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Activities that Relieve Psychological Stress in PANS/PANDAS

Activities that Relieve Psychological Stress
Picture of Dr. Roseann Capanna-Hodge

Dr. Roseann Capanna-Hodge

Psychological stress significantly impacts families dealing with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS). 

As a PANS parent and a therapist who has helped many children and families, no one really can understand the stress, trauma and hell a PANS family goes through. The trauma, the fear, isolation and frustration for lack of care is overwhelming to say the least. 

Understanding the disorder and getting proper care is one part of the puzzle but learning how to manage this stress is crucial for the child and their family. Finding moments of calm isn’t always easy but it is critical for getting through the storm.

Psychological Stress on Children and Families


Children with PANS/PANDAS experience sudden and severe symptoms, including obsessive-compulsive behaviors, anxiety, tics, and other neuropsychiatric symptoms. This abrupt onset can be highly distressing for the child and may lead to high levels of psychological stress. 

Psychological stress examples in these children include:

  • Anxiety and panic attacks
  • Increased irritability and mood swings
  • Difficulty concentrating and academic challenges
  • Sleep disturbances

The impact of PANS/PANDAS extends beyond the child, profoundly affecting the entire family. 

Parents and siblings may experience:

  • Heightened anxiety and worry about the child’s well-being
  • Emotional exhaustion from managing unpredictable symptoms
  • Physical symptoms such as sleep issues, gut problems, hair loss
  • Disruption of family routines and dynamics, including discord with partner over care
  • Financial strain due to medical expenses and potential loss of income

What is a Flare? 

A flare in the context of PANS and PANDAS refers to a sudden and severe worsening of symptoms. These symptoms can intensify rapidly, often within hours or days, and can be triggered by infections, stress, or environmental changes. 

Flares are characterized by their abrupt onset and heightened severity, lasting from days to weeks and significantly impacting the child's daily functioning and well-being.

Managing flares involves a combination of medical, therapeutic, and lifestyle interventions to reduce symptoms and support the child and family. Prompt medical attention and possible medication adjustments are crucial, alongside increased therapy sessions and nervous system calming tools, to provide coping strategies and emotional support. 

Maintaining a consistent daily routine, implementing stress-relieving techniques such as sensory support, mindfulness and physical activity, and ensuring a healthy diet and adequate sleep are essential for managing the child's symptoms and reducing overall family stress during these challenging episodes.

How Does Flares Cause Psychological Pressure? 

Psychological stress happens when someone feels like the demands around them are too much for them to handle. Researchers study stress by looking at events generally agreed to be challenging or how individuals respond to these events, like feeling stressed out or having negative emotions (Cohen et al., 2007). 

Flares in children with PANS/PANDAS cause significant psychological stress for both the affected child and their family. The sudden and severe onset of symptoms can be overwhelming. 

For the child, this abrupt change can lead to feelings of confusion, fear, and frustration as they struggle to cope with their intensified symptoms. The unpredictability and intensity of flares disrupt their sense of normalcy and security, leading to increased anxiety and emotional distress.

For the family, managing a flare can be equally stressful. Parents may experience heightened anxiety and worry about their child's well-being, feeling helpless in the face of their child's suffering. 

The need for constant vigilance and care can lead to emotional exhaustion, strained family dynamics, and disrupted routines. Siblings may also feel neglected or stressed by the increased attention given to the affected child. 

The strain of deciding which treatments will help, how to pay for them and getting one’s spouse or partner to agree to them is all too much.  There is no doubt that unpredictability and severity of flares create a high-stress environment that impacts the mental health and emotional stability of the entire family.


