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Lions, And Tigers, And Bears, Oh My! The Scary Truth About PANDAS

By Rifka Schonfeld

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December 29, 2014, 7 PM ET

In the past, I have written about the different anxieties that children and adults experience. This week I would like to highlight one that is often associated with Obsessive Compulsive Disorder (OCD) and most people do not talk about.

The New York Timesdefines obsessive-compulsive disorder as “an anxiety disorder in which people have thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions).” Some examples of OCD are excessive hand-washing to ward off infection or repeatedly checking the locks on the door to ensure that they are secured. Children with OCD often recognize that their behavior is excessive, but cannot stop themselves from their compulsive actions. OCD can sometimes be accompanied by tics and other abrupt physical behaviors.

Over the past few decades, more research on Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) has given us a better understanding of certain manifestations of OCD. Children with PANDAS act the way many children with OCD do, but these symptoms abruptly occur. Parents describe them as developing “overnight” and are generally preceded by a strep throat infection.

Researchers believe that the antibodies used to fight the strep infection begin to attack other parts of the body once the infection is gone, causing OCD and tic formation.

The test for PANDAS is actually a medical diagnosis and not every child who has OCD or tics has PANDAS. That said, there are two courses of recommended treatment: a long-run of antibiotics to reduce the antibodies and cognitive behavioral therapy to minimize the symptoms of OCD.

Below are some other anxiety disorders that children may experience throughout their time in elementary or high school:

 

Social Anxiety

In 2001, in The New York Times, Margaret Talbot reported that around 13% of the population is affected by social anxiety. While social anxiety was originally considered a rare condition, in the late ‘90s, psychologists, teachers, and parents began to identify it as a much more common issue.

 

People who believe they might have social anxiety exhibit some the following symptoms:

Frequently blushing in front of people Sweating in front of people Trembling or shaking in front of others Heart palpitations around people Fear of embarrassment causing one to avoid speaking with people Aversion to speaking to anyone in authority Going to great lengths to avoid criticism Excessive fear of strangers Depression – quiet resignation and isolation

 

Separation Anxiety

Children with separation anxiety worry about separating from their parents during school, work, and a quick errand, bedtime, or even when they are in the next room. Kids with separation anxiety report a vague feeling that something bad will happen and they need to be near their parent to prevent it. In order to diagnose separation anxiety, these symptoms must not be isolated and must occur for more than four weeks consecutively.

 

It’s common for these children to:

Have difficulty attending school Make frequent calls home Show unwillingness to play at friends’ houses

 

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder involves anxiety and stress about traumatic events in one’s past. This disorder frequently occurs after violent personal assaults – mugging, domestic violence, terrorism – natural disasters or accidents. Children who experienced an extremely disturbing event might subsequently develop generalized anxiety. PTSD is often triggered by sounds, smells, or sights that remind the sufferer of the trauma.

 

Symptoms of PTSD include:

Anger and irritability Guilt, shame, or self-blame Substance abuse Depression and hopelessness Feeling alienated and alone Feelings of mistrust and betrayal Headaches, stomach problems, chest pain

Parents: Be Part of the Solution

Marianna Csoti, in her book, School Phobia, Panic Attacks, and Anxiety in Children,outlines different ways that parents can help their children overcome anxiety:

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