"Since the bacteria can mutate and surround itself with a cyst like wall, in all likelihood there are periods of time where abx may be completely ineffective."
...which is why Flagyl/metronidazole is often prescribed along with other abx, to act as a 'cyst-buster' that allows the other abx to kill the bacteria. There may also be other formulations that accomplish the same task.
Don't despair with the research. It's confusing because not enough scientific/clinical research has been done so that there is a lot of conflicting information out there as well as misinformation.
Several years ago, one lab thought that it was on the verge of perfecting a test that would detect the Bb spirochete in the blood. This would have been a phenomenal breakthrough, in that it would tell whether an individual is currently infected, instead of having to rely on antibodies which may stay reactive for some time after the bacteria has died off.
The other major area where research is needed is to thoroughly study the life cycle of the Bb spirochete and its response to different types of antibiotics. Since the bacteria can mutate and surround itself with a cyst like wall, in all likelihood there are periods of time where abx may be completely ineffective.
Many LLMD's can make a clinical diagnosis, which may leave you wondering why you then need to also get expensive specialty lab tests. But medicine is a largely evidence-based science, so your LLMD is wise to test you through this highly regarded lab.
Igenex tests for more bands than other labs, and also gives a more detailed report. While some labs give only the bottom line, positive or negative by CDC standards, Igenex reports the interpretation of each band on a scale from -, IND, +, ... ++++.
The results of the Western blot can help your LLMD better estimate how long you have been sick, and in some cases certain bands are associated with certain symptoms. This can help them to make an educated guess about the role of Lyme versus co-infections in your health.
But back to my first point: While an LLMD may make a clinical dx, it is better for all (doc, patient, insurance) to have some evidence.
Personally, I was not depressed about Lyme disease because before my diagnosis, I had no hope of getting help. Currently, at 18 months of treatment, I'm frustrated to still be dealing with it, though grateful for my overall improvement. Overwhelmed is a feeling to which I can relate: There is a lot of information (and misinformation) about Lyme disease.
Have you read Cure Unknown by P. Weintraub yet? That is one of my favorites. It details the history of LD in the US and helps put the current controversy in context. It also traces stories of her family and others as they struggled to get diagnosed and treated.
Hang in there!