“There is a direct causal link between mental health issues and neuroinflammation.”

With this powerful statement, Dr. Rosann Capanna-Hodge leads us into the steadily increasing world of brain -inflammatory conditions in children: PANS, PANDAS and Autoimmune Encephalitis.

Listen to understand key identifying features of each of these labels, and how to navigate your way through this condition as a parent.



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Disclaimer: The information in this Podcast is for educational purposes only. Vaishnavi Sarathy, Ph.D. is an educator, not a doctor, specifically not your child’s doctor. Please consult your physician before implementing any supplement or diet recommendations.

Audio Transcription: 


Hi, everyone. Welcome back to your podcast on functional medicine and equal learning and neurodiversity for children with autism, Down syndrome, or learning disability. Today’s guest is going to be giving us some deep wisdom about the world of neuroinflammation, which is one of the core topics that I hope to dive in many times in my podcast. Now one of the things you will learn over and over is that a fundamental non-negotiable for an inflammatory condition, especially a neuroinflammatory condition is diet.

In other words, an anti-inflammatory diet. Now if you go to functionalnutritionforkids.com and navigate to the contact me link, which is on the tabs to your top right, I would be happy to chat with you for 20 minutes on how you can apply an anti-inflammatory diet in your child’s life. Don’t wait to do this critical foundational step. While you’re there, don’t forget to check out a freebie document on focus hacks on my website, the same website right now, this document goes away in a week and will be replaced by an exciting ebook. So right now if you still want to get a few focus hacks. This is the right time.

I am super super excited to interview Dr. Rosann Capanna today, Dr. Rosann Capanna Hodge is a pediatric mental health expert and a thought leader on children’s mental health and integrative therapies. She is the founder and director of Dr. Rosann Associates’ extraordinary moments and the originator of the 360-degree Reboot intensive therapies program.

She’s helped 1000s of children and young adults reverse inflammatory conditions associated with ADHD, autism, anxiety, depression, concussion, learning disability, Lyme disease, and pans and pandas using proven holistic therapies. She has been an expert on many media outlets, including the Mel Robbins Show, Fox News, CBS, NBC, and The Huffington Post. She’s also a sought-after speaker and she is a co-author of the brain under attack, which is a resource guide about pandas and pandas. Our discussion today is going to focus predominantly on pans and pandas.

Welcome, Dr. Rosen, thank you so much for coming.

Dr. Roseann Capanna-Hodge:

Well, thank you so much for having me. You know, talking about hands in pandas is both a professional and personal mission that I have to help those families who are struggling with this inflammatory condition.


Yeah, and as I was listening to your work and reading your work, Dr. Ross, and some of the things that you have said have resonated so much, you say that our work as functional physicians are functional practitioners is to take a systems approach and not a symptom approach. I’m just so thrilled to read that, and I think he just killed it right there. But before we jump into pans and pandas, could you talk to parents about how and why they should choose a practitioner that does just that, like takes a systems approach and not a symptom approach?

Dr. Roseann Capanna-Hodge:

Yeah, so you know, when we’re struggling, as parents, because our children are struggling, and I should say that, you know, I’m a Special Needs mom of two kids with special needs. So I understand it, you know, as a very personal level. But, you know, I’ve been working with children with issues and special needs and different symptoms for almost 30 years, which I’m super grateful for. But when we talk about mental health, in the United States, and really even in the world, because it’s changing, not for the good, we focus on those micro symptoms. And we’re not really thinking about root causes, how things are connected.

We’re certainly not making a mind-body-spirit connection, that’s for sure. So when we focus on one aspect, and I’ll give you an example, if you focus on my child is having a hard time paying attention. And so you start going down that rabbit hole, my child is, you know, not focusing in school, they can’t listen, and this recently happened to me. And please know that anybody I talk about it. So change details, and preserve people’s privacy, of course. So this is just such a common scenario that happens to me, somebody came in, they did an intake with me, we did a QED brain map and the main reason they came to me was that their child couldn’t focus.

Even though we knew what started in this child’s, let’s say middle school years, was anxiety. In the end, he had a diagnosed of ADHD. But when we got to the brain map, when we see we didn’t see ADHD, we saw a diet. And so a brain that gives us a visual representation of the health of the brain and knows exactly what the brain does.

When we take a look at the brain, we can see what functioning detail and which areas are working or not. And that’s how we can be really definitive in our diagnostics. So by focusing on the symptom, right, and not really taking a complete picture of this child, forget about even having this brain map, if we just really did a deep dive and try to connect those dots.

Where did this all start? Right, we would see that the focus was out of alignment because this was a very anxious person who was actually spending all of their time worrying. And all of us have experienced anxiety, especially moms, right? You never know, you worried so much. And so what happens is, you’re over-focusing on whatever worry it is. And then you can’t pay attention. And that’s exactly what happens to this child or this young adult. And, and so when we go to a root cause we dig backward, we figure it out. And in, in this person’s history, you know, was there illness? Was there nutritional deficiencies? Was there pieces that would contribute to the overall mental health and physical health of this person? I mean, that’s the kind of comprehensive assessment that I do.

I wish all practitioners did this, because again, we then connect mind, body and spirit. And then we really started to understand what is driving the issue or issues. And instead of just focusing on that one piece, you have to try to connect all the dots.


And one of beautifully said, one of the things that we often see, even in functional practitioners is the pill for an ill approach. And then, and so I think that is a really important distinction that you brought in when somebody is actually connecting the dots, looking at the root cause issues and looking beyond the symptom.

Dr. Roseann Capanna-Hodge:

Yeah, heal for the ill I love that. You know, we think conditions, you know, in our culture, that there is a pill for everything, and that there is a magic wand and a quick fix. It is not that way, if it were that way, our children and individuals and our culture would not be in a mental health crisis, that they want to children in America have a physical or mental health problems. 22.2% of 13 to 18 year old’s have a highly significant anxiety or mood disorder. And hospitals are being used as crisis intervention centers for mental health and behavioral problems.

I mean, things are bad. So we’re not getting better with a quick fix, fix approach, because really, you know, if you even just use the example of ADHD, so you really do have ADHD, you take ADHD medication, your brain may be possibly more focused? Possibly? And I’ll explain that. But what behavioral changes are you making? How are you actually learning how to get work? How are you learning organizational skills, so that magic bullet that that taking that pill isn’t going to change something on its own, it’s the same thing, as what we do in our office, we use your feedback, which is highly, highly research 10s of 1000s of research studies, over 3000 peer review, you know, 50 years of data, and it really does change the way the brain is working and makes lasting change in the brain. So even when people come to me to use that we pair it with new learning. So that’s coaching, counseling around specific issues. So no magic facts, you know, and certainly getting to the true root causes. Because we also typically don’t have one thing, that’s a mess. We typically have multiple things, right?


Yes, absolutely. We’re living in a matrix of so many, multiple issues that are impacting us on a daily basis. And you mentioned that one in two children have physical or mental health problems, and we know that there’s these are chronic inflammatory conditions, and maybe we can, would it be fair to say that mental health problems can be used interchangeably with neuro inflammation?

Dr. Roseann Capanna-Hodge:

Oh, 100