Managing psychological stress in children with PANS/PANDAS and their families is crucial. Here are some activities that relieve psychological stress effectively:

  1. Art Therapy: Encourages expression through drawing, painting, or sculpting. It helps children process emotions and reduce anxiety.
  2. Play Therapy: Use play to help children express feelings and cope with symptoms. It provides a safe space for children to explore and manage their emotions.
  3. Music Therapy: This involves listening to or creating music. It reduces anxiety, improves mood, and enhances emotional regulation, as well as can turn off a busy mind.
  4. Animal-Assisted Therapy: Involves interaction with therapy animals. It decreases stress and anxiety, provides comfort, and improves mood.
  5. Physical Activity: Includes activities like dancing, yoga, or playing sports. It releases endorphins, reduces stress, and improves overall well-being. Even a 10 minute walk can improve mood and sleep. 
  6. Mindfulness and Meditation: Practices like deep breathing, guided meditation, and mindfulness exercises. It reduces stress, promotes relaxation, and improves emotional regulation.
  7. Outdoor Activities: Activities like hiking, biking, or walking in nature help reduce stress, improve mood, and promote physical health for the child and family. 
  8. Relaxation Techniques: Progressive muscle relaxation, guided imagery, or aromatherapy reduce tension, promote relaxation, and improve sleep quality.

Dealing with PANS/PANDAS is undoubtedly challenging, but with the proper stress management methods and stress relief techniques, families can find effective ways to cope. Good stress management techniques are essential for maintaining emotional balance and ensuring the child's and family's well-being. 

Discover a game-changing resource filled with techniques that I have used with thousands of clients who struggle with dysregulation. Stop going down rabbit holes and searching the internet at 2 AM, this resource was designed to get you on the right path. Download the Natural Pans/Pandas Calm Brain Kit and empower yourself to help your child achieve a calm nervous system.

What is the most effective stress management strategy?

Consistent exercise releases endorphins, mindfulness techniques like meditation reduce anxiety, and sufficient sleep restores emotional balance. It can create a holistic approach to managing stress effectively.

How do you treat stress?

Treating stress involves combining regular physical activity, mindfulness practices like meditation, and maintaining a healthy lifestyle with a balanced diet and adequate sleep. Psychological techniques such as cognitive-behavioral therapy (CBT), relaxation exercises, and professional support from a therapist are also effective in managing stress.

What is a good stress reliever?

Walking, running, and yoga are highly effective stress relievers. Exercise helps release endorphins, improves mood, and reduces tension in the body, making it an excellent way to alleviate stress.

How can I reduce stress naturally? 

Ensure a balanced diet and adequate sleep. Seek social support to manage stress levels effectively. With natural stress reduction techniques in your daily routine, you can effectively manage stress and improve your overall well-being.

What are some natural cures for stress?

Natural cures for stress include herbal supplements like chamomile or lavender, aromatherapy, and herbal teas known for their calming properties. These remedies can complement other stress management techniques.

What are some practical stress relief tools?

Effective stress relief tools include journaling, engaging in hobbies, and spending time in nature. These tools provide a positive outlet for stress and promote emotional well-being.

What are some evidence-based stress reduction techniques?

Evidence-based stress reduction techniques include cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and relaxation response techniques. These techniques have been scientifically proven to reduce stress and improve mental health.

What are some good stress management techniques for the workplace?

Good stress management techniques for the workplace include setting realistic goals, practicing time management, and taking regular breaks to recharge. Additionally, open communication with colleagues and seeking supervisor support can help manage workplace stress effectively.

What are some techniques for relieving stress in adults?

Techniques for relieving stress in adults include engaging in hobbies, spending time with loved ones, and practicing relaxation techniques like deep breathing or progressive muscle relaxation. These activities help adults unwind and manage stress effectively.

How do stress management and relaxation techniques differ?

While stress management techniques focus on coping with stressors and reducing their impact, relaxation techniques promote calm and reduce physiological arousal. Both approaches complement each other in promoting overall well-being and resilience.


Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007). Psychological Stress and Disease. JAMA, 298(14), 1685–1687.

Dr. Roseann is a mental health expert in PANS/PANDAS who frequently is in the media:

Always remember… “Calm Brain, Happy Family™”

Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.

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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.

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She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health. 

Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches. 

She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain. 

Her trademarked BrainBehaviorResetⓇ Program and It’s Gonna be OK!Ⓡ Podcast has been a cornerstone for thousands of parents facing mental health, behavioral or neurodevelopmental challenges.

She is the founder and director of The Global Institute of Children’s Mental Health, Neurotastic™Brain Formulas and Dr. Roseann Capanna-Hodge, LLC. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Mental Health Professional (CIMHP) and an Amen Clinic Certified Brain Health Coach.  She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF).

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