A young woman thought she was going crazy. Suddenly, this once perfectly healthy college freshman developed severe anxiety, panic attacks, insomnia and loss of appetite.

A doctor and a psychologist at her college's health service recommended rest for what they thought were problems in adjusting to being away from home.

Forced to take a medical leave, she underwent an extensive examination that showed no abnormalities except one: evidence in her spinal fluid of infection by the spirochete Borrelia burgdorferi, which causes Lyme disease.

Only then did she recall having had a circular rash characteristic of Lyme disease months earlier, followed by a brief bout of headaches and unusual fatigue. At the time, she did not take these symptoms seriously and did not seek medical attention.

The young woman's case is among dozens reported in which the Lyme spirochete was the apparent cause of a wide range of psychiatric and neurological problems. Three months after receiving a six-week course of intravenous antibiotics to eradicate the spirochete, the woman felt better.

But a year later more therapy was needed when the anxiety and panic attacks returned, along with musical hallucinations, deja vu experiences and obsessional thoughts.

Although such extreme cases are rare, neurological problems resulting from Lyme disease are more common than realized by most doctors, who tend to look for the more characteristic arthritic conditions associated with the disease.

When Lyme disease is promptly recognized and properly treated, the overwhelming majority of patients recover uneventfully. But often the initial sign of a bite by a Lyme-infected tick - a red circular rash that clears in the center - is not recognized.

Only when more severe symptoms develop weeks or months later is a diagnosis and treatment pursued.

Meanwhile, within weeks of entering the body, the spirochete, a bacterium that resembles the organism that causes syphilis, can invade the brain and spinal cord.

At first, patients may develop meningitis, encephalitis or problems like pain or loss of sensation stemming from an attack on the nerves that emanate from the brain or spinal cord. But as with syphilis, months or years may pass before the late signs of a neurological infection appear.

Once inside the central nervous system, the organism can wreak all kinds of havoc, from memory problems, moodiness and depression to hallucinations, panic attacks, paranoia, manic depression, seizures and even dementia. Memory problems are the most common sign of a brain infection. When the organism invades spinal nerves, patients may develop numbness and tingling in fingers and toes and pain radiating to the front of the body.

In rare cases, the spirochete may "unmask" an attack on the protective sheath of nerves, resulting in spastic muscle weakness in the extremities that resembles multiple sclerosis, said Dr. Allen C. Steere of Tufts-New England Medical Center in Boston.

Steere first recognized Lyme disease as a distinct disorder in 1975, and soon realized that it could cause neurological problems.

Dr. Brian Fallon, a psychiatrist at the State Psychiatric Institute in New York, recently reviewed the neuropsychiatric aspects of Lyme disease in The American Journal of Psychiatry, in hope of prompting his colleagues to consider the possibility of this infection when examining patients who might have been exposed to Lyme-infected ticks.

In Europe, where the disease is called borreliosis, patients commonly develop neuropsychiatric symptoms after being infected by the same spirochete that causes Lyme disease, Fallon said. But in this country, arthritic symptoms are most common and many doctors still do not appreciate the threat to the nervous system.

Fallon said that up to 40 percent of patients with Lyme disease developed some involvement of the nervous system affecting either the extremities or the central nervous system.

May I say...Lymies are lucky to have you on their side. You should be in one of those commercials... This costs this much, that costs that much, and you can charge it. Having Sarah as a friend...PRICELESS! Keep up the good work. TCOY!