How Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) Touches the Whole Family

(From the lens of The Highland Center for Mental and Behavioral Health - a Dallas-based therapy practice that welcomes clients and patients from all over Texas)

There is no manual for what happens when a child’s personality, mood, and behaviors shift almost overnight. For parents, the experience can feel like standing on the edge of a cliff, unsure if the ground beneath will hold. Many describe a deep, gnawing worry that they are failing their child, or that the family they knew is disappearing. Siblings often notice too, even if they cannot always put it into words. They might feel confused, jealous of the attention the child with PANS receives, or frightened by the intensity of outbursts or anxiety they witness. The ripple effect of PANS is felt in every corner of the household, even in moments that look calm from the outside.

At The Highland Center for Mental and Behavioral Health, we begin by creating a space where parents and siblings can express these feelings without guilt or judgment. It is common for parents to carry a persistent sense of responsibility, wondering if something they did or did not do triggered the change. Siblings may carry their own quiet anxiety, feeling invisible or unsure how to interact with the child who seems unpredictable. Acknowledging these emotions is the first step toward regaining a sense of safety and balance within the family. We help families see that these reactions are natural responses to an extraordinary situation, not signs of weakness or failure.

Our approach centers on connection and understanding. For parents, we provide tools to respond calmly and effectively to sudden behavioral changes. We guide them in setting gentle, consistent boundaries that help children feel secure, and in learning how to advocate for their child with teachers, doctors, and caregivers. Siblings are an important part of this work as well. Through individual or family sessions, we help siblings express their worries, confusion, and even resentment, while also learning ways to reconnect with their brother or sister in ways that feel safe and positive. These sessions create a space where everyone’s voice matters, and no one’s feelings are dismissed.

Therapy with PANS is never about fixing the child or returning everything to exactly how it was. It is about guiding the family through uncertainty with compassion, stability, and practical strategies. Parents learn to respond with awareness rather than anxiety, and children learn that they are loved and understood even when their emotions feel uncontrollable. Families may enter our office feeling overwhelmed, scared, or exhausted, but we help them leave with tools, understanding, and a renewed sense of hope.

Even in the midst of sudden and intense change, connection, balance, and resilience can still be found.