Could Strep Throat Be Causing Your Child’s OCD?
Have you noticed sudden changes in your child’s behavior after a bout with strep throat? It could be more than just a coincidence. For some children, a strep infection can trigger a condition called PANDAS, where the immune system attacks the brain, leading to rapid onset of OCD symptoms. Many parents don’t realize how common this is until they’ve gone through a journey of misdiagnosis and confusion.
The Link Between Strep Throat and OCD
Strep throat can sometimes trigger sudden and severe OCD symptoms in children. This happens because of an unusual immune system response. When the body creates antibodies to fight the strep bacteria, those antibodies may mistakenly target parts of the brain involved in controlling emotions, behaviors, and movements. This process, called molecular mimicry, occurs because the strep bacteria can develop and hide behind molecules that look similar to brain tissue, confusing the immune system.
As a result, children may suddenly develop tics or experience intense OCD symptoms, such as distressing compulsions or overwhelming anxieties, seemingly out of nowhere. What starts as a common infection can lead to significant challenges for both the child and their family.
This reaction is associated with a condition known as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). It’s also linked to other conditions triggered by strep, like Tourette syndrome and rheumatic fever. Recognizing this connection is vital for healthcare providers to offer the right diagnosis and effective treatments to help children and families navigate these difficult experiences.
What is PANDAS Syndrome?
First identified in the 1990s, PANDAS typically affects kids between the ages of 3 and puberty. What makes PANDAS so unsettling is how quickly it can show up. Within just days or weeks after a strep infection, children may experience sudden and drastic changes in behavior—like extreme mood swings, increased anxiety, tics, heightened irritability and sudden emotional ups and downs.
As a parent, these changes can be alarming and confusing. The good news is that if you catch the signs early, you can get the right help to support your child. Understanding PANDAS and recognizing the symptoms can make a big difference in how quickly you get the support your child needs to start feeling better. Let’s explore how you can identify these red flags and take action.
How is the PANDAS and OCD link diagnosed?
Diagnosing PANDAS can be tricky, but it starts with carefully looking at your child’s symptoms and their connection to a recent strep infection.
We look for a clear link between the timing of your child’s symptoms and their recent strep infection. This is often confirmed through throat culture tests or blood tests that show elevated antibody levels.
This connection is key in distinguishing PANDAS from other conditions, ensuring your child gets the right treatment tailored to their needs. If you’re noticing unusual changes in your child after a strep infection, it’s important to talk to a healthcare provider to get a clearer picture and the right support.
How common is OCD from PANDAS?
OCD caused by PANDAS is relatively rare, affecting fewer than 10% of children with OCD. That said, it's often hard to know just how common it is because diagnosing PANDAS can be tricky, and many healthcare providers are still learning about it.
PANDAS was first identified in the 1990s and is considered a distinct but uncommon condition. Some research suggests that about 1 in 2,000 children may develop PANDAS, but it's possible that the real number is higher, as many cases go undiagnosed. While OCD itself is seen in around 1% to 2% of children, most of these cases are not connected to PANDAS.
What makes PANDAS-related OCD different is how suddenly it appears, often right after a child has had a strep infection like strep throat. This is what sets it apart from other forms of OCD. Unfortunately, many children with PANDAS symptoms may be misdiagnosed with general OCD, anxiety, or even Tourette syndrome. Other infections, such as those caused by viruses or mycoplasma, can also cause similar symptoms, but they don’t fit the specific criteria for PANDAS, which is linked only to strep bacteria.
If you suspect your child might be showing signs of PANDAS, recognizing it early is so important. Getting the right diagnosis can help you understand your child’s experience better and ensure they receive the support and treatment they need. You're not alone in this, and with the right help, there is hope for your child to feel better again.
Treatment Options for Strep Throat-Triggered OCD and PANDAS
Addressing active strep infections in children with PANDAS typically begins by administering antibiotics, which is vital for controlling acute episodes and averting complications. It’s important to note that these antibiotics are often utilized specifically for current infections but may also be needed for elevated strep titers.
To effectively manage OCD symptoms associated with PANDAS alongside antibiotic treatment or other ways to treat PANDAS, cognitive-behavioral therapy (CBT), incorporating exposure and response prevention (ERP) techniques is used. This strategy assists children in facing their fears and diminishing compulsive behaviors by equipping them with strategies to navigate their symptoms.
Medications such as selective serotonin reuptake inhibitors (SSRIs) should be used with caution by your child's doctor. It’s noteworthy that children affected by PANDAS might exhibit heightened sensitivity to the side effects of SSRIs. Thus careful dosage adjustments and vigilant monitoring are imperative when we treat PANDAS.
Treatment for PANDAS is personalized based on the severity of your child’s symptoms. In mild cases, antibiotics combined with behavioral therapy may be enough to help manage the symptoms. However, more severe cases might require a combination of treatments to address both PANDAS and any related neuropsychiatric symptoms.
Advanced Treatments: Plasma Exchange and IVIG
Children suffering from severe PANDAS may experience substantial improvement through sophisticated therapies such as plasma exchange and intravenous immunoglobulin (IVIG). The objective of these treatments is to diminish the autoimmune reaction that exacerbates neuropsychiatric symptoms.
Nevertheless, it’s critical to consider the advantages alongside any potential adverse effects. Despite the high efficacy rate of plasma exchange and IVIG in alleviating symptoms, they carry associated risks. Consequently, parents are advised to engage in comprehensive discussions with their healthcare providers regarding these treatment options.
- Plasma Exchange or Plasmapheresis
In children who are severely affected by PANDAS, a process called plasmapheresis, or plasma exchange, which entails the removal and substitution of blood plasma to purge harmful antibodies, can be highly effective. This therapy aims to diminish the autoimmune reaction associated with PANDAS and thus relieve its symptoms.
