At just 22 months old, a tick bite turned our world upside down. My son Max, once a happy, lively toddler, began displaying alarming changes—extreme pickiness with food, explosive tantrums, and an irritable demeanor we’d never seen before. We had no idea this was only the beginning of a larger struggle. By the time Max was 3, he was diagnosed with Lyme Disease, and soon after, PANS. The emotional toll was immense—frightening, overwhelming, and utterly exhausting. Since my child faced this challenge, I've been committed to seeking integrative health solutions instead of relying on medication.
As a mom with a child with PANS, I fully understand that the nervous system of a child with PANS/PANDAS experiences stress due to the acute onset of symptoms, causing an overworked and agitated state. Fortunately, catching the diagnosis early proved to be a significant advantage. As an empowered mom, I have searched for treatment options that are holistic and effective in treating PANS symptom onset.
What is Pediatric Autoimmune Neuropsychiatric Disorder?
PANS/PANDAS refers to a group of conditions in children where an autoimmune response mistakenly targets the brain, leading to the dramatic onset of symptoms. A well-known subset of these disorders is PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), which is triggered by infections with group A streptococcus.
Sudden Onset of Symptoms of PANDAS
A sudden onset of PANDAS can cause symptoms like obsessive compulsive symptoms, irregular motor skills, vocal tics, autoimmune encephalitis, emotional disturbances such as anxiety and mood swings, and emotional lability. Severely affected children can show various physical symptoms like disabling tics, joint pain, and sleep disturbances.
While PANDAS is not a formal clinical diagnosis and is specifically associated with streptococcal infections, PANS encompasses a broader range of triggers, including viral infections and other autoimmune responses. Neither PANS nor PANDAS are classified as formal clinical diagnoses in the DSM-5, but they are important concepts that highlight the need for a comprehensive approach to pediatric mental health, emphasizing the potential connection between infections, autoimmune reactions, and neuropsychiatric symptoms.
Strep Infection (streptococcal infections)
Identifying a preceding strep infection or strep throat as a potential trigger for PANS/PANDAS is crucial, as it helps meet the diagnostic criteria and manage the condition effectively. Strep bacteria or Streptococcus bacteria are a group of bacteria commonly associated with infections such as strep throat (sore throat), scarlet fever, and, in some cases, autoimmune responses that can lead to neuropsychiatric disorders like PANDAS.
Diagnosis typically involves distinct criteria, medical history, and ruling out other causes, while treatment may include antibiotics, immune-modulating therapies, psychiatric medications, and behavioral therapy. Early diagnosis and appropriate treatment are crucial for improving outcomes, though some children may experience relapses often linked to new infections.
Why use Integrative Health Solutions for Pediatric Autoimmune Neuropsychiatric Disorders (PANS/PANDAS)?
Holistic therapies for PANS/PANDAS disease provide one of the least invasive but most useful ways to help relieve the symptoms associated with this very difficult and draining illness. Antibiotic treatment is a conventional approach that can be complemented by holistic therapies. Since the body is physiologically designed to deal with stress before healing, practicing daily relaxation techniques is the first step to a healing regimen.
Chronic illnesses cause a higher level of stress which in turn interferes with the healing process. There are a variety of homeopathic therapies that may be beneficial for afflicted patients. Because everyone’s physiology and makeup are different, each person responds to therapy in a unique manner.
Many therapies work synergistically and most who live well with or remediate PANS/PANDAS tend to do a combination of these holistic treatments and adopt a more holistic lifestyle.
To explore natural treatments for PANS and PANDAS, be sure to check out my program, The Natural PANS/PANDAS Calm Brain Kit. It offers comprehensive, holistic approaches to support and manage these conditions effectively.
12 Integrative Healthcare Solutions to Treat PANDAS /PANS
1. Detoxification
Problems with detoxification are another common issue preventing those with chronic illnesses from healing. Detoxification is what your body constantly does naturally to neutralize, transform, or get rid of unwanted materials or toxins.
