PANS & PANDAS — Understanding Sudden-Onset OCD in Children

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) are conditions in which children experience a dramatic, sudden change in behavior—often literally overnight. For many families, the shift is so abrupt that they describe it as “waking up to a different child.”

These conditions occur when inflammation or an autoimmune response affects the brain, particularly areas involved in emotion regulation, impulse control, and obsessive–compulsive functioning. Instead of gradually worsening symptoms, children may suddenly develop severe OCD, intense anxiety, tics, school refusal, separation anxiety, eating restrictions, handwriting changes, sensory sensitivities, rage episodes, or dramatic mood swings. This rapid onset is confusing and frightening for both the child and their family.

Many parents describe feeling dismissed or misunderstood as they search for answers. PANS/PANDAS symptoms are often misdiagnosed as behavioral problems, typical anxiety, depression, or oppositionali

ty — when in reality, the child is experiencing a neurological and immunological disruption.

At TrueNorth, we understand both the emotional toll on families and the clinical complexity of these cases. While medical providers address the underlying inflammation or infection, our role is to support the child’s functioning and help them rebuild confidence and stability through evidence-based OCD treatment, primarily Exposure and Response Prevention (ERP). We work to separate what belongs to OCD from what belongs to the medical picture, helping children regain a sense of control and helping parents learn how to respond in ways that reduce accommodation and strengthen recovery.

Our therapists also collaborate with pediatricians, rheumatologists, immunologists, and school teams to ensure each child receives truly comprehensive care. With the right treatment and coordinated support, many children make significant improvements and return to school, friendships, and daily life.

PANS/PANDAS is real, overwhelming—and treatable. Families don’t have to navigate it alone. At TrueNorth, we provide compassionate, specialized care to help children and their families find stability, understanding, and hope again.