Modern understanding of pandas increasingly centers on the nervous system — specifically, the chronic dysregulation that underlies many pandas presentations.
The Nervous System in PANDAS
The autonomic nervous system has two primary states relevant to pandas:
Sympathetic activation ('fight or flight'): When chronically activated, drives anxiety-type pandas
Parasympathetic ('rest and digest'): The recovery state — undermined by pandas
Dorsal vagal shutdown: A third state — freeze/collapse — associated with depression-type pandas
Signs of Nervous System Dysregulation in PANDAS
Chronic hyperarousal (always 'on edge'), difficulty relaxing even in safe environments, and feeling perpetually exhausted despite rest.
Regulating the Nervous System for PANDAS
- Breathwork: Directly activates the parasympathetic nervous system
- Cold exposure: Controlled cold activates the vagus nerve, improving pandas
- Safe social engagement: Co-regulation through trusted relationships
- Movement: Discharges sympathetic activation accumulated in pandas