Understanding PANDAS/PANS and Sudden-Onset OCD in Children

If your child has experienced a sudden and dramatic onset of OCD symptoms, anxiety, or behavioral changes, it can feel confusing and alarming.

In some cases, these symptoms may be related to PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) or PANS (Pediatric Acute-onset Neuropsychiatric Syndrome).

At Dear Therapy, we help families navigate the emotional and behavioral challenges that come with PANDAS/PANS, while providing evidence-based therapy for OCD and anxiety.

We offer support in Atlanta and virtually, working collaboratively with families and medical providers when needed.

What Are PANDAS and PANS?

PANDAS and PANS are conditions in which a child experiences a rapid onset of symptoms, often including:

• Sudden OCD behaviors

• Severe anxiety or separation anxiety

• Tics or unusual movements

• Emotional outbursts or irritability

• Changes in sleep, eating, or behavior

The key difference:

• PANDAS is associated with a strep infection

• PANS may be triggered by other infections or environmental factors

What makes these conditions unique is:
The speed and intensity of symptom onset

How PANDAS/PANS Relates to OCD

Children with PANDAS/PANS often develop OCD symptoms very quickly, such as:

• Repetitive behaviors or rituals

• Intense fears (contamination, harm, safety)

• Need for reassurance

• Avoidance of certain people, places, or situations

Unlike typical OCD, parents often report:

“It felt like it came out of nowhere”

Why Symptoms Feel So Severe

Because symptoms appear rapidly, children may:

• Feel overwhelmed and confused

• Struggle to understand what’s happening

• Experience heightened distress and emotional reactivity

Families often feel:
Urgent, unsure, and searching for answers

The Role of Therapy in PANDAS/PANS

While medical evaluation is important, therapy plays a critical role in helping children:

• Manage OCD symptoms

• Reduce anxiety and distress

• Re-engage in daily activities

• Build coping skills

At Dear Therapy, we focus on supporting the child’s emotional experience, regardless of the underlying cause.

How We Treat OCD in PANDAS/PANS

We use Exposure and Response Prevention (ERP), the most effective treatment for OCD.

ERP helps children:

• Gradually face feared thoughts or situations

• Reduce compulsive behaviors

• Build tolerance for anxiety

• Regain confidence and functioning

Treatment is always:
Adapted to the child’s pace, age, and current level of distress

What Therapy Looks Like

Our approach is structured, compassionate, and collaborative.

We focus on:

• Creating a safe, supportive environment

• Building small, achievable steps

• Helping children feel successful early on

• Supporting parents in how to respond at home

• Coordinating with schools when needed

We understand that:
These cases can feel intense—and we move at a pace that feels manageable

Supporting Parents Through the Process

Parents are a key part of treatment.

We help guide:

• How to respond to compulsions and reassurance-seeking

• How to reduce accommodation behaviors

• How to support exposure work at home

• How to manage stress as a caregiver

You don’t have to navigate this alone.

Who This Is For

We work with families who notice:

• Sudden onset of OCD or anxiety symptoms

• Rapid behavioral or emotional changes

• Increased distress, rigidity, or avoidance

• Difficulty returning to normal routines

Whether your child has a formal PANDAS/PANS diagnosis or not, we focus on:
Helping them regain stability and confidence

Start Support for PANDAS/PANS and OCD

Sudden changes in your child’s behavior can feel overwhelming—but effective support is available.

With the right approach, children can:
Reduce anxiety, regain functioning, and feel like themselves again