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Curious about the link between strep throat andOCD symptomsin children?
For some, an immune reaction to a strep infection may inadvertently target the brain, leading to abrupt onset of OCD signs. This nightmarish condition is referred to as PANDAS.
Yes, what may look like “strep throat OCD” is actually PANDAS—and it’s more common than most parents or even doctors realize.
PANS/PANDAS families come from all over the world with stories of misdiagnosis and improper treatment before they get to me. As a therapist and PANS/PANDAS strategist my goal isn’t just to help calm their nervous system but help parents with PANS/PANDAS treatmentplanning.
What is Strep Throat OCD (PANDAS)?
Strep Throat OCDis a nickname for a real medical condition called PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections(Swedo et al., 2012)
This happens when the immune system of your child overreacts on getting a strep infection.
Strep infection continues to start attacking the basal ganglia, part of the brain which helps with emotional regulation and decision making (Chang et al., 2015).
Common signs of PANDAS/ Strep throat OCD:
- Sudden onset OCD (hand washing, fear of germs, checking)
- Tics (blinking, throat clearing, shoulder shrugging)
- Separation anxiety or school refusal
- Aggression or emotional outbursts
- Bedwetting or regressive behavior
Can Strep Throat Affect Your Child’s Mental Health?
Yes — and it can feel like it happens overnight. When strep antibodies mistakenly attack brain tissue, they cause neuroinflammation. That inflammation shows up as behavior changes.
Think of it like this: your child’s brain is inflamed, not misbehaving.
Here’s what you might notice:
- Irrational fears or new compulsions
- Mood swings and meltdowns
- Sleep disturbances or night terrors
- Trouble with focus, memory, or learning
It’s not bad parenting — it’s a dysregulated brain.
Can Strep Throat Really Cause OCD in Kids?
Absolutely. In kids with PANDAS, the strep infection triggers an immune response that mistakenly targets brain tissue. This leads to sudden-onset OCD, which looks different from typical OCD.
PANDAS OCD vs. Classic OCD:
| PANDAS OCD | Classic OCD |
|---|---|
| Sudden onset | Gradual onset |
| Often follows strep | Not triggered by illness |
| Co-occurs with tics or regression | May not include tics |
How Does Strep Throat Affect Anxiety in Kids and Teens?
The brain inflammation that comes with PANDAS doesn’t just trigger OCD; it also sends anxiety into overdrive.
Kids might:
- Refuse to go to school
- Become afraid of being alone
- Worry obsessively about things that didn’t bother them before
- Cry or panic when separated from you
Real-life story:
Grace, a mom of a 9-year-old, shared how her daughter went from confident to terrified of sleeping alone just days after a strep infection. She was convinced her parents would die if she closed her eyes.
“Seeing your child unravel is terrifying, but with the right help, you can get them back.”
What Are “Strep in Brain” Symptoms Parents Should Watch For?
The brain controls everything — thoughts, emotions, sleep, movement. So when strep attacks it, the symptoms can seem unrelated at first.
Watch for:
- Clinginess or separation anxiety
- Motor or vocal tics
- Emotional outbursts or rage attacks
- Compulsionslike handwashing or tapping
- Trouble writing or math regression
How is PANDAS Diagnosed and What Tests Are Used?
There isn’t a single test for PANDAS, which can make diagnosis frustrating. It’s a clinical diagnosisbased on:
- Sudden onset of OCD or tics
- Evidence of a recent strep infection (throat culture, ASO titers)
- Neuropsychiatric symptoms that fluctuate or worsen after illness
Labs to request:
- Throat culture
- Anti-streptolysin O (ASO) titers
- Anti-DNase B titers
TIP:Keep a symptom log to help doctors see the timeline.
Treatments That Help Kids with Strep Throat OCD (PANDAS)?
Treatment usually includes:
- Antibioticsto fight strep
- Anti-inflammatoriesto calm the immune system
- Psychotherapylike CBT or ERP (Exposure and Response Prevention)
But for lasting change, we also need to calm the brain and regulate the nervous system.
Natural and Holistic Support Options for PANDAS
At our center, we focus on integrative care that gets to the root of what’s going on in the brain and body (Kovacevic et al., 2015).
These can help calm the inflammation and support recovery:
- Neurofeedback: trains the brain to regulate better
- PEMF: reduces inflammation at the cellular level
- Targeted nutrition: like omega-3s and gut support
- Immune support: vitamins D, C, zinc, and probiotics
Let’s calm the brain first. Then everything else gets easier.
Real-life story:
Ben, age 11, started neurofeedback after months of rage episodes following strep. After 10 sessions, his parents said they finally had their son back. It was the first time he laughed in weeks.
Parent Action Steps
FAQs
What age does PANDAS usually start?
Most kids show symptoms between ages 3 and 12, but it can happen earlier or later.
Is PANDAS contagious?
No, but strep is. And in sensitive kids, it can trigger the immune response that leads to PANDAS.
Will my child grow out of it?
Some kids do, but many need support to fully heal. Early treatment helps.
How long does recovery take?
Every child is different. Some improve in weeks with treatment. Others need longer support.
Can a child have PANDAS more than once?
Yes, symptoms can flare with new infections. Ongoing immune support is key.
Terminology:
PANDAS– Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus. Sudden onset OCD or tics after strep.
Basal Ganglia– A part of the brain that helps control movement and emotions. Often affected in PANDAS.
ASO Titer– A blood test that shows if the body has reacted to strep.
Citations:
Swedo, S. E., Leonard, H. L., Garvey, M., Mittleman, B., Allen, A. J., Perlmutter, S., … & Rapoport, J. L. (1998).Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: Clinical description of the first 50 cases. The American Journal of Psychiatry, 155(2), 264–271. https://doi.org/10.1176/ajp.155.2.264
Murphy, T. K., Kurlan, R., & Leckman, J. (2010).The immunobiology of Tourette’s disorder, pediatric autoimmune neuropsychiatric disorders associated with streptococcus, and related disorders: A way forward. Journal of Child and Adolescent Psychopharmacology, 20(4), 317–331. https://doi.org/10.1089/cap.2009.0118
Chang, K., Frankovich, J., Cooperstock, M., Cunningham, M. W., Latimer, M. E., Murphy, T. K., … & Williams, K. (2015).Clinical evaluation of youth with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference. Journal of Child and Adolescent Psychopharmacology, 25(1), 3–13. https://doi.org/10.1089/cap.2014.0065
Dr. Roseann Capanna-Hodge is a licensed mental health expert that is frequently cited in the media:
- Healthy Parenting Connector (Video)Why “My Kid is Acting Crazy” Might be PANS/PANDAS
- Living with Lyme (Podcast) Neurofeedback and biofeedback for PANS/PANDAS
- Maria Rickert Hong (Audio)PANS/PANDAS
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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