’s fear, irritability, or despair. The body and brain are speaking the same language; we just have to learn to listen.”