Can PANS/PANDAS Cause Sudden Low Self-Esteem? What Parents Need to Know
If your child has been diagnosed with PANS or PANDAS, you may have noticed sudden changes in their self-esteem. A once confident, happy child may now express feelings of worthlessness, guilt, or self-doubt. They might suddenly feel like they’re “bad” or “broken,” struggle to engage with friends, or withdraw from activities they once loved.
As a parent, this shift can be alarming. You may wonder, “Is this just part of the condition? Will it pass? How can I help?” The good news is that there are ways to support your child through these emotional struggles. Let’s explore why this happens and what you can do about it.
Why Does PANS/PANDAS Affect Self-Esteem?
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections) are conditions that cause sudden and severe behavioral, emotional, and cognitive changes due to inflammation in the brain. While most parents recognize symptoms like obsessive-compulsive behaviors, anxiety, and tics, the emotional toll—particularly on self-esteem—is often overlooked.
Here’s why children with PANS/PANDAS may struggle with self-worth:
Sudden Behavior Changes – Many children with PANS/PANDAS experience intrusive thoughts, rage episodes, or compulsions that they can’t control. This can lead to deep feelings of shame and self-blame.
Anxiety & Depression – The neuroinflammation that causes PANS/PANDAS can also trigger intense anxiety, sadness, or hopelessness, making a child feel like they’re “not good enough.”
Social Struggles – Children may withdraw from friends or struggle with emotional outbursts, leading to rejection, isolation, or bullying. This can reinforce the belief that they are unlikable or different.
Cognitive Impacts – Brain fog, trouble concentrating, and memory issues can make school feel impossible. A child who once excelled may suddenly feel “stupid” or “incapable,” even though their struggles are neurological, not a reflection of their abilities.
What Parents Can Do to Help
While the sudden onset of low self-esteem can feel overwhelming, your support plays a crucial role in helping your child rebuild confidence. Here are some ways to help:
1. Validate Their Feelings (But Gently Challenge Negative Self-Talk)
When your child says things like “I’m bad” or “I’m stupid,” it’s tempting to immediately say, “That’s not true!” Instead, acknowledge their feelings first:
“I can see that you’re feeling really down about yourself right now. That must be really hard.”
Then, gently challenge the thought:
“I know your brain is telling you that you’re bad, but I see a kind, brave, and strong kid who is going through something really tough.”
2. Separate the Child from the Symptoms
Many kids with PANS/PANDAS internalize their symptoms and believe their compulsions, rage, or anxiety define who they are. Help them see that this is their illness talking, not their true self.
“This isn’t YOU. This is the PANS/PANDAS making things feel this way.”
This helps them understand that these thoughts and behaviors are temporary and treatable.
3. Use Strength-Based Language
Even on hard days, remind your child of their strengths and positive qualities.
“I see how hard you’re trying every day, and that makes you so strong.”
“Even when things feel tough, you always find a way to keep going.”
“You are more than your symptoms. You are creative, kind, and loved.”
These reminders help reshape their internal narrative.
4. Prioritize Emotional & Mental Health Support
Because PANS/PANDAS affects both the brain and emotions, mental health support is just as important as medical treatment. A therapist who understands chronic illness and neuroimmune disorders can help your child: ✅ Process the emotional impact of their symptoms
Learn coping strategies for anxiety, intrusive thoughts, and depression
Rebuild confidence and resilience
5. Encourage Connection, Even in Small Ways
Social withdrawal can reinforce low self-esteem. While pushing your child into overwhelming situations isn’t helpful, finding gentle ways to keep them connected can be.
Invite a trusted friend over for a short visit
Encourage creative outlets like art, music, or journaling
Consider animal therapy or time with pets, which can boost mood and self-worth
When to Seek Professional Help
If your child’s low self-esteem is leading to self-harm, suicidal thoughts, or severe depression, professional support is crucial. You don’t have to navigate this alone. Therapy can provide a safe space for your child to express their emotions, gain coping tools, and rebuild their confidence.
As a pediatric psychologist specializing in chronic illness and neuroimmune disorders, I understand how deeply PANS/PANDAS can impact a child’s mental health. If your child is struggling, I’d love to help. Book a consultation today to start getting the support your family deserves.
Final Thoughts
PANS/PANDAS can cause sudden and severe drops in self-esteem, but with the right support, children can regain their confidence. By validating their feelings, helping them separate from their symptoms, and seeking mental health support when needed, you can guide your child through this difficult time with love and reassurance.
Your child is more than their illness—and with your support, they will see that too.
