Adults with possible PANS

[Alyonushka]

Hello everyone!

My daughter is almost 20 years old now. When she was 6, she was diagnosed with PANDAS and got better after taking antibiotics.

When she was 11, she started experiencing similar symptoms - intrusive thoughts, OCD-like behaviors, and anxiety about food. She was afraid of eating because she thought she would become fat. She had severe anxiety, frequent crying, and obsessive fears about food.

Starting in 2022, she began counting calories and exercising excessively, but I didn’t initially realize that something was wrong. Over time, she became more afraid of food, felt guilty after eating, and disliked her appearance.

Right now, she is terrified of gaining weight (she has normal weight, she is 135 lbs). She feels guilty after eating, struggles to enjoy food, and finds it hard to relax around meals. If she eats and feels even slightly full, she believes she has overeaten. Sometimes, she even hits her stomach out of frustration. She often feels like she hates herself and says she wants to die, although she insists she has never seriously considered suicide.

Last fall, she took Prozac, which helped her feel calmer, but it did not stop her obsession with losing weight. She still sees food only as a tool for either weight loss or weight gain. She fixates on reaching 125 lbs and was 112 lbs in 2023 after intentional weight loss, but even then, she was not happy.

I need help. Could this be PANS/PANDAS again? What should I do?

What tests should she take to determine if she has PANS again?