When someone suddenly develops intense anxiety, panic attacks, irritability, or episodes of rage, the obvious assumption is often psychiatric. Sometimes that is exactly what is happening. But sometimes we need to ask a different question: Why did these symptoms start in the first place?
This is especially important when emotional changes appear alongside fatigue, brain fog, sleep problems, pain, or other unexplained symptoms. Bartonella is one infection I consider in that situation. Anxiety does not mean you have Bartonella, but it may be worth digging deeper when the entire clinical picture does not make sense.
Bartonella Is More Than a "Cat Scratch" Infection
Most people who have heard of Bartonella associate it with cat scratch disease. That is only part of the story.
Bartonella refers to a group of bacteria that can infect humans and animals. Bartonella species have also been associated with several vectors and animal exposures. A person may not remember a classic bite, scratch, rash, or obvious acute infection.
The important point is that Bartonella can produce symptoms beyond those we traditionally associate with an infection. In my practice, Bartonella is considered within the broader category of stealth and vector-borne infections.
These infections can be difficult to recognize because symptoms can overlap with many other conditions. Patients with vector-borne infections may experience:
- Fatigue
- Brain fog and cognitive changes
- Muscle and joint pain
- Neurological symptoms
- Sleep disturbances
- Mood changes
- Anxiety or depression
How Can an Infection Affect Mood and Behavior?
Your immune system and nervous system do not operate independently. When the immune system responds to an infection, that response can affect many other systems.
This includes the brain.
Inflammation and immune signaling may influence neurological function. When that happens, symptoms can involve cognition, sleep, sensory processing, mood, and behavior.
That means a symptom can look psychiatric while still having biological contributors. It does not make the anxiety or emotional distress any less real.
It also does not mean every psychiatric symptom is caused by an infection. Mental health treatment and biological investigation do not have to compete with each other.
The question I want to answer is simple: What is driving the symptoms in this particular person?
Why Is Bartonella Associated With Rage, Anxiety, and Panic?
Neuropsychiatric symptoms can be particularly confusing for patients and families. They may seem disconnected from everything else happening physically.
They may actually be another piece of the same puzzle.
Rage and Irritability
One concerning pattern is a dramatic change in emotional regulation. Someone who was previously fairly even-tempered may become unusually irritable, reactive, or explosive.
Families may describe:
- Sudden episodes of intense anger
- Aggressive or unusually reactive behavior
- Extreme responses to relatively minor frustrations
- Emotional reactions that seem completely out of character
- Irritability that worsens when other symptoms flare
Anxiety
Anxiety can take many forms. Some patients describe traditional worry, while others describe an uncomfortable internal agitation.
They may feel constantly alert or unable to settle their nervous system. They may know intellectually that they are safe while their body seems convinced otherwise.
This distinction matters. Sometimes what we call "anxiety" is part of a much larger state of physiological hyperarousal.
Panic Attacks
Panic attacks are an intense version of that alarm response. Symptoms may include:
- Racing heart
- Trembling
- Chest tightness
- Shortness of breath
- Dizziness
- Sweating
- A feeling of impending danger
- An overwhelming need to escape
The Amygdala, Fight or Flight, and the "Tired but Wired" Patient
The amygdala is constantly evaluating whether your environment is safe or threatening. Think of it as part of the brain's alarm system.
When that alarm system becomes hypervigilant, relatively small triggers can produce a disproportionately large response. I refer to this as amygdala hypervigilance.
Chronic inflammation, microbes, and biotoxins can contribute to this cycle. Increased inflammation can make the amygdala more reactive and easily triggered.
That can push the autonomic nervous system toward its sympathetic, or fight-or-flight, state. Patients often describe themselves as "tired but wired."
They may be exhausted but still experience:
- Difficulty relaxing
- Trouble falling or staying asleep
- Increased startle responses
- Irritability
- Racing thoughts
- Persistent anxiety
- A feeling of always being on edge
Clues That Tell Me We Need to Dig Deeper
I would never diagnose Bartonella because someone has anxiety or rage. There are far too many potential causes.
