How does pandas affect an indavigoual emotionaly?

Hypothisis: 

I think that having PANDAS will have an negative emotional impact on an individual due to the amount of mood swings and the impact on the development of the person. Since PANDAS more commonly occurs in younger individuals having PANDAS could potentially cause permanent damage to the young person since they are still in their early development stages. 

 

My research process included number of different tactics. I mainly used resources like google or pediatric surgeon essays on the issue. During my research I did stumble across an issue trying to find information on how PANDAS affect our brain chemistry but I reached out to my teachers and they provided me with links to find the information I needed to continue with my project. 

 

What is PANDAS?

PANDAS is short for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. PANDAS is a temporary mental dysfunction caused by one of two things: Strep Throat, or Scarlet fever. PANDAS causes many younger people to have symptoms that often show up with ADHD, tourettes, tic disorder, or obsessive compulsive disorder also known as (OCD). Someone can only be diagnosed with PANDAS if these symptoms follow a recent infection like strep throat. 

 

What are the symptoms?

• Anxiety or depression.
• Bedwetting.
• Changes in mood or personality, especially sudden rage or irritability.
• Difficulty sleeping.
• Disinterest in food.
• Fidgeting and symptoms similar to attention-deficit/hyperactivity disorder (ADHD).

 

How does PANDAS affect an indavigouals brain chemistry?

Brain chemistry is a complex network in the brain that controls chemical processes in the brain. These processes are essential for everything the brain does from producing our thoughts, emotions, and even controlling our bodily fluids. The basal ganglia is apart of your brain chemistry. This part of our brain as well controls our motor functions, learning, emotions, judgment, etc. When our immune system starts to attack this part of our brain it is also attacking a very important part of our brain chemistry therefore having an impact on some of the things these parts of our brain control.

 

How is it caused?

Experts believe that PANDAS is caused by a problem with the immune systems response to the infection. Instead of attacking the infection the immune system attacks a part of the brain called the basal ganglia. By attacking this area of the brain it can cause some of the symptoms that can come with PANDAS.

 

How can it be prevented?

In some cases, when throat infections are treated early with antibiotics it eliminates the bacteria therefore reducing the risk of getting PANDAS. When streptococcal infections are treated early with antibiotics it reduces the risk/prevents PANDAS from appearing in young individuals.

 

How can iy be treated?

The best treatment for PANDAS is to treat the throat infection with antibiotics if the infections is still present.  As Dr. Sarah owens says “psychologists can provide therapy to the child’s parents and/or family in the meantime to (a) further develop their knowledge and understanding about the condition, (b) support them in processing their own thoughts and feelings in the context of having a family member with PANDAS, (c) reducing parent and family accommodation of OCD symptoms (as accommodation tends to make the symptoms worse over time), and (d) developing strategies to reduce functional impairment for the child and family, even when the child is in a flare.”If the infection is not present there are alternatives like: 

• Immunomodulatory therapies such as IVIG or plasmapheresis to reduce the autoimmune response.
• Cognitive Behavioral Therapy (CBT) and medications like SSRIs to manage neuropsychiatric symptoms.

 

What happens if it is left untreated?

If PANDAS is left untreated it would cause permanent damage and all of the following symptoms would become permanent. Since PANDAS more regularly occurs in younger individuals it would drastically affect their growth because there brain would be permanently damaged. 

 

 

