Bullying & PANS/PANDAS
Bullying is a frequent concern within the PANS/PANDAS community.
Bullying is never the child’s fault. When symptoms are misunderstood, children may be labeled as “different,” “disruptive,” or “too much,” increasing their risk of being targeted by peers. A child with PANS/PANDAS may go from being social and adaptable to suddenly experiencing anxiety, OCD, developmental regression, tics, irritability, or withdrawal. These changes can make it harder to connect with peers, and others may not understand what has happened. Symptoms can affect both behavior and social functioning, increasing vulnerability in peer settings and influencing how a child interacts with others and is perceived by peers.Some children may not realize they are being bullied or may mistake someone targeting them for a friend. These challenges may include:
- Sudden changes in behavior or personality
- Obsessive-compulsive behaviors
- Tics or unusual movements or sounds
- Severe anxiety or separation anxiety
- Irritability, rage, or emotional dysregulation
- Developmental regression that impacts social skills and peer interactions
- Difficulty keeping up socially or academically
- Withdrawal or heightened emotional reactivity
- Cognitive changes such as brain fog, memory issues, or slowed processing
PANS/PANDAS affects each child differently. Symptoms can impact:
- Social awareness and understanding of interactions
- The ability to recognize when they are being mistreated
- Emotional responses, which may appear disproportionate to others
- Peer relationships, especially when functioning changes quickly
What is Bullying
Bullying is when one child intentionally and aggressively targets another, often because there is a real or perceived imbalance of power. This behavior happens repeatedly or could happen more than once. Both children who are bullied and those who bully others can experience long-term emotional and behavioral effects.
Bullying can take many forms, including:
- Verbal actions such as teasing, name-calling, or threats
- Social behaviors such as exclusion or spreading rumors
- Physical actions such as hitting or damaging belongings
A key part of bullying is the imbalance of power, which may come from:
- Physical strength
- Social status or popularity
- Access to embarrassing information
- A child’s vulnerability due to health, behavior, or differences
Self-Advocacy for Students with PANS/PANDAS
Self-advocacy is an important skill, but it can be especially challenging for students with PANS/PANDAS when symptoms are active. Support should be gradual, realistic, and matched to where the child is in that moment.
Knowing When to Step Away
Students need to recognize when symptoms are escalating and when a situation is becoming too overwhelming.
- Using an anytime pass or pre-approved break
- Leaving before symptoms intensify
- Knowing where they can go to reset and feel safe
Accessing Help
Symptoms like brain fog, anxiety, OCD, or fatigue can interfere with learning.
- Recognizing when they are falling behind
- Requesting extra time or flexibility
- Knowing who to go to and how to ask for help
Getting Help if Bullied
Students need clear, simple guidance on what to do if they are being bullied.
- Knowing exactly who to report to
- Telling an adult right away
- Feeling supported in speaking up
Learning to Describe Their Condition
It can be empowering for students to have simple language to explain what is happening to them. This does not need to be detailed.
- “I have a medical condition that affects my brain and behavior sometimes.”
- “I might need breaks or extra help when my symptoms flare.”
There is still stigma around both mental health and chronic illness. Helping students talk about their condition without shame can reduce misunderstandings and build confidence over time.
Helping Others Understand about PANS/PANDAS
Providing clear information about PANS/PANDAS to peers and teachers can help reduce confusion and stigma.
Start here:
- What I Want My Friends to Know About PANS/PANDAS – Handout
- Understanding PANS/PANDAS – for friends and family
These resources offer children easy, age-appropriate ways to explain what they are experiencing. This can help make social situations feel less overwhelming.
Parents – What to Do Right Away
If your child is being bullied:
- Start documenting
Keep a simple record:
- Date and time
- What happened
- Who was involved
- Any witnesses
- Report in writing
Email the teacher, counselor, or administrator.
Written communication creates a record and increases accountability.
