One morning, you woke up to a child you didn’t recognize.

The confident, happy and curious child you once knew changed almost overnight into someone you barely recognized. Suddenly, they became terrified to go to school, and everyday routines turned into battles. Lights felt too bright, sounds too loud, and once-favorite foods suddenly seemed disgusting or even dangerous.

They clung to you with relentless anxiety; lashed out in rage over the smallest things; or repeated phrases endlessly until they were “just right.” You watched helplessly as tics developed, eating habits shrank to a handful of bland, white foods, and your once-engaged child withdrew into a world of fear and compulsions. You’re left asking the question so many parents in your shoes have asked: what happened to my child?

What are PANS and PANDAS?

For some families, this sudden shift can be explained by PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) or PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). These are theorized to be post-infectious, inflammatory conditions where a child’s immune system mistakenly attacks the brain after an infection, causing sudden changes in mood, behavior, and neurological function.

In PANS, triggers can include a wider range of infections such as mycoplasma. PANDAS is a subset of PANS in which the trigger is a streptococcal infection. Per the latest research, children who do develop PANS/PANDAS are thought to be genetically or immunologically predisposed, making their brains vulnerable to immune-related inflammation.

Common Signs and Symptoms

One of the hallmarks of PANS/PANDAS is the sudden onset of symptoms. Parents often describe it as an “overnight” change. However, some children experience a more insidious onset, or one that is difficult to pinpoint—especially if they are diagnosed years after the initial triggering event. This is why a thorough assessment is essential, involving a detailed medical, behavioral, and psychosocial history conducted by multiple specialists working collaboratively. Symptoms can vary but often include:

Sudden, intense OCD symptoms

Separation anxiety so severe that school or sleep becomes impossible

Tics like blinking, throat clearing, shoulder shrugging

Rage episodes, aggression, or emotional meltdowns

Food refusal or development of ARFID (Avoidant Restrictive Food Intake Disorder)—due to sensory changes, fear of choking, or contamination fears

Regression, such as baby talk, bedwetting, or clinging behavior

Profound sensory sensitivities to clothing, food, textures, light, and sound

A noticeable drop in academic skills—especially handwriting or math

Many parents describe it simply: “It’s like my child disappeared.”

The Complexity of Diagnosis

Diagnosing PANS is undoubtedly complex. Symptoms often overlap with other conditions such as traditional OCD, anxiety disorders, ADHD, or tic disorders. There isn’t a single test that confirms the diagnosis, so physicians carefully rule out other medical, neurological, and autoimmune causes including Sydenham chorea from rheumatic fever, neuropsychiatric lupus, and other immune-related disorders.

These challenges mean that some families face skepticism from providers. Parents may need to advocate strongly for their child. If PANS or PANDAS is indicated, these symptoms are not not simply phases in which the “wait and see” approach can be applied. Rather, these conditions represent medically significant events requiring urgent attention from an interdisciplinary team.

It may not always be PANS/PANDAS, but this possibility deserves careful consideration. Mothers know their children best, and their intuition should be considered worthy of a well-trained, attentive listener who takes their concerns seriously. Awareness is growing (especially in Syracuse, NY!), yet many families still travel to specialists familiar with PANS/PANDAS to receive a thorough evaluation.

The good news is that families who carefully track symptom onset, seek appropriate specialist input, and advocate effectively can obtain the answers and treatment plans their children need. Recovery from PANS/PANDAS is entirely possible with the right medical and psychological support.

Awareness campaigns, such as Global PANDAS Awareness Day are helping more physicians recognize these conditions and more families access care. Stanford University and Massachusetts General Hospital are world-renowned medical facilities with PANS clinics. Early recognition and advocacy can make a profound difference in outcomes, school participation, and overall family well-being.

Treatment Options

Treatment for PANDAS/PANS is highly individualized because each child’s immune response and symptom profile are unique. A combination of medical and mental health interventions is often needed.

Alongside medical treatment, mental health support for both the child and the parents navigating an immense caregiver burden is essential. Children may experience sudden, intense OCD, anxiety, tics, or emotional dysregulation. Early intervention with evidence-based therapies, such as Exposure and Response Prevention Therapy, can prevent long-term disruption to school, friendships, and family life.

Medical Treatments May Include:

Antibiotics to target underlying infections

Anti-inflammatories (such as NSAIDs or short-term steroids)

In more severe or persistent cases, IVIG (Intravenous Immunoglobulin) to help reset the immune response

Ultimately, every child is different and treatment often involves a blend of medical, psychological, and family support strategies tailored to your unique situation.

It Affects the Whole Family

When a child is struggling with PANDAS or PANS, the impact ripples through every corner of family life. It touches your relationship with your partner, your other children, your work, your mental health, and the overall sense of peace in your home. There’s no manual for parenting a child who looks physically well but wakes up in distress—refusing food, overwhelmed by compulsions, or suddenly unable to face the day. The unpredictability is exhausting, and the emotional weight of it all can be incredibly heavy.

