When someone develops anxiety, depression, OCD, brain fog, or major behavioral changes, we tend to focus on the brain. That makes sense, but it may not tell us the whole story. The brain is connected to the immune system, nervous system, hormones, gut, and everything else happening in the body.
This is why I often encourage patients to ask a different question. Instead of only asking, “What do we call these symptoms?” we need to ask, “Why are these symptoms happening?” Sometimes, mental health symptoms are part of a much larger pattern of immune dysfunction and chronic inflammation.
The Brain and Immune System Are Constantly Communicating
Your immune system does much more than fight infections. It is constantly communicating with other systems throughout your body, including your brain.
When the immune system senses a threat, it creates an inflammatory response. This is a normal and necessary part of protecting you. Problems can develop when that response does not shut back down appropriately.
Persistent immune activation can affect how the brain functions. In some patients, that may contribute to changes involving:
- Mood
- Anxiety
- Concentration
- Memory
- Sleep
- Energy
- Behavior
- Sensory processing
This does not mean every mental health symptom comes from inflammation. It certainly does not mean psychiatric care is unnecessary. It means we should remain open to physical contributors when the clinical picture points in that direction.
Looking at the Downstream Mess
I often describe symptoms and diagnoses as the “downstream mess.” A diagnosis can be useful because it gives us language for what someone is experiencing. But a descriptive diagnosis does not always explain why those symptoms developed in the first place.
If someone has anxiety, for example, treating the anxiety may provide important relief. I still want to know why that person's nervous system is so activated. The same applies to depression, OCD, brain fog, irritability, and other neuropsychiatric symptoms. Sometimes we need to keep digging.
What Can Immune-Related Neuropsychiatric Symptoms Look Like?
There is no single symptom that tells us someone has immune dysfunction. What gets my attention is usually the overall pattern.
Patients may experience symptoms such as:
- New or worsening anxiety
- Panic or a constant feeling of being on edge
- Obsessive or compulsive behaviors
- Irritability or unusual emotional reactions
- Depression or significant mood changes
- Brain fog
- Memory problems
- Difficulty concentrating
- Sleep disturbances
- Fatigue
- Headaches
- Sensitivity to light, sound, or other stimuli
The timeline can also give us important clues. Did symptoms suddenly appear after an illness? Do they flare when other physical symptoms worsen? Are there unexplained neurological, gastrointestinal, allergic, or inflammatory symptoms happening at the same time?
PANS and PANDAS Show Us How Closely Immunity and Behavior Can Be Connected
One of the clearest examples of this relationship involves PANS and PANDAS. These conditions can involve an abrupt onset of significant neuropsychiatric symptoms in children.
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It describes neuropsychiatric symptoms associated with an abnormal immune response following a strep infection.
PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. PANS is broader and is not limited to strep.
When Your Child Seems Different Overnight
Parents sometimes describe the change as feeling like they woke up with a different child.
A child who previously functioned well may suddenly develop:
- Severe anxiety
- Obsessive-compulsive behaviors
- Tics or unusual movements
- Emotional outbursts
- Irritability
- Sleep problems
- Bedwetting or other regression
- Difficulty concentrating
- Declining academic performance
- Changes in handwriting
PANS and PANDAS are not explanations for every case of childhood anxiety or OCD. But they demonstrate an important point. Immune activity and neuropsychiatric symptoms can be connected.
Digging Deeper Into What Is Driving Immune Dysfunction
At Restorative Medicine Center, we use what I call the Root Cause Triad. It helps organize the major areas we investigate when dealing with chronic immune dysfunction.
The three areas are:
- Microbes
- Toxins and biotoxins
- Stress response and nervous system dysregulation
Microbes
Microbial issues can include bacteria, viruses, fungi, and parasites. Certain infections may contribute to ongoing immune activation in susceptible patients.
Vector-borne infections are one example. Borrelia, Bartonella, and Babesia can produce complex symptoms that involve multiple systems.