Sometimes the toxic load is too much for one’s body to keep up with, and other times there are genetic issues interfering with detoxification. Supporting detoxification is an integral part of supporting the healing process.
2. Proper Nutrition
Diet is essential for individuals suffering from PANS/PANDAS. A healthy diet emphasizing an anti-inflammatory diet helps with micronutrient absorption, which in turn helps the body and brain work better. Additionally, a healthy diet supports the immune system in children with PANS/PANDAS.
Certain eating restrictions can be beneficial for managing PANS. It’s often recommended to avoid foods that may exacerbate inflammation or trigger immune responses. These typically include highly processed foods, sugar, and foods high in artificial additives. Additionally, some children may benefit from avoiding gluten or dairy if sensitivities are present.
Disease states rob the body of nutrients, so eating nutrient-dense food is essential to promoting healing. Moreover, an anti-inflammation PANS/PANDAS diet reduces inflammation in the body and brain, which improves affect and behavior.
Inflammation plays a key role in autoimmune disease, making its reduction essential for children who are subject to a misdirected immune response, like in PANS/PANDAS. Importantly, reducing inflammation in a patient with PANS/PANDAS correlates with a reduction in neuropsychiatric and neurocognitive symptoms.
3. Neurofeedback
PANDAS /PANS can impact brain functioning because inflammation and damage can lead to over-activity or low activity. Adults and children with PANDAS /PANS can display a variety of neuropsychiatric and neurocognitive symptoms that can ultimately interfere with one’s functioning and life.
While the signs of PANS/PANDAS vary from child to child, symptoms of PANDAS often wax and wane with environmental and new infection variables. Common child's symptoms include, but are not limited to, tics, obsessive compulsive behavior, rage, and anxiety.
Neurofeedback is a way to directly change brain wave functioning and to get the brain to self-regulate. When we get the brain to self-regulate, then we reduce negative behaviors and symptoms.
In the case of a child with PANS/PANDAS, anxiety, obsessive compulsive behaviors, anger, and mood issues can improve with Neurofeedback.
For example, one child was crippled by his separation anxiety, and the neurofeedback calmed his nervous system down significantly enough where he could have rational thinking. Once coupled with psychotherapy and parent coaching, he was able to fully normalize his anxiety.
Over time, adding neurofeedback led to a gradual decline in anxiety in daily life which reduced separation anxiety allowing the parents to get therapeutic coaching to support the child at school performance at home. Learn more about my 5-pronged integrative approach to treating children with PANDAS/ PANS.
4. PEMF Therapy
Pulse Electro Magnetic Frequency Therapy (PEMF) and Advanced Bioregulation Therapy (BRT) is a technology that helps to create an environment that promotes cellular communication, increased cellular nutrition, and self healing.
This can lessen associated symptoms, reduce pain, improve detoxification, decrease anxiety, and increase feelings of well-being. PEMF amplifies the “healthy” harmonic frequencies and sends them back to the cells. Once the cells are working more optimally, the nervous system calms down, and disruptive signals, which have become magnified over time, diminish.
PEMF promotes an environment for the body to be able function optimally. The body’s nervous system then uses that feedback to reorganize itself and improve its own intercellular communication. With the feedback, the cells better align themselves within the organ system and entire body. As a holistic remedy for PANDAS/ PANS, PEMF therapy can provide immediate calming and improve restorative sleep.
It is also a very non-invasive and easy to administer therapy, which is important with the range of difficult behaviors that can be present. Learn more about PEMF therapy and how it can help your child get better mental health.
5. Homeopathy and Functional Medicine
Individuals with PANDAS/ PANS often use homeopathy, herbs, and supplements as integral parts of their healing and to improve their daily lives.
Functional lab work looks at deficiencies, sensory abnormalities, and irritants in the body, which allows PANS/PANDAS doctors and practitioners to evaluate organ and system functions rather than looking for a specific disease. Individuals take a prescribed regimen of supplements that help their body and brain work better.