My Approach

I support families using Exposure and Response Prevention (ERP) Therapy, the gold-standard, evidence-based treatment for OCD in children. When OCD is triggered by PANDAS or PANS, ERP becomes even more nuanced. During a flare, the child’s symptoms may be more intense, irrational, or resistant to typical interventions, and therapy requires even greater sensitivity and flexibility.

My role is twofold:

1. To support your child in navigating and reducing OCD symptoms.

2. To support you—the parent—through one of the most emotionally exhausting and unpredictable experiences a family can face.

This diagnosis places an exceptional amount of stress on a family. The relapsing-remitting nature of PANDAS/PANS means you never quite know what each day will bring. One morning, your child might pad down the stairs and say, “Hey Mom, what’s for breakfast?” The next, they may be screaming that the lights are too bright and can’t even stand the feeling of their clothes on their body. It impacts the whole family system—siblings, relationships, routines, and your sense of safety in your own home.

I’m here to help you hold steady through those storms. While I do not provide medical advice beyond my scope of providing Exposure and Response Prevention Therapy, I can collaborate with your medical team and make referrals to medical providers. My job is to help you respond in ways that support your child’s long-term recovery from how to care for yourself through all of it.

For Educators & Community Mental Health Partners

For information on in-service trainings & consulting services, click here.

Syracuse Lights up Green for World PANS/PANDAS Awareness

On October 9, 2025, Syracuse joined more than 220 global landmarks in recognizing World PANS/PANDAS Awareness Day — marking the first time our city has ever participated. I was honored to organize this event and help bring local visibility to these often misunderstood pediatric disorders.

Syracuse is trailblazing as the only city in New York State to light up green in recognition of PANS/PANDAS this year. Families, children, teachers, and local OCD and pediatric mental health providers gathered downtown to share stories, raise awareness, and build community. Some families traveled more than an hour to attend — a powerful reminder of how isolating these disorders can be and how desperately local support is needed.

Many parents in our community have had to travel out of state for care, pay out of pocket for treatment, or even leave their jobs to care for their children full time. Their children’s struggles are immense — from life-threatening food restriction requiring feeding tubes, to severe aggression or immune-related complications that can lead to hospitalization. Yet, families are too often told “this disorder isn’t real,” despite decades of research and specialized teams at world-class institutions like Stanford and Mass General validating PANS/PANDAS.

This event represented a turning point for awareness and advocacy in Central New York. Seeing our community come together — parents, providers, educators, and neighbors — was profoundly moving. Thank you to everyone who shared posts, distributed flyers, lit up your porches green, and helped start conversations about PANS.

This is how change begins: one act of advocacy at a time.

Further Resources

Whether you are just beginning to navigate this journey or looking to deepen your understanding of PANS/PANDAS, these organizations offer valuable information, research, and support for families affected by these disorders:

International OCD Foundation: PANDAS/PANS Fact Sheet – A helpful overview of the condition from a leading organization in OCD research and treatment

International OCD Foundation – Practical Advice for Practitioners and Parents

PANDAS Physicians Network – A clinical resource hub with diagnostic and treatment guidelines used by medical professionals

PANDAS Network – A nonprofit offering education, research updates, and support resources for families and clinicians

ASPIRE – A nonprofit organization dedicated to raising awareness, providing education, and advocating for children and families

PANS/PANDAS School Resources – Most PANS/PANDAS students require individualized school accommodations. These are resources to help navigate that process.

Navigating PANS/PANDAS Skepticism Effectively – Neuroimmune Foundation offers a comprehensive guide for individuals seeking to address doubts with credible resources and research. Explore verified information, peer-reviewed studies, and expert opinions to bolster your understanding and advocacy efforts.

Avoidant/Restrictive Food Intake Disorder (Resources related to PANS)

PANS & Eating Disorder/Food Restrictions & Toolkits/Handouts (ASPIRE)

Disordered Eating in Children & Adolescents with PANS, Presented by Stanford Medicine

Cognitive Behavioral Therapy Workbook for ARFID

Key Research

Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome

Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions 

Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part II—Use of Immunomodulatory Therapies

Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III—Treatment and Prevention of Infections

Cognitive-behavioral therapy for PANDAS-related obsessive-compulsive disorder: findings from a preliminary waitlist controlled open trial -This study provides preliminary support for CBT/ERP in treating the PANDAS subtype of pediatric OCD. 

Epigenetic, ribosomal, and immune dysregulation in paediatric acute-onset neuropsychiatric syndrome (2025)

Disordered Eating and Food Restrictions in Children with PANDAS/PANS

Certain eating disorders may be a neuropsychiatric manifestation of PANDAS: case report

Additional PANS/PANDAS research