PANS/PANDAS: What Every Parent Should Know

Have you ever watched your child transform overnight from their usual self into someone you barely recognize? One day they're laughing and playing, and the next they're consumed by fears, compulsions, or behaviors that seem to come from nowhere. If this sounds familiar, you might be dealing with PANS or PANDAS—conditions that can leave parents feeling confused, scared, and desperately searching for answers.

I've worked with countless families navigating this journey, and I want you to know that what you're experiencing is real, valid, and—most importantly—treatable. Your child isn't "broken," and you're not imagining things. Let's dive into what PANS and PANDAS actually are, why they happen, and how you can support your child while seeking the care they need.

Understanding PANS and PANDAS: The Basics

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. This condition occurs when a strep infection triggers an autoimmune response that affects the brain, leading to sudden onset neuropsychiatric symptoms.

PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is the broader umbrella term that includes PANDAS but also covers similar sudden-onset symptoms triggered by other infections, environmental factors, or unknown causes.

Both conditions share one crucial characteristic: the dramatic, seemingly overnight appearance of neuropsychiatric symptoms in children who were previously developing typically.

Why Does This Happen? The Nervous System Connection

Here's what I find fascinating about PANS and PANDAS—they perfectly illustrate how deeply connected our immune system and nervous system really are. When your child's immune system is fighting off a strep infection or other trigger, sometimes the antibodies meant to protect them accidentally attack healthy brain tissue instead.

Think of it like this: your child's immune system is trying to be the hero, but it gets a bit confused about who the villain is. The inflammation that results can affect areas of the brain responsible for mood, behavior, and executive function. This is why you might suddenly see obsessive compulsive disorder symptoms, tics, anxiety, or dramatic personality changes.

Your child's nervous system is essentially stuck in a state of high alert, which explains why traditional behavioral interventions often fall short. We're not dealing with a behavioral choice—we're dealing with a medical condition affecting how their brain functions.

Recognizing the Signs: What to Look For

The hallmark of both PANS and PANDAS is the sudden onset of symptoms. We're talking about dramatic changes that happen within days or weeks, not gradual shifts over months.

Common pandas symptoms include:

• Sudden onset of obsessive compulsive disorder or severe anxiety

• Physical or vocal tics that appear out of nowhere

• Dramatic personality changes or mood swings

• Regression in handwriting or fine motor skills

• Sleep disturbances or night terrors

• Changes in eating habits or new food restrictions

• Increased sensitivity to clothing, textures, or sounds

• Difficulty concentrating or "brain fog"

• Separation anxiety or clinginess

  
  

What makes this particularly challenging for parents is that these symptoms can be severe and disruptive, yet blood tests and standard medical evaluations often come back "normal."

The First Steps: When and How to Seek Help

If you're noticing these sudden changes in your child, trust your instincts. You know your child better than anyone, and if something feels dramatically different, it probably is.

Start with your pediatrician. While not all doctors are familiar with PANS and PANDAS, they can rule out other causes and potentially refer you to specialists. Be prepared to advocate for your child—bring a timeline of symptoms and any potential triggers you've noticed, including recent illnesses like strep throat or other infections.

Document everything. Keep a detailed log of symptoms, when they started, and any potential triggers. This information will be invaluable for healthcare providers trying to understand your child's condition.

Consider specialists. Immunologists, neurologists, or integrative medicine doctors who are familiar with pediatric autoimmune neuropsychiatric disorders can provide more targeted evaluation and treatment.

Supporting Your Child's Nervous System While You Wait

While you're navigating the medical system, there are ways to support your child's nervous system regulation that can provide relief and comfort.

Prioritize nervous system support. Remember our house metaphor? We need to make sure your child's foundation is as strong as possible. This means focusing on quality sleep, reducing inflammation through nutrition, and creating a calm, predictable environment.

Reduce inflammation naturally. Anti-inflammatory foods like omega-3 rich fish, leafy greens, and berries can support overall brain health. Some families find that reducing sugar and processed foods helps with symptom management. Be sure to consult with your child’s pediatrician or a pediatric dietitian before making major changes to their diet, especially if your child has other medical or sensory needs.

Create safety and predictability. Your child's nervous system is already overwhelmed. Maintaining consistent routines, reducing overstimulation, and creating calm spaces at home can help their system regulate.

Practice co-regulation. Your calm, regulated presence is one of the most powerful tools you have. When your child is struggling, your ability to stay grounded helps their nervous system find safety.

Hope for Healing: The Recovery Journey

Here's what I want every parent to know: recovery is possible. I've witnessed children who seemed completely consumed by PANS or PANDAS symptoms return to their joyful, thriving selves with appropriate treatment and support.

Treatment often involves a combination of approaches—medical intervention to address the underlying immune dysfunction, along with therapeutic support to help your child process their experience and rebuild confidence. Some children respond well to antibiotics, others to immune-modulating treatments, and many benefit from integrative approaches that support overall nervous system health.

The recovery process isn't always linear. There might be good days and challenging days, but with the right support team and treatment plan, most children can return to their baseline functioning and continue developing typically.

When Traditional Therapy Approaches Fall Short

Many parents find themselves frustrated when conventional behavioral interventions don't work for their child with PANS or PANDAS. This makes perfect sense—if your child's symptoms are rooted in immune-mediated brain inflammation, teaching coping skills alone won't address the underlying cause.

This is where our root-cause approach becomes essential. Instead of focusing solely on managing behaviors, we need to support the nervous system healing that allows your child to access their natural resilience and coping abilities.

Building Your Support Team

Recovery from PANS and PANDAS typically requires a team approach. You might work with medical doctors for immune system support, occupational therapists for sensory integration, and mental health professionals who understand the mind-body connection.

Look for practitioners who:

• Understand that this is a medical condition, not a behavioral choice

• Take a holistic, nervous system-informed approach

• Include you as an active partner in your child's care

• Focus on supporting your child's natural healing capacity

Your Child's Bright Future

I know how overwhelming this journey can feel. Watching your vibrant child struggle with symptoms that seem to come from nowhere is one of the most challenging experiences a parent can face. But I want you to hold onto hope.

Your child is still the same wonderful person they've always been. PANS and PANDAS may temporarily affect how their brain functions, but it doesn't change who they are at their core. With proper understanding, treatment, and support, most children not only recover but often develop incredible resilience and self-awareness through the process.

You're not alone in this journey, and you don't have to figure it out by yourself. The most important thing you can do right now is trust your instincts, seek appropriate medical care, and remember that supporting your own nervous system regulation is one of the greatest gifts you can give your child.

If you're feeling overwhelmed and need guidance on how to support your child through this challenging time, I'm here to help. Book a thriving child strategy call and let's create a personalized plan that honors your child's unique needs and supports their journey back to joy.