Homeopathy, herbs, and supplements can be very effective and powerful in addressing a variety of issues. There are great products for addressing both the immune part of the disease and the psychiatric issues that can result, as well as problems with detoxification. They not only become part of daily regimen, but also part of the PANDAS/ PANS treatment arsenal when severe symptoms increase.
Functional and integrative medicine approaches for PANS and PANDAS prioritize treating the root causes of symptoms rather than merely managing them. This holistic method emphasizes nutritional support through a nutrient-dense diet that promotes optimal health for the brain and body and reduces inflammation, often by eliminating processed foods and allergens while incorporating anti-inflammatory foods rich in omega-3 fatty acids. It also addresses gut health by correcting microbiome imbalances through probiotics, prebiotics, and dietary changes, recognizing the crucial role gut health plays in neuropsychiatric conditions.
6. Craniosacral Therapy
Using a soft touch, practitioners release restrictions in the craniosacral system to improve the functioning of the central nervous system and the child's brain. It is a very gentle therapy but can be very effective in reducing some of the core symptoms found in PANS/PANDAS. Craniosacral therapy can also help alleviate sleep disturbances. Many PANS/PANDAS patients report improvements in stress, anxiety, headache, pain, feelings of well-being, and reduced agitation.
7. Psychotherapy
Individuals afflicted with and parents of children with PANDAS/ PANS are often traumatized by their harrowing and long health journey. Symptom severity can be managed through psychotherapy, which helps in addressing the dramatic ups and downs. Psychotherapy at the right time with a literate therapist combined with more holistic therapies can make a world of difference for both parent and child. Managing these behaviors and the constant flaring that wreaks havoc on the patient’s life requires therapeutic support to help learn coping skills.
No parenting handbook for the behaviors and issues associated with PANS/PANDAS exists. Having a literate PANS expert to support your child's doctor can help the family mentally handle periods of flare and work through lingering issues during non-flare periods too.
My own personal experience as a mom of a child with PANS has been hard. Even with my knowledge, it took me about seven years to realize that we weren’t going to cure Max’s illness with all our mad dashes in the search for a cure, rather, we needed to conserve our energy and look at this like a marathon. That shift and an emphasis on stress reduction therapies became a game changer for us.
8. EFT/Tapping and EMDR
Individuals with PANS/PANDAS often experience anxiety and even trauma around their medical issues, and parents can experience the same when the patient is their child. EFT and EMDR are tools to unlock those unwanted feelings from our subconscious in a very effective way and help to reduce anxiety, irritation, anger, and a variety of feelings.
Any emotional stress can impede the human body’s ability to heal itself. EFT and EMDR are tools that therapists use to release negative emotions and beliefs that are interfering with a patient’s emotional well-being. They are also highly effective tools for those experiencing psychiatric issues associated with PANS/PANDAS. EFT can be used to help manage pain, OCD symptoms, anxiety, anger, and other symptoms of common psychiatric issues that cause children stress and make it hard for the body to heal.
9. Hypnotherapy
Yes, hypnotherapy can be applied to many psychological, emotional, and physical disorders. Hypnotherapy can also help manage symptoms of acute onset neuropsychiatric syndrome by tapping into the subconscious to reprogram one’s state of mind, which can positively alter one’s issues.
For patients with the psychiatric components of the disease who are resistant to any type of cognitive or talk therapy, hypnotherapy is one of the most effective holistic mental health remedies for PANS/PANDAS.
Since the subconscious is typically in control of one’s psyche, using therapies like hypnotherapy and neurofeedback, which work at the subconscious level, can be very effective.
10. Massage Therapy
Aside from having physical advantages like pain reduction, reduced muscle tension, and improved detoxification, therapeutic massage can also be psychologically beneficial in that it reduces stress and can improve mood. Massage therapy can also help manage symptoms of pediatric acute onset neuropsychiatric conditions, such as PANS and PANDAS.
People with chronic disease often have significant issues with detoxification, which interferes with clearing the disease and massage is a wonderful tool not only for stress and pain reduction but for aiding in detoxification.
