A multi-disciplinary approach to treatment is key to the center’s success.By Laura DeSisto
As a neuropsychologist, Dr. Elena Monarch says her job is a little bit like detective work. Patients are referred to her for a whole host of psychological symptoms such as those associated with OCD, ADHD and depression. In 2016, she joined a team of specialists on the South Shore to serve the needs of patients suffering from two particularly mysterious illnesses.
In order to make an accurate diagnosis in a child, Monarch will often spend five to six hours evaluating the patient, as well as interviewing their parents, teachers and babysitters. In 2004, Monarch started to notice a disturbing trend.
“I began observing that many of my clients had physical problems such as low-grade fevers, headaches, joint pain and more. While MDs might say that the physical symptoms were caused by psychological problems, I thought it was often the other way around. There was a distinct proportion of my patients whose physical symptoms did not fall into any psychological category,” says Monarch.
At the same time, she began learning more about Lyme disease and other tick-borne illnesses (such as Bartonella and Babesia) that can cause psychiatric as well as physical symptoms. “I learned that malaise and depression can be a symptom of persistent Lyme and that only about 40 percent of people who contract Lyme see a bullseye rash.”
It was during this time that Monarch also became aware of “PANS” or Pediatric Acute-onset Neuropsychiatric Syndrome, a little-known condition that causes rapid-onset psychiatric symptoms.
“A small percentage of children have a weak blood/brain barrier. If they get an untreated infection such as strep or Lyme, their body can have a misdirected immune response that can cross into the brain,” says Monarch. “They look like they have OCD, ADHD, Tourette’s, and/or separation anxiety.”
Monarch’s growing awareness of PANS as well as the increased incidence of Lyme and other tick-borne illnesses (the CDC estimates that 300,000 new cases are diagnosed each year) motivated her to begin digging deeper before labeling children with a psychological diagnosis. She began to work in conjunction with doctors to help determine whether a child’s symptoms could have a root physical cause.
“Because I recognized my own limits as a neuropsychologist and the great demand for this type of approach, I decided to assemble a team of doctors, therapists, diet coaches and other wonderful healing practitioners,” she says.
Ultimately, this team of specialists found a home at the Lyme and PANS Treatment Center in Cohasset where the demand for their services for both children and adults has been overwhelming.
“When we opened our doors, we already had a waitlist of over 100 people,” says Monarch. “Since then, we have had patients fly in from Florida, Texas, Illinois, Canada and even the Bahamas.”
While Monarch says that about 20 percent of the center’s patients are found to have no infection, they are still able to help them.
“Instead of jumping into psychiatric medications, we are interested in looking at root causes,” she says. “The most important neurotransmitters for psychological wellness are manufactured in the gut. So instead of giving an 11-year-old an antidepressant, we try to think of all the other ways we can help this child. The importance of gut health is one of them.”
Although the center was established chiefly to address Lyme and PANS, Monarch and her colleagues also see patients who are simply interested in taking a more holistic approach to their healthcare concerns.
Staff member Trish Hart, a therapeutic yoga instructor and a mind-body specialist, for example, is able to help patients recover from long-term stress, whether from disease or such issues as trauma. “Even if you don’t have an exact medical diagnosis, you can still experience physical symptoms because stress increases cortisol levels,” says Hart. “Cortisol causes inflammation in the body, including the brain, where it presents as depression. Long-term stress, whether emotional or physical, can literally cause your brain to get stuck in the ‘fight or flight’ mode. Mind-body techniques, such as meditation and yoga, can actually rewire the brain by eliciting the relaxation response, and move the body into the healing mode.”
Monarch has seen many of her patients recover their health through the multi-disciplinary approach at the center and wishes that other doctors and health care providers would follow suit.
For more information, visit lymeandpanstreatmentcenter.com.