Some patients experience brain fog, cognitive problems, mood changes, or neurological symptoms. These can occur alongside fatigue, pain, or other physical complaints.
Toxins and Biotoxins
Environmental exposures can also be part of the picture. At our office, we pay particular attention to biotoxins, including those associated with water-damaged environments and mold.
These exposures may contribute to immune dysfunction in some patients. They should be considered within the patient's complete history, symptoms, environment, and testing.
The Stress Response
The third part of the Root Cause Triad involves the stress response. Your amygdala constantly evaluates whether your environment is safe or threatening. When the brain repeatedly perceives danger, the body can spend too much time in fight or flight.
That affects the autonomic nervous system and can make healing much more difficult. Chronic inflammation may also make the system more reactive, creating a cycle that becomes difficult to interrupt.
Why “It’s Just Anxiety” May Be an Incomplete Answer
Anxiety is real. Depression is real. OCD is real. But sometimes those words describe what a person is experiencing without explaining why it started.
Imagine someone develops anxiety alongside severe fatigue, brain fog, headaches, sleep problems, and unusual sensitivities. Treating the anxiety may be helpful. But ignoring everything else would leave a lot of unanswered questions.
The same is true when symptoms suddenly follow an infection. It also applies when psychiatric symptoms fluctuate with physical symptoms.
This does not create an either-or situation. Someone can benefit from therapy or psychiatric treatment while also investigating possible physical contributors.
How We Look for Clues Instead of Guessing
Complex cases require detective work. There is rarely one laboratory test that gives us the entire answer.
We start with the patient's story. I want to understand when symptoms began and what changed around that time.
Important questions can include:
- Was there an infection before symptoms started?
- Did symptoms appear suddenly or gradually?
- Are there autoimmune conditions?
- Are allergies or sensitivities present?
- Are infections recurring?
- Are symptoms worse in certain environments?
- Do stress and sleep affect symptom severity?
- What treatments have helped?
- What treatments have caused symptoms to flare?
Laboratory testing can provide additional clues. Depending on the patient, our evaluation may include inflammatory, immune, nutrient, hormone, or other biomarkers.
At Restorative Medicine Center, biomarkers used in appropriate cases may include C4a, TGF-beta 1, MMP-9, ECP, and VEGF. We may also evaluate vitamin D markers, immunoglobulins, autoantibodies, hsCRP, and other labs.
Your Response to Treatment Is Data Too
One of the most important things we track is how the patient actually responds.
For every treatment, I want to answer two basic questions:
- Is it tolerated, and at what dose?
- Is it beneficial, and how?
Treatment Means Calming the System While Addressing the Roots
Once we identify likely contributors, treatment needs to happen at a rate the patient can tolerate. Treatment may include addressing relevant microbial, environmental, inflammatory, nutritional, hormonal, or nervous system factors. The exact approach depends on the individual.
Foundational health matters too. We commonly focus on:
- Hydration
- Clean, nourishing foods
- Restorative sleep
- Indoor air quality
- Appropriate movement
- Stress reduction
- Nervous system regulation
Your Symptoms Deserve a Bigger Question
Mental health symptoms should always be taken seriously. Sometimes that means treating the psychiatric symptoms directly. Sometimes it also means asking whether immune dysfunction, inflammation, infection, environmental exposure, or nervous system dysregulation could be contributing.
We do not need to force every patient into the same explanation. We need to follow the clues. Instead of stopping at “What do we call this?” I believe we should keep asking, “Why is this happening?”
Ready to Dig Deeper? Start With the Root Causes
If you or your child has unexplained neuropsychiatric symptoms, there may be more pieces worth investigating. This is especially important when mental health changes occur alongside chronic immune, inflammatory, neurological, infectious, or other physical symptoms.
At Restorative Medicine Center, we use Integrative and Functional Medicine to investigate the potential root causes behind complex symptoms. We Dig Deeper. No bandaids. No gimmicks.
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