Emotional Wellbeing

Mental Health

Mandy Kloppers

From Throat to Mind: How Strep Throat Causes Mental Illness

Strep throat is a bacterial infection that is common in young children. In many cases, strep throat can be successfully treated with antibiotics or the use of strepsils plus. However, strep can cause neurological and psychological issues. The complications, also called paediatric autoimmune neuropsychiatric disorders or PANDAS, are usually caused by streptococcal infections.

The Discovery of Strep-PANDAS

The first sign of mental illness caused by a strep throat was noticed in the 1980s by Dr. Susan Swedo from the National Institute of Mental Health. She noticed that some children appeared to have twitch and odd behaviours similar to obsessive-compulsive behaviour (OCD), which included a lot of hand washing at night, and all the children with this behaviour had suffered strep throat recently. However, signs of strep throat were gone, but a blood test revealed the presence of strep antibodies in extraordinary levels.

Since this condition is common in young people, some people argued it was a coincidence. But over the years, a lot of clinical data has been amassed, and it has been proven that, indeed, strep throat can induce psychiatric and neurological complications in people.

How Does It Happen?

According to the National Institute of Mental Health, the symptoms of mental illness caused by strep throat can happen out of the blue without any warning signs. Some of the signs of psychological illness are anxiety, anger, and violence, physical and vocal tactics.

The symptoms are usually mild, so the affected person may only have behavioural regression. In children, they may act younger than their age and become whiny and clingy. However, this can last for only a few weeks.

In some rare cases, the symptoms can be extreme, causing a brilliant child to start crawling, finding interest in baby’s games, or wanting to spend time with their parents. Besides, these children experience extreme anxiety and take too much time to do some everyday tasks.

Symptoms of Strep-PANDAS

A child who has PANDAS due to strep throat is likely to have some unusual symptoms such as lack of appetite.

Other symptoms include;

  • Temper tantrums and baby talk
  • Severely depression, which can lead to suicidal thoughts
  • Symptoms of ADHD, for instance, fidgeting, hyperactivity, and trouble playing and concentrating
  • Joint pain
  • They experience deterioration in their excellent motor skills, for example, their drawing, and writing becomes terrible.
  • Sensory problems, for example, Some children might experience sensitivity to light or noise
  • Somatic signs include bed-wetting and peeing more frequently during the day
  • Anxiety panics of fear of being away from their guardians
  • Uncontrolled jerky movement

 How Is Strep And Mental Illness Connected?

Strep throat is caused by bacteria identified as streptococcus pyogenes, which is contagious. The bacteria are spread when someone comes into contact with any respiratory tract secretions from someone infected. This mostly happens when the person sneezes or coughs. Anyone regardless of their age can catch strep throat; however, it is more common in children between 5 and 15 years old. 

The strep molecules are known to hide from the host’s immune system by mimicking the host cells. When the body’s immune system responds by fighting the bacteria with antibodies, some of the host brain cells are attacked due to the cross activity.

Risk Factors for PANDAS

There are numerous factors that can play a significant part in the progress of this syndrome, including recurring group-A streptococcal contagions, the mothers’ history of autoimmune diseases as well as the family past of rheumatic fever. Even though strep throat can happen at any time of the year, it has a tendency to flourish more during winter and early spring.

When to Get Concerned

Not every child will develop signs of PANDAS due to strep throat. The first doctor who recognized PANDAS, Dr. Swedo, says only between two thirds and three-quarters of school children get strep throat every year, this means that only few will suffer from PANDAS; In fact, 1 in every 500 children will suffer from the post strep throat reaction, which manifests as mental illness.

However, Steven Schlozman from Clay Centre for Young Healthy Minds in Massachusetts General Hospital advises parents to observe their recovering kids for any signs of PANDAS. The characteristics of this syndrome are defined by how fast the symptoms appear.

Strep throat may be severe, but children might end up recuperating well without any psychiatric symptoms. The post-strep complications depend on the body reacting to the infection. Other signs to look out for include disturbed sleep, dilated pupils, and frequent urination.

Can PANDAS Be Treated?      

According to Dr. Swedo, early diagnosing and treating strep throat with antibiotics is one of the effective ways to reduce the chances of developing PANDAS. If a parent suspects their kid might have strep throat, they should go for a throat culture. This test will not only help you prevent chances of developing mental illness but also rheumatic fever, kidney disease, and arthritis, among other post-strep throat health complications.

Apart from antibiotics treatment, some children may have to pair treatments with cognitive behavioural therapy. It comes in handy where the symptoms are severe and helps the child to recover. Psychiatric treatment can be offered to children who are depressed and suffer from frequent anxiety attacks.

In extreme cases, the patient may have to go through plasmapheresis, which is a process to eliminate the harmful antibodies out of the blood. During this treatment, the liquid part of the blood, which is the plasma, is separated from the blood cells, treated, and then return to the body. Such patients may also benefit if given intravenous immunoglobulin treatment.

Surgical removal of tonsils and adenoids has not yet been proven to be effective in preventing PANDAS; therefore, it is highly discouraged.

Preventing Strep-throat

  • To avert a strep infection, teach your children to cover their mouths when they cough or sneeze.
  • Teach your children not to share personal items like drinking cups or eating dishes and spoons. Also, make sure that you wash the dishware in warm and lathered water or in a dishwasher.
  • Cleaning their hands is the best way to prevent a strep infection. Children should be taught about the importance of hand cleanliness. Additionally, they should be educated about the proper technique of washing their hands using water and soap or an alcohol-based hand sanitizer.

The Controversy

Some people in the medical field do not agree that strep throat and other infections can trigger mental illness. There are still debates on the topic. However, most of the paediatricians will consider PANDAS if a child suddenly changes in behaviour and seem to have obsessive thoughts

With some doctors clearly stating that there is nothing like PANDAS, some patients may be at risk. Those who believe strep throat can cause mental illness care about their patients and will look for any post-strep throat symptoms and offer treatment on time. Being cautious is very significant and helps patients recover fully without complications.

What to Do If You Your Child Has PANDAS

Most children take some time to recover fully from PANDAS; however, the symptoms tend to improve over several months once the signs of the underlying condition clear. Strep-PANDA is likely to recur if your children are exposed to germs. Help your children stay healthy by teaching them good hygiene habits, like washing hands, changing their toothbrushes often, and staying away from people who are sick. Additionally, it is essential to maintain mental health in both children and adults. Therefore, you should be vigilant of any signs that could indicate any psychological problem.

Mandy X


Image via Shutterstock, by ShotPrime Studio

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