What's your opinion on the increasing amount of pandas diagnosis? Why do you think
this is increasing?
I think that more healthcare providers are now familiar with PANDAS due to advocacy,
research, and education campaigns, which leads to better identification and diagnosis of cases
that might previously have been misdiagnosed as primary psychiatric disorders like OCD or
Tourette’s syndrome. I think that the COVID-19 pandemic also significantly increased
awareness of post-infectious syndromes (due to recognition of cases of long-COVID), which has
probably helped with identification and diagnosis of PANDAS as well.
What are the challenges with diagnosing pandas, and how can it be differentiated from
other psychiatric conditions?
Diagnosing PANDAS is challenging because it shares symptoms with many other psychiatric
and neurodevelopmental conditions including Attention Deficit Hyperactivity Disorder (ADHD),
Obsessive Compulsive Disorder (OCD), Oppositional Defiant Disorder (ODD), and Autism
Spectrum Disorder (ASD), amongst others. Thus, in order to make the diagnosis, clinicians
must rely on a detailed medical and mental health history and be on the lookout for a sudden
onset of symptoms temporally linked to a streptococcal (“strep”) or other infection (in which
case the diagnosis is PANS – pediatric acute onset neuropsychiatric syndrome). Furthermore, if
the symptoms tend to come and go and tend to worsen with any illness, infection, allergies, or
other immune triggers, or if they respond to treatment with antibiotics or anti-inflammatories
(e.g., Ibuprofen), then this can help to distinguish PANDAS from other psychiatric conditions.
What role does therapy play in treating children with pandas, in addition to medical
treatments like antibiotics or immunotherapy?
Oftentimes children need to start with the medical aspects of PANDAS treatment first to address
the underlying infection and/or inflammation, before starting individual psychological therapy.
However, psychologists can provide therapy to the child’s parents and/or family in the meantime
to (a) further develop their knowledge and understanding about the condition, (b) support them
in processing their own thoughts and feelings in the context of having a family member with
PANDAS, (c) reducing parent and family accommodation of OCD symptoms (as
accommodation tends to make the symptoms worse over time), and (d) developing strategies to
reduce functional impairment for the child and family, even when the child is in a flare.
Once the infection/inflammation has been at least somewhat addressed, individual therapies for
the child with PANDAS often include cognitive behavioural therapy (CBT) and exposure and
response prevention (ERP).
- CBT addresses the emotional and cognitive disruptions caused by PANDAS. Children
often experience intense anxiety, mood swings, and difficulty regulating their emotions
during flares. CBT teaches tools to identify and reframe negative thought patterns and
helps children develop coping mechanisms for emotional regulation and stress
management.

- ERP is one of the most effective therapies for helping children manage obsessive-
compulsive symptoms. ERP encourages children to face anxiety-provoking thoughts or

situations without engaging in compulsions, gradually reducing the intensity of their
symptoms. This is particularly important for children with PANDAS, as their OCD-like
symptoms emerge abruptly and can significantly impact their daily functioning.
In your practice what are the long term physiological effects of children who experience
pandas?
This depends on how early the child is diagnosed and treated. With proper identification and
treatment, and with careful monitoring of inflammatory/immune triggers and strategies to
prevent symptom flare-ups (“flares”), most children recover fully with no long-term physiological
effects. However, children may experience lingering symptoms if the infection/inflammation has
been untreated for too long. In these cases, the child may continue to suffer from physical
symptoms including tics, chronic pain (e.g., headaches, abdominal discomfort), fatigue, sleep
issues, and food aversion even after the initial inflammatory/immune trigger has resolved.

In conclusion Pandas has a negative emotional impact on the individual proving my hypothesis to be right. Based on my research between the possibility of permanent symptoms, extreme mood swings, and decline in school performances, pandas could affect a younger individual drastically (in a negative way).

 

• https://www.nimh.nih.gov/health/publications/pandas#:~:text=Many%20children%20with%20OCD%20or,their%20symptoms%20suddenly%20worsen%20again.
• https://kidshealth.org/en/parents/pandas.html#:~:text=Experts%20believe%20PANDAS%20and%20PANS,%2C%20movement%2C%20and%20other%20behaviors.
• https://pandasnetwork.org/what-is-pandas/#:~:text=Abnormal%20autoantibody%2Dmediated%20signaling%20in,in%20emotional%20or%20behavioral%20instability.
• https://my.clevelandclinic.org/health/body/23010-substantia-nigra-sn
• https://www.nimh.nih.gov/health/publications/pandas#:~:text=Treatment%20with%20Antibiotics,strep%20bacteria%20in%20the%20throat.
• https://pandasnetwork.org/understanding-pandas/#:~:text=Untreated%2C%20PANDAS%2FPANS%20can%20cause,while%20the%20child%20is%20healing.
•  

Dr. Sarah Owens

Rachel Phillips

Meara Dougherty

Cassie Gougau