Instead, I look at the entire clinical picture. The combination and timing of symptoms can provide important clues.
I become more interested in possible root causes when neuropsychiatric symptoms occur with problems such as:
- Unexplained fatigue
- Brain fog or cognitive decline
- Sleep disturbances
- Muscle or joint pain
- Neurological symptoms
- Recurrent or unusual infections
- Multiple inflammatory symptoms
- Symptoms that wax and wane
- Several diagnoses that do not fully explain the illness
Vector-borne infections are particularly challenging because their symptoms can overlap with other chronic illnesses. Patients may first receive diagnoses such as fibromyalgia, chronic fatigue syndrome, autoimmune disease, depression, or anxiety.
This is why your timeline matters. When did the anxiety start? What happened before it? Did other symptoms change at the same time? These questions help us move beyond naming symptoms and toward understanding them.
Testing for Bartonella Is Not Always Straightforward
One of the biggest misconceptions about stealth infections is that one negative test always settles the question. Testing can be more complicated than that.
Some tests look for the immune system's response to an organism. Others attempt to directly identify evidence of the organism itself.
Direct testing approaches can include methods such as PCR. Testing decisions need to be individualized and interpreted within the larger clinical picture.
We may also evaluate broader immune and inflammatory biomarkers. At Restorative Medicine Center, one marker we use is VEGF, which can provide another clue when evaluating Bartonella and CIRS patterns.
But I want to be very clear about biomarkers. They are clues. They are not standalone diagnoses. A laboratory value needs context. Symptoms, history, exposures, examination findings, other testing, and treatment responses all matter.
Bartonella May Be One Root Cause, Not the Whole Story
This is where my Root Cause Triad becomes particularly important.
I generally organize the major drivers of chronic immune dysfunction into three interconnected categories:
- Microbes
- Toxins
- Stress Response
Bartonella falls into the microbial piece of that picture. But finding Bartonella does not necessarily mean we have found the entire answer.
Someone may also have Borrelia, Babesia, fungal organisms, environmental biotoxin exposure, or other microbial issues. Meanwhile, their nervous system may have been stuck in fight or flight for years.
These factors can interact.
That is why I do not like simply chasing symptoms downstream. Giving someone something for anxiety may help the anxiety, but it may not answer why the anxiety developed.
The opposite approach can also create problems. We cannot become so focused on killing an organism that we ignore everything else.
My general treatment philosophy is to Stay Calm and simultaneously cover your root cause issues at a rate you can handle. We keep doing that long enough for the downstream mess to improve.
Tolerance matters.
I ask patients to track treatment changes and symptoms carefully. For each intervention, we want to answer two basic questions:
- Is it tolerated, and at what dose?
- Is it beneficial, and how?
Looking Upstream Changes the Conversation
If you or your child suddenly seems like a different person, being told it is "just anxiety" can leave important questions unanswered. Anxiety, panic, irritability, and rage are real symptoms that deserve appropriate care. They can also be signals telling us to investigate what is happening upstream.
The goal is not to blame every emotional symptom on Bartonella. The goal is to avoid stopping too soon when the complete clinical picture suggests something else is going on. Instead of only asking what we should call the symptoms, I want to keep asking the more useful question: Why are they happening?
Ready to Dig Deeper? Contact Restorative Medicine Center
At Restorative Medicine Center, we evaluate complex chronic symptoms through an Integrative Functional Medicine approach. That may include looking at stealth and vector-borne infections, immune dysfunction, environmental exposures, and the stress response. Our goal is to identify the root cause issues that may be creating the downstream symptoms.
Restorative Medicine Center
Teresa Birkmeier-Fredal, MD
705 Barclay Cir #115
Rochester Hills, MI 48307
Phone: 248-289-6349
Fax: 248-289-6923
Office Hours: Monday through Thursday - 9 AM to 5 PM, Friday - Closed
Website: restorativemedcenter.com