11. Oxygen Therapy
Many individuals with PANS/PANDAS find themselves trying oxygen therapy after many years of failed treatments. Lyme disease is another condition that may benefit from oxygen therapy. By increasing the amount of oxygen in the body, oxygen therapy encourages the body to heal itself. It can be a potent restorative healing therapy.
Some children heal quickly with PANS/PANDAS, but for many, the journey for healing is long. Since many providers lack knowledge and the inadequate means of diagnosis and treatment interfere with children getting the necessary help quickly, making the healing journey even longer.
While oxygen therapy may be one of the last holistic remedies for PANS/PANDAS some try, it is becoming an increasingly popular viable treatment.
12. Behavioral therapies
What I have learned in the 10-plus years of having a child with Lyme and PANS is that you have to incorporate integrative therapies, eating correctly, restorative sleep, and relaxation therapies into your regimen.
Reducing the amount or intensity of academic work or switching to homeschooling with less social pressure is also essential in reducing illness flares. The daily grind of drone-like work production is too much for most kids but is intolerable for those with PANS/PANDAS. Increased stress can lead to a worsening of symptoms or an inability to heal.
In dealing with the OCD symptoms of a child with PANS/PANDAS, Exposure and Response Prevention (ERP) therapy can also help. These therapies are helpful for episodic symptom as well as long term management.
A change in lifestyle, whether you want to or not, is needed to support chronic disease states and chronic stress. As a parent or loved one supporting a child with Lyme or PANS/PANDAS, you also need to take care of yourself.
This may have turned on overnight for some, but it often won’t rectify quickly or easily for most. You must do what you can to protect yourself and reduce stress levels. This is traumatic! As I see every day, emotional stress can be the most harmful aspect of the disease that prevents healing.
There may be many reasons why disease persists in some genetics, problems with detoxification and elevated stress are vital issues that prevent one from healing that need to be directly addressed and supported.
There are many parents looking for services that offer integrative health solutions for PANS and PANDAS, which is often lacking in our present healthcare system. This is why I created the BrainBehaviorReset Program. It focuses on finding the root cause of the issue and healing not only the symptoms but also the whole person holistically. It's a combination of science-backed strategies and brain tools, including neurofeedback, PEMF, ERP, and behavioral therapies. Click here to learn more.
How can PANS and PANDAS affect the immune system?
PANDAS and PANS can significantly impact the immune system due. In these conditions, the immune system mounts an inappropriate response to an infection or other triggers, producing antibodies that mistakenly target and attack healthy brain tissue. This results in inflammation, particularly in brain areas involved in behavior, movement, and cognitive functions, leading to the onset of neuropsychiatric symptoms.
Additionally, the autoimmune reaction can cause immune dysregulation, disrupting normal immune function and potentially increasing susceptibility to other infections. The systemic inflammation and immune disturbances associated with PANS & PANDAS can also affect other parts of the body, contributing to physical symptoms such as joint pain, gastrointestinal issues, and general malaise. Overall, the impact on the immune system is complex, involving both direct effects on brain tissue and broader implications for overall mental health.
How can strep infection / streptococcal infections trigger PANS and PANDAS?
Strep infections, caused by group A strep bacteria, are common in childhood and often present as strep throat or scarlet fever. While a strep infection typically resolves with antibiotic treatment, strep throat and strep infections can have significant implications for some children by triggering autoimmune responses that affect the brain.
While all strep throat cases involve a sore throat, not all sore throats or other infections are caused by strep bacteria. A throat culture is a diagnostic test used to identify the presence of bacteria or other microorganisms in the throat. When a person is diagnosed with strep bacteria, it occasionally leads to immune-mediated complications affecting the brain and other organs. This phenomenon is mainly linked to PANS and PANDAS with strep infection.
What are some strep infection remedies?
Treating strep infections effectively requires a multi-faceted approach. The primary remedy is a course of antibiotics, such as penicillin or amoxicillin, which is essential for eradicating the group A streptococcus bacteria causing the strep infection. In addition to antibiotics, over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate the discomfort associated with a strep infection, including throat pain and fever. Gargling with warm salt water, staying hydrated, and using a humidifier can also provide symptomatic relief and support the healing process. Proper hygiene and avoiding irritants are crucial for both recovery and preventing the spread of the infection to others.
