What’s the #1 burning question about your child’s behavior that keeps you up at night?

274: 10 Top Signs Your Dysregulated Child Might Have PANS/PANDAS

PANS and PANDAS often resemble ADHD, OCD, and anxiety. This episode explores early signs, misdiagnosis, and effective treatment strategies.

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When a child experiences constant dysregulation, severe anxiety, obsessive-compulsive behaviors, or school avoidance, it’s easy to link these challenges to conditions like ADHD, anxiety, OCD, or autism. However, there’s another possibility that often goes overlooked: Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS). These conditions, triggered by infections or underlying inflammation, can closely mimic the symptoms of these other diagnoses, leading to frequent misdiagnoses and delays in getting the right help.

Recognizing the signs early could make all the difference. That’s why this episode is so important—it sheds light on how PANS and PANDAS can often be mistaken for other conditions, and how understanding the link between dysregulation and these disorders can help guide parents toward the appropriate interventions.

PANS, PANDAS and Misdiagnosis

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) can be triggered by any infection or toxin, which is a scary thought for many parents.Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS), on the other hand, is specifically linked to strep infections. These conditions can result from the immune system going haywire and attacking the body, including the brain, leading to neuroinflammation. Unfortunately, they’re often misdiagnosed for ADHD, autism, or mood disorders. One key characteristic that sets PANS and PANDAS apart is the sudden and dramatic onset of symptoms.

I’ve had parents describe it as if their child was fine one day, and the next, they were dealing with something out of a horror movie. The symptoms can be extreme and sudden like intense anxiety, obsessive-compulsive behaviors, or even what looks like psychosis. Sometimes, kids with preexisting issues like mild anxiety or focus challenges experience a sudden, severe worsening of their symptoms, which is often missed because it gets attributed to life stressors or developmental changes.

It’s crucial to rule out situational stressors like bullying or trauma, but when the change is this sudden and dramatic, PANS or PANDAS should be on the radar. One of the most overlooked signs of these conditions is anxiety and OCD. These internal struggles often don’t become visible until they’ve taken a significant toll, and even then, the behaviors might be subtle, like stomach aches, trouble sleeping, or hand-wringing. As someone who specializes in OCD and PANS/PANDAS, I rarely treat OCD without uncovering an infection or toxin that’s either triggering or worsening the symptoms. That’s why early intervention is so important—not just for calming the nervous system but for addressing the root causes and unwinding the behaviors before they become deeply entrenched.

Common Symptoms of PANS and PANDAS

As parents, we all want to leave our children not just financial security but emotional wealth having resilience, confidence, and the ability to navigate life’s challenges. That’s why it’s so critical to recognize when something is seriously impacting your child’s emotional and neurological health. One of the top signs parents notice is emotional dysregulation.

While all kids have moments of dysregulation, a sudden, intense inability to recover from emotional outbursts is a major red flag. If your child is generally calm and then seems completely unrecognizable overnight being angry, tearful, or highly reactive, you need to consider the possibility of PANS or PANDAS. Always rule out situational stressors like bullying or social exclusion first, but when the shift is dramatic and recovery is poor, it’s time to dig deeper.

Another big indicator is the sudden onset of tics or motor issues. These uncontrollable movements, like throat clearing or eye blinking, might appear out of the blue and signal something more serious when paired with other symptoms. Similarly, developmental regression is a hallmark of these conditions. I’ve seen children go from thriving students to struggling readers or writers almost overnight, leaving parents confused and searching for answers.

What makes PANS and PANDAS so challenging is how they mimic other conditions, like ADHD or anxiety, and how they pull on each child’s unique biology, creating different symptoms. Early expert care is essential to stop these conditions from snowballing into something even more challenging. If your gut is telling you something’s wrong, trust it. Recognizing the signs and acting quickly can make all the difference in helping your child recover.

Behavioral and Physical Symptoms

When it comes to PANS and PANDAS, I have seen some patterns over the years that I feel compelled to share. Sleep disturbances are a big one. Kids struggle to fall asleep, wake up frequently, and even experience sudden nightmares that were not an issue before. If these changes persist despite trying everything, it might be worth considering PANS or PANDAS. Physical symptoms such as joint pain, sensory issues, stomach problems, and bowel changes often show up. While gastrointestinal issues are often tied to anxiety, when they combine with other symptoms like joint pain, they could point to something deeper, such as a tick-borne illness or inflammation.

I have worked with kids experiencing unrelenting pain, and it is heartbreaking. When there is no clear medical explanation, these cases are often dismissed as psychiatric. Thankfully, more mental health professionals are starting to recognize the medical roots of these issues. Behavioral shifts are another sign. School avoidance, restrictive eating, rage, and obsessive-compulsive behaviors are some of the most common symptoms I see.

I have worked with so many kids and teens who hit a wall with school or suddenly refuse to eat, leaving parents wondering what happened. Flares are another important indicator. I recently worked with a young woman who shared how every illness seemed to destabilize her. If you notice that your child worsens during illness, or improves with treatments, it is a strong indication that neuroinflammation or infection is playing a role.

Even smaller signs like urinary frequency can serve as clues. It is a soft sign that often appears before major episodes. Severe separation anxiety is another one. If your child suddenly develops separation anxiety where there was none before, it is worth exploring. While anxiety can be developmental, an abrupt and extreme onset could mean something more.

PANS and PANDAS are manageable, but early intervention is essential. Not sure where to start? We'll help you find the right solution tailored to your needs. Visit https://drroseann.com/help/ today and take our FREE Brain and Behavior Solutions Matcher.

Discover science-backed mental health solutions and gain valuable insights from Dr. Roseann Capanna-Hodge by exploring the resources available at www.drroseann.com.

Get the right support with our Natural PANS/PANDAS Kit—designed to fast-track your child's healing naturally and without medication: https://drroseann.com/panskit

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Links and Resources:

➡️ Join our FREE Natural Parenting Community to receive science-backed resources for your child and family. Join here.

➡️ Get help from Dr. Roseann and her team. Apply here. 

➡️ “Is it ADHD or something else?” Take the quiz. 

Dr. Roseann Capanna-Hodge: Revolutionizing Children’s Mental Health

 
Dr. Roseann Capanna-Hodge’s podcast, It’s Gonna be OK!™: Science-Backed Solutions for Children’s Behavior and Mental Health, is in the top 2% globally. The podcast empowers parents with natural, science-backed solutions to improve children’s self-regulation and calm their brains. Each episode delivers expert advice and practical strategies, making it indispensable for parents of neurodivergent children or those with behavioral or mental health challenges.

Dr. Roseann, founder of The Global Institute of Children’s Mental Health and Dr. Roseann, LLC, created the Neurotastic™ Brain Formulas and BrainBehaviorReset® method. With her extensive experience, she provides families with hope and effective strategies to manage conditions like ADHD, anxiety, OCD, and PANS/PANDAS. 

Forbes has called her “A thought leader in children’s mental health,” highlighting her revolutionary impact on mental health education and treatment. Through her podcast and innovative methods, Dr. Roseann continues to transform how we approach, treat and understand children’s mental health.

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