What to Do If You Think Your Child Has PANS or PANDAS?

If you suspect your child may have PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) or PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), you’re not alone. Families across Washington are increasingly recognizing the signs of these neuroimmune conditions—sudden, intense changes in mood, behavior, or functioning that seem to appear overnight.

Unfortunately, Washington State has very few medical providers who specialize in diagnosing and treating PANS or PANDAS, which can leave families feeling lost and unsupported. At Empower & Heal Counseling, I provide therapy and family guidance to help you navigate this complex journey while collaborating with your medical team to ensure your child receives comprehensive care.

PANS and PANDAS are clinical diagnoses, meaning there is no single blood test or definitive lab test that confirms them. Diagnosis is based on the sudden onset of neuropsychiatric symptoms, such as obsessive-compulsive behaviors, food restriction, anxiety, or severe mood swings, often following an infection or immune activation.

As a licensed mental health therapist, I am not able to diagnose medical conditions such as PANS or PANDAS. However, I can provide diagnostic evaluation and treatment for the psychiatric and behavioral symptoms commonly associated with these syndromes, including:

• Obsessive-Compulsive Disorder (OCD)

• Severe anxiety, fears, or worries

• Irritability, anger, or oppositional behaviors

• Mood swings, depression, or emotional regression

• School refusal or separation anxiety

• Sleep disturbances or night-time fears

• Disordered or restrictive eating (ARFID)

With your consent, I collaborate with medical providers familiar with PANS/PANDAS—including pediatricians, psychiatrists, and functional or integrative medicine specialists—to ensure that your child’s care is both coordinated and compassionate.

Comprehensive care for PANS and PANDAS often includes a three-part treatment approach, addressing both the immune system and the brain-behavior connection:

1. Antimicrobial treatment — Targeting infections that may have triggered the immune response.

2. Immunomodulatory treatment — Calming inflammation and rebalancing the immune system.

3. Psychotherapy and family support — Helping children and parents manage the emotional and behavioral challenges that accompany neuroinflammation.

At Empower & Heal Counseling, I provide evidence-based therapy such as CBT, Exposure and Response Prevention (ERP) for OCD, and Supportive Parenting for Anxious Childhood Emotions (SPACE). These approaches help children and parents regain a sense of stability, confidence, and connection while the medical aspects of treatment are being addressed.

(Graphic from Aspire.Care)

• Northwest PANDAS/PANS Network: If you are in Washington, please submit an intake form here so the team at NWPPN can direct you to skilled providers taking new cases who may be a good fit for your case.

• ASPIRE: Aspire has a wealth of information for working with school, preparing for your appointments, and a broad range of other resources you may find helpful.

• PANDAS Physician Network: The provider list is not as thorough as NWPPN, but you can find flowcharts and diagnostic criteria that may be useful if your child's primary care physician is willing to diagnose and treat.

• PANDAS Network: PANDAS Network is focused on supporting the needs of families as well as physicians who research and treat PANS/PANDAS.

• Neuroimmune Foundation: This is primarily focused on research and clinical case applications, but you can find many of the latest publications on their website. 

• Untangling PANDAS and PANS Podcast by the Alex Manfull Fund: https://untanglingpandaspans.buzzsprout.com/

• Demystifying PANDAS/PANS Podcast by Dr. Nancy O'Hara: https://podcasts.apple.com/gb/podcast/demystifying-pans-pandas-podcast/id1798735991

Demystifying PANS/PANDAS: A Functional Medicine Desktop Reference on Basal Ganglia Encephalitis — Nancy O’Hara, MD, MPH, FAA

Dr. O’Hara also offers a free PANS/PANDAS Field Guide for practitioners, downloadable from her site.

The Comprehensive Physicians’ Guide to the Management of PANS and PANDAS — Scott Antoine (2024)

A systematic, clinically oriented reference for pediatricians and subspecialists detailing diagnostics, lab protocols, immunotherapies, and flare management.

Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness — Neil Nathan, MD
A foundational text in environmental medicine, often cross-referenced in discussions of overlapping etiologies with PANS.

The Sensitive Patient’s Healing Guide — Neil Nathan (editor/author)
Collection of expert essays on environmental sensitivities, mold, EMFs, and recovery strategies.

A Light in the Dark for PANDAS & PANS — Jill Crista (2022)

Break the Mold: 5 Tools to Conquer Mold and Take Back Your Health — Jill Crista, ND

Children's Books

These are written in accessible, compassionate styles to help children, siblings, educators, and caregivers understand PANS/PANDAS.

• Lyla & Pickles’ Guide to PANDAS by Jacqueline Lembesis & Maya Valenciano
  A gentle narrative from the perspective of a child diagnosed with PANDAS — included in PANDAS Network’s “Helpful Books” list. PANDAS Network

• In a Pickle Over PANDAS by Melanie S. Weiss (2015)
  A picture-book style introduction that frames PANDAS onset and recovery in kid-friendly language.

• Super Sam and the Battle Against PANS/PANDAS by Dr. Lindsey Wells
  A sibling-friendly story illustrating how families can support a child during relapses (available via Dr. Wells’ author site).

• My Story About PANS/PANDAS by Owen Ross (2019)
  First-person narrative by a child who experienced PANS/PANDAS — helpful for peers or siblings to build empathy.