What is a scarlet fever?
PANDAS is associated with streptococcal infections, such as strep throat, which can sometimes include scarlet fever. Scarlet fever is caused by group A streptococcus bacteria, the same bacteria responsible for strep throat. It typically begins with a sore throat and fever and is characterized by a distinctive red rash that feels like sandpaper. The rash usually starts on the neck, chest, and back and then spreads to other body parts. Other symptoms may include a red, swollen tongue (sometimes called “strawberry tongue”) and a flushed face with a pale area around the mouth.
What are the neurological symptoms of pans and pandas?
The neurological symptoms of PANDAS /PANS can be quite severe and varied. They often include sudden onset or worsening of obsessive-compulsive behaviors, such as intense and intrusive thoughts accompanied by repetitive actions. Tics, both motor (e.g., blinking, head jerking) and vocal (e.g., grunting, throat clearing), are also common.
Affected children may experience extreme anxiety or panic attacks, along with severe mood issues and irritability. Depression and significant changes in personality, including aggression or social withdrawal, can occur. Additionally, there may be noticeable cognitive decline, such as difficulties with attention, concentration, or memory.
These symptoms typically emerge abruptly, frequently following dramatic or abrupt onset of an infection or other trigger, and can severely disrupt daily functioning and overall quality of life.
Are PANS and PANDAS considered psychiatric disorders?
PANS and PANDAS are not classified as psychiatric disorders in the traditional sense but rather as conditions that involve neuropsychiatric symptoms resulting from underlying medical issues.
Can SSRI help?
Selective serotonin reuptake inhibitor (SSRI) can help manage some of the neuropsychiatric symptoms associated with PANS and PANDAS, particularly symptoms such as obsessive-compulsive disorder (OCD) and severe anxiety. SSRIs are commonly used to treat obsessive compulsive disorder because they can help regulate serotonin levels in the brain, which may alleviate the intensity of obsessive-compulsive behaviors, tics, and mood disturbances. It is important to note that SSRI may have side effects on most children, watch my video on SSRI to learn more.
How do you diagnose pandas and pans?
Diagnosing PANS involves a comprehensive evaluation process to identify the specific symptoms and underlying triggers to come up with a clinical diagnosis. Clinical diagnosis of PANS/PANDAS involves evaluating clinical features, signs, symptoms, and medical history, sometimes ruling out other medical disorders through testing. The diagnostic process typically includes the following steps:
- Clinical Evaluation: A thorough medical history and clinical assessment are crucial. The healthcare provider will look for a sudden onset of symptoms, such as OCD symptoms, tics, severe anxiety, mood swings, and behavioral changes. Symptoms often appear abruptly and may follow an infection or other trigger.
- Symptom Criteria: For a diagnosis of PANDAS, the onset must be preceded by a streptococcal infection. PANS, on the other hand, include a broader range of triggers, such as other infections, environmental factors, or metabolic disturbances. Both conditions require the presence of significant psychiatric symptoms that markedly interfere with daily functioning.
Citations
Cabrera-Mendoza, B., Genis-Mendoza, A. D., & Nicolini, H. (2019). Diagnosis in PANDAS: An Update. Current Psychiatry Research and Reviews Formerly: Current Psychiatry Reviews, 15(4), 237–247. https://doi.org/10.2174/2666082215666190917161514
Dr. Roseann is a mental health expert in PANS/PANDAS who is frequently in the media:
- Clearly Clinical Podcast: What you need to know about PANS/PANDAS
- Healthy Parenting Connector (Video) Why “My Kid is Acting Crazy” Might be PANS/PANDAS
- Therapy Chat (Podcast) PANS / PANDAS + Mental Health Part One Mental Health
- The Science of Healing Reverse your child's PANS / PANDAS, ADHD
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.”
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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