I am not a doctor, but at the age of 19 (currently) at college I got very sick, suddenly had extreme OCD, life went down toilet, etc. I had PANS/PAnDAS as a kid along with neruo lyme, very bad seizures extreme mood issues, etc. got better at adolescence after Iv treatment, until my second year of college when I became disabled. Being in a disabled state and having my perfectly normal life ruined I desired greatly to get better, so I researched, a lot. Once again I am not a dr. But from the drs I have talked to along with reasearchers this is my take. If I were you I would get igenex pcr and western blot tested for lyme and all co infections, specifically bartonella. Your symptoms speak very clearly of bartonella symptoms, shin pain fatigue anxiety problems OCD along with a weak immune system. To further this point, the reason humans, and more specifically certain people and not everyone get very bad lyme is because lyme effectively screws with our immune systems. In a non immune compromised person lyme usually results in just fatigue and joint pain, as your body is fighting the infection, fatigue, and the lyme spirochetes clog capillaries, and joints with low blood flow are especially effected. However certain people get lyme much worse as we all know, and the symptoms experienced by these individuals is much greater in varience(most likely autoimmune related). Also, confections often show up in bad lyme cases, as once again they only show weird bad symptoms when the individual is immune compromised. Example of bartonella, which normally is only know for cat scratch fever, but in a immune compromised person flourishes and common symptoms of heel pain anxiety bone pain(inside the bones themselves ache especially shins) psych problems fatigue etc. Not surprisingly, many people with PANS are shown to have lyme or co infections, as I believe both these diseases( the symptoms themselves) are caused by an autoimmune response, which is caused by the presence of a bacteria. One only has to look at deer, which can and do carry lyme to see this. As deer are animals and much more likely to be susceptible to death when sick, natural selection has favored a breed more readily able to handle the presence of lyme and other tick borne diseases. In other words, throgh time the population has been highly compromised of individuals with immune systems that don't freak out to the presence of lyme, and therefore they can live with it, just as a person who dosnt get PANDAS when he or she has strep is due to a normal immune system. So if I were you, I would get tested for bartonella, as it has been shown IVIG will do nothing unless you are currently free from infection, so if you have bartonella lyme co infection then IVIG won't do much. You would need antibiotics to clear the infection and then proceed with IVIG. I know how bad the suffering is, my life to has vanished in the span of 4 months, I am reduced to sitting on the couch spacing out all day so that I don't have panic attacks. I origionally assumed I would just need psych meds and like you had a reaction to 25mg of zoloft. So in a breif summery, use igenex to get tested for lyme bartonella babes is relic his mycoplasma candida yeast. If any are present then eliminate infection, then ivig. Eliminating the infections will suck due to herximers, but ultimately it will help you. If our life is as bad as you say then it won't hurt to take risks to win the battle. I wish you the best of luck.