PANDAS/PANS Parenting Stress: How to Pause and Respond When Symptoms Flare
Introduction
Parenting a child with PANDAS/PANS brings a level of stress few people fully understand. Sudden changes in your child’s behavior or emotional state, the unpredictability of symptoms, and the ongoing search for the right medical and therapeutic support can keep your nervous system on high alert.
When your child is crying, yelling, panicking, or withdrawing due to brain inflammation, it can quickly trigger your own stress response—your heart races, thoughts speed up, and your muscles tighten. This blog is here to help you learn to slow down and pause before reacting. Even a brief pause gives your body and mind a moment to settle so you can respond with intention rather than automatically reacting to the intensity in front of you.
A pause might be as simple as taking a slow breath, grounding your feet, softening your voice, or silently reminding yourself: My child is struggling with PANDAS/PANS symptoms, and my body is reacting too. The goal isn’t instant calm—it’s to give yourself a moment to settle and respond with greater choice, steadiness, and connection.
Imagine a common PANDAS/PANS parent moment: your child is spiraling, and the intensity fills the room. Almost immediately, your body reacts. You feel pressure to stop the behavior or prevent things from getting worse. Practicing the pause doesn’t mean ignoring your child; it means noticing your own response and intentionally slowing down—maybe with a breath, a steady posture, or a grounding thought. Even a small pause can help you respond with more clarity and compassion.
Many parents are told to “stay calm” or “respond rather than react.” While well-intentioned, this advice can feel impossible under chronic stress. Reacting quickly or feeling flooded is natural; your body is responding to a very real sense of threat and responsibility.
This blog offers some ways to “practice the pause” as a parent of a child with PANDAS/PANS—with self-compassion and practical support for easing nervous system stress when symptoms flare.
Recognizing Your Natural Responses to PANDAS/PANS Challenges
“When you notice that your nervous system is responding to your child’s PANDAS/PANS-related stress, it’s a natural response—and with gentle practice, you can begin to shift toward steadiness and connection.” — Julie Cox, LCSW
Your nervous system stress can take many forms. You might notice:
Feeling on edge or bracing for the next flare
Reacting quickly or sharply and then feeling guilty
Difficulty sleeping or relaxing
Urges to fix, explain, reassure, or control situations
Emotional exhaustion or shutdowns
Comparing yourself to other parents and feeling behind
These reactions are protective responses, reflecting your nervous system doing its best to keep your child and family safe. Over time, though, they can feel draining—and noticing them is the first step toward creating small moments of steadiness and connection.
Practical Ways to Feel More Regulated—and More Capable of Practicing the Pause
Nervous systems communicate constantly. Your child’s alarm can activate yours—and slowing yourself, even slightly, can signal safety back. Working with a trained PANDAS/PANS therapist can help you develop these skills.
Regulation builds gradually, through small, repeatable experiences of safety. Try these simple strategies:
Start With Micro‑Pauses
Even one slow breath, a brief grounding phrase that you repeat to yourself ("I’m OK," "I am safe."), or placing your feet firmly on the floor can interrupt automatic reactions.
Focus on Your Nervous System First
Step into another room, splash cool water on your face, or name three things you can see in your surroundings. Your regulation will help your PANDAS/PANS child’s regulation.
Reduce Urgency Where You Can
Ask yourself: Is this truly urgent right now? Slowing down slightly reduces your sense of threat.
Practice Self‑Compassion Over Comparison
Acknowledge: This is hard. I’m doing the best I can with a very complex situation. Comparison fuels urgency and self-blame.
Build Regulation Outside of Crisis Moments
Gentle movement and stretching, predictable routines, supportive connection, and moments of rest strengthen your capacity for future stress.
What Can Change When the Pause Is Possible
Even when your PANDAS/PANS child escalates, you notice your own body tightening and you take a breath. Your voice is steadier. You respond more slowly, with fewer words. Your child may not calm immediately—but your nervous system is no longer escalating alongside theirs. Over time, this steadier presence reduces spirals and helps your child feel less alone.
Practicing the pause changes the tone of the moment. It reduces nervous system collision and increases coregulation, even when symptoms are loud. Over time, these moments build a deeper sense of safety, not instant calm. This capacity develops gradually, outside of crisis moments.
Consider Therapy as a Place to Strengthen Safety and Regulation
Therapy provides a supportive space to understand stress responses, process trauma history if you need to, and build tools for emotional regulation. Approaches focusing on the nervous system can help you feel safer in your body, making it easier to access the pause—even during challenges. Learn more about therapy for PANDAS/PANS.
Therapy supports your capacity to stay present, connected, and grounded while navigating a demanding parenting journey.
You Don’t Have to Do This Alone
Practicing the pause is ongoing, shaped by stress, support, and safety. Feeling overwhelmed or reactive doesn’t mean you’re doing something wrong—it means your nervous system has been carrying a lot for a long time.
Support can make a meaningful difference.
If you are looking for help with emotional regulation, nervous system stress, or trauma-informed therapy, I invite you to reach out. Together, we can work toward more safety, steadiness, and compassion—for you and your family.
Schedule a free 15-minute consultation to explore how therapy can support you in practicing the pause and caring for yourself while caring for your child.
Julie Cox, LCSW is a fully licensed therapist with 25 years of experience supporting children, teens, parents, and adults in New York and Delaware.
She specializes in working
with families navigating PANDAS/PANS, offering child and parent-centered support based on co-regulation, nervous system education, and evidence-based approaches that help reduce anxiety, OCD symptoms, and demand-avoidance behaviors. She helps parents feel more empowered and supported while caring for children experiencing neuroinflammatory symptoms.