Children Don't Just Misbehave: Recognizing the Signs of PANS and PANDAS
- Seda Melikyan
- Jun 16
- 4 min read
As a pediatric nurse, Craniosacral Therapist, IASIS Neurofeedback provider, and mother, I have learned an important lesson:
Children don't just misbehave.
When a child suddenly becomes anxious, aggressive, withdrawn, oppositional, or emotionally dysregulated, there is often a reason. Behavior is communication, and sometimes that communication is telling us that something deeper is happening beneath the surface.
One condition that many parents and even some healthcare providers may not be familiar with is PANS and PANDAS.
Learning about these conditions changed the way I view certain behavioral and neurological symptoms in children, and I believe every parent should know what to look for.
What Are PANS and PANDAS?
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.
PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome.
According to Dr. Nancy O'Hara, author of Demystifying PANS/PANDAS, these conditions involve an abnormal immune response to a pathogen that affects the brain and nervous system. When this occurs, children can develop sudden and dramatic changes in behavior, emotions, and cognitive function.
Many parents describe the experience by saying:
"My child changed overnight."
This sudden onset is one of the characteristics that makes PANS and PANDAS different from many other childhood conditions.
Common Signs and Symptoms
While every child is unique, some common symptoms include:
Sudden onset OCD symptoms
Severe anxiety
Separation anxiety
Rage episodes
Aggression
Emotional outbursts
Tics
Sleep disturbances
Sensory sensitivities
Regression in behavior or learning
Restricted eating
Brain fog
Difficulty concentrating
Frequent urination
Sudden decline in handwriting or school performance
Many parents report that their child no longer seems like themselves.
If you find yourself saying, "This isn't my child," trust that observation and continue seeking answers.
Why These Children Are Often Misunderstood
Unfortunately, children experiencing PANS or PANDAS symptoms are often labeled as:
Defiant
Oppositional
Attention-seeking
Manipulative
Behavioral problems
While behavioral support may still be necessary, it is important to recognize that these symptoms may have a biological basis.
When inflammation affects the brain and nervous system, behavior can change dramatically.
This does not mean every child with behavioral challenges has PANS or PANDAS. However, sudden and significant changes deserve further investigation.
Potential Triggers
PANDAS is specifically associated with streptococcal infections.
PANS, however, may be triggered by a variety of factors, including:
Strep infections
Lyme disease
Mycoplasma infections
Viral illnesses
Mold exposure
Environmental toxins
Other immune or inflammatory challenges
Because triggers vary from child to child, comprehensive evaluation is often necessary.
The Importance of Looking Beyond Symptoms
In my practice, many families seek support through Craniosacral Therapy and IASIS Neurofeedback because their children are struggling with anxiety, emotional dysregulation, behavioral challenges, sensory issues, or sleep disturbances.
These therapies can be powerful tools for supporting nervous system regulation.
Many children experience improvements in their ability to self-regulate, cope with stress, and function more comfortably in daily life.
However, when symptoms are being driven by an underlying infection, immune dysfunction, or inflammatory process, as may occur with PANS and PANDAS, nervous system therapies alone do not address the root pathogenic cause.
This is why I believe a multidisciplinary approach is so important.
Children may benefit from a team that includes medical providers, naturopathic doctors, homeopaths, therapists, nutrition professionals, nervous system support practitioners, educators, and other specialists depending on their individual needs.
Healing is rarely about finding one magic solution. It is often about understanding the whole child and addressing the factors contributing to their symptoms.
Where Can Parents Find Help?
If you suspect your child may have PANS or PANDAS, begin by documenting:
When symptoms began
Recent illnesses or infections
Behavioral changes
Sleep changes
School difficulties
OCD symptoms or tics
This information can be extremely valuable when speaking with healthcare providers.
Not all practitioners are familiar with PANS and PANDAS, so it may be helpful to seek professionals who have experience evaluating and treating these conditions.
Organizations such as the PANDAS Network and the PANS Research Consortium offer educational resources, provider directories, and support for families.
A Personal Note
I am not affiliated with Dr. Nancy O'Hara in any way. I reference her work because her book, Demystifying PANS/PANDAS, is one of the resources that helped me better understand these conditions and the challenges many families face.
Wellness Resources
If you are looking for wellness resources that I personally use and recommend, please visit the Wellness Resources page on my website.
There you will find:
A 15% discount on Fullscript supplements
Discounts and information on many other products that I use
These resources are intended to support overall wellness and should be discussed with your healthcare team as part of an individualized approach.
If your child has experienced sudden behavioral or emotional changes and you feel like no one understands what your family is going through, please know that you are not alone.
There is hope. There are answers and there are professionals dedicated to helping children and families navigate this journey.
The most important thing I want parents to remember is this:
Children don't just misbehave.
Their behavior is often telling us a story.
Our role is to listen, investigate, and support them with compassion while seeking to understand the underlying cause.
Disclaimer: This article is for educational purposes only and is not intended to diagnose, treat, or replace medical advice. Please consult a qualified healthcare professional regarding your child's specific needs.
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