- Talk with your child
- Reassure them that this is not their fault
- Ask specific questions about what is happening
- Don’t encourage your child to fight back, since that can make things worse.
- Identify a safe plan at school
Make sure your child knows:
- Who they can go to
- Where they can go
- How to ask for help
Know the School’s Responsibility
All students have the right to a Free Appropriate Public Education (FAPE) in a safe environment.
When bullying interferes with a student’s ability to access their education, schools have a responsibility to act.
When bullying is directed at a child because of a medical condition or disability and creates a hostile environment, it may rise to the level of disability-based harassment under federal civil rights laws. In these situations, schools are required to respond promptly and effectively.
Schools are expected to:
- Take reports seriously
- Investigate concerns
- Take appropriate action to stop the behavior
IEP and 504 Considerations
If your child has an IEP or 504 Plan, you can request a meeting to address bullying.
This meeting allows you to:
- Share what has been happening
- Review whether the current supports are sufficient
- Request additional protections or services
- Discuss whether counseling or other supports are needed
This meeting is also a chance to make sure the school is taking steps to stop the harassment and keep your child safe.
Having a supportive school environment is one of the best ways to prevent bullying.
Impact on Mental Health
Bullying can have a big impact on mental health, especially for kids who are already dealing with a medical condition.
There is a strong connection between bullying and:
- Anxiety
- Depression
- Low self-esteem
- School avoidance
Children who are bullied again and again may start to fear social situations, worry a lot about what others think, and pull away from their peers.
When to Escalate
If bullying continues or the school is not responding:
- Contact the school administration in writing
- Request a formal meeting
- Ask for a clear plan to address the situation
- Continue documenting all incidents and communication
If a school does not take reasonable steps to stop bullying, it might not be meeting its legal obligations.
Getting Additional Support on Bullying
If concerns are not being addressed, families can reach out to:
- U.S. Department of Education – Office for Civil Rights
- Phone: (800) 421-3481
- https://www2.ed.gov/about/offices/list/ocr/complaintintro.html
- Office of Special Education Programs
- Phone: (202) 245-7468
- https://www.ed.gov/about/offices/list/osers/osep/index.html
- U.S. Department of Justice – Civil Rights Division
- Phone: 1-877-292-3804
- https://www.justice.gov/crt/complaint/#three
Additional Resources on Bullying
- American Psychological Association
For children and teens:
- Pacer Teens Against Bullying
- Pacer Kids Against Bullying
You’re Not Alone
This situation is very hard, especially when your child is already dealing with PANS/PANDAS symptoms.
Families shouldn’t have to work this hard to keep their child safe at school. There are steps you can take, and support is out there.
Parent Email Template: Reporting Bullying
Subject: Concern Regarding Bullying of [Child’s Name]
Dear [Teacher/Principal/Counselor Name],
I am writing to formally report concerns about bullying involving my child, [Child’s Name], in [class/grade].
Over the past [timeframe], there have been multiple incidents that have affected their sense of safety and their ability to access education. Below are a few examples:
- [Brief, factual example: date, what happened]
- [Brief, factual example]
- [Brief, factual example]
These incidents are not isolated and are beginning to affect [Child’s Name]’s well-being and ability to participate in school.
As you may know, [Child’s Name] has PANS/PANDAS, a medical condition that can impact behavior, emotional regulation, and functioning. Some of the behaviors that may be misunderstood by peers are actually symptoms of this condition.
Because this is ongoing and affecting my child’s ability to access their education, I want to ensure this is being addressed in accordance with district policy and applicable protections.
I am requesting the following:
- That these incidents be formally documented and investigated
- That a plan be put in place to ensure [Child’s Name]’s safety
- That we identify a staff member [Child’s Name] can go to if something happens
I would also like to schedule a time to meet and discuss next steps, including how the school plans to address this moving forward.
Please confirm receipt of this email and let me know how you would like to proceed.
Thank you for your attention to this matter.
Sincerely,
[Your Name]
Gabriella True
