How to Deal with PANDAS: Practical Strategies

Evidence-based strategies to manage, reduce, or overcome PANDAS in everyday life.

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, PANS, Pediatric Acute-Onset Neuropsychiatric Syndrome, Childhood Acute Neuropsychiatric Symptoms

Managing PANDAS Day to Day

Dealing with pandas effectively requires a multi-layered approach. No single strategy works for everyone — the most effective plans combine professional support with evidence-based self-management techniques and lifestyle changes.

Immediate Coping Strategies

When pandas feels overwhelming, these techniques can help in the moment:

  • Grounding exercises: Use the 5-4-3-2-1 technique (name 5 things you see, 4 you hear, etc.)
  • Controlled breathing: Slow, diaphragmatic breathing activates the parasympathetic nervous system
  • Progressive muscle relaxation: Systematically tense and release muscle groups
  • Mindful observation: Describe your experience neutrally, without judgment
  • Reach out: Contact a trusted person — connection reduces acute distress

Building Long-Term Resilience

Evidence-Based Approaches

To treat PANDAS, the NIMH emphasizes, the underlying strep infection must be treated. In many cases, this can be accomplished with a single course of antibiotics. More serious strep infections may require a longer course of treatment or multiple courses of antibiotics. Once the strep has been treated, PANDAS symptoms will typically start to fade, the NIMH reports, though they may take a few months to disappear altogether. To prevent strep reinfection, parents should discard toothbrushes and sterilize other objects that go into a child’s mouth. Testing siblings for strep may also be a good idea

Lifestyle Foundations

Research consistently shows these lifestyle factors significantly impact pandas:

  1. Sleep: 7–9 hours of quality sleep is foundational; pandas and sleep are bidirectionally linked
  2. Exercise: 30 minutes of aerobic exercise 3–5 times weekly has proven effects comparable to medication for many conditions
  3. Nutrition: Anti-inflammatory eating, reduced alcohol and caffeine, adequate protein
  4. Social connection: Meaningful relationships are among the strongest buffers against pandas
  5. Stress management: Regular practices like meditation, nature time, and creative outlets

When to Seek Professional Help

Self-management alone is insufficient when pandas:

  • Is severe or rapidly worsening
  • Involves safety concerns
  • Has persisted more than a few weeks without improvement
  • Is significantly impairing daily functioning

A mental health professional can diagnose, provide evidence-based treatment, and monitor progress.

Building Your Support System

Recovery from pandas rarely happens in isolation. Building a support system includes:

  • A therapist or counselor as primary professional support
  • A GP or psychiatrist for medication assessment if needed
  • Trusted friends or family members
  • Peer support groups (in-person or online)
  • A crisis plan with emergency contacts

Related Resources

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