Researchers have also found that anxiety and depression occur with an increased rate in people with Lyme disease. A lyme disease treatment for one month with oral doxycycline or amoxicillin is usually effective. For refractory cases, intravenous therapy with ceftriaxone or penicillin G, and arthroscopic synovectomy may lead to clinical improvement. Following a bite from an infected tick of the Ixodes genus the saliva of the tick is transmitted with accompanying spirochaetes into the skin during feeding. This saliva has components which disrupt the normal immune response to a bite and which afford protection to the infectious spirochaetes allowing them to establish themselves in the local area. In the early stages, your health care provider will look at your symptoms and medical history, to figure out whether you have Lyme disease.