- IVIG
Intravenous immunoglobulin (IVIG) therapy involves infusing high doses of immunoglobulin to modulate the immune system and reduce the autoimmune attack on the brain. Studies have shown that IVIG can significantly reduce neuropsychiatric symptoms in PANDAS patients, with some experiencing up to 45% reduction in symptoms. In some cases, a single IVIG treatment can lead to long-term symptom relief, making it a promising option for those severely affected.
Although IVIG shows impressive short-term benefits, the long-term outcomes are still under study. Initial results are promising, with many children experiencing lasting improvements. However, it’s important for parents to have realistic expectations and to follow up with their healthcare provider regularly.
Managing OCD Symptoms
Managing OCD symptoms in children who have PANDAS requires a comprehensive strategy. Cognitive-behavioral therapy (CBT) with Exposure and Response Prevention (ERP) is pivotal for assisting these children in controlling their obsessive-compulsive behaviors and lowering stress levels. These therapeutic approaches aim to soothe the brain, thus providing kids with an improved capacity to regulate their feelings and actions.
It’s equally important to tackle issues like sleep disruptions and emotional fluctuations. Establishing a steady schedule along with maintaining a tranquil atmosphere contributes significantly to creating stability for youngsters suffering from PANDAS, which can aid in better symptom management.
Preventing Future Flare Episodes
It is essential to adopt preventive strategies to ward off subsequent occurrences of PANDAS. Vigilantly watching for initial indicators of strep infections and providing prompt treatment can halt potential exacerbations. It may also be beneficial for families to test every member for strep, which helps pinpoint any carriers and diminishes the chance of recurring infections.
Maintaining excellent hygiene practices such as sanitizing or changing out toothbrushes following antibiotic therapy plays an additional role in averting Strep infections. By implementing these precautions, one can decrease the chances of experiencing new episodes of PANDAS.
Working to calm the nervous system with tools such as neurofeedback, PEMF, essential oils, magnesium and other supplements are important.
When to Seek Help
If a child shows immediate or intense symptoms of OCD or tics following a strep infection (or any infection), it is crucial for parents to obtain medical assistance. If the child also experiences behavioral shifts like heightened irritability, episodes of anxiety, or fluctuations in mood, this may be a sign of PANS or PANDAS.
It is important to recognize that a sudden onset of a mental health problem isn't normal.
Should these symptoms continue over an extended period—typically exceeding one week—or if they severely disrupt everyday activities, reaching out to a healthcare provider or your child’s physician is advisable. Prompt attention can greatly influence the control and treatment of PANDAS and enhance the well-being of the affected child.
Dr. Roseann's BrainBehaviorReset® Program
I have created the BrainBehaviorReset® initiative, a program meticulously tailored to aid children struggling with mental health challenges, notably PANS and PANDAS with or without OCD. This approach incorporates therapies such as Neurofeedback and Biofeedback to calm the nervous system and tackle root causes.
In collaboration with parents, I guide them in grasping and addressing their child’s unique requirements.My pioneering strategies provide encouragement and for many efficacious outcomes for families grappling with PANDAS and PANS.
Your Next Steps If You Suspect Strep Throat OCD (PANDAS)
Grasping the link between strep throat and OCD is crucial for families navigating PANDAS, as it can transform a child’s well-being. Acknowledging the symptoms of strep, promptly pursuing diagnosis, and considering different treatment possibilities are key steps in enhancing your child’s life.
It’s important to remember that there is support and successful treatments out there—you’re not isolated on this path and our Dysregulation Solution and CALM Brain Community is there to support you every step of the way.
You can also listen to my podcast to learn more about natural solutions for dysregulated kids.
Key Takeaways
- Strep throat can trigger OCD in children through an autoimmune response when antibodies mistakenly attack the brain, leading to conditions like PANDAS.
- PANDAS is characterized by a sudden onset of obsessive-compulsive symptoms and tics following a strep infection, requiring careful evaluation for diagnosis and treatment.
- Effective treatment for PANDAS often includes antibiotics, cognitive-behavioral therapy, and, in severe cases, advanced options like plasma exchange or IVIG.
What are the first signs of PANDAS in a child?
The first signs of PANDAS usually show up as sudden OCD symptoms or tics, along with heightened irritability and anxiety, often following a strep infection.
If you notice these changes in your child, it’s important to seek help.
How is PANDAS diagnosed?
PANDAS is diagnosed by connecting the sudden onset of OCD or tic symptoms to a recent strep infection, confirmed through throat cultures or high antibody levels.
It’s all about making that crucial link between symptoms and infection!
What are the treatment options for PANDAS?
In addressing PANDAS, a range of treatment strategies are available, including the administration of antibiotics to tackle strep infections. Additional therapies consist of cognitive-behavioral therapy and SSRIs. In more extreme situations, patients might undergo advanced procedures such as plasma exchange or IVIG.
Consulting with a medical professional is crucial in order to determine an optimal course of action for either yourself or your child regarding these treatments.
How can I prevent future PANDAS episodes?
In order to avoid subsequent episodes of PANDAS, it is crucial to be vigilant for initial signs of a strep infection. It’s also important to test family members who may be carriers and ensure proper hygiene practices such as sterilizing or replacing toothbrushes once antibiotic treatment has been completed.
Being proactive is essential in managing this condition!
When should I seek medical help for my child?
You should seek medical help for your child if they show sudden or severe OCD or tic symptoms after a strep infection, or if behavioral changes are significantly affecting their daily life. It’s always better to be cautious when it comes to your child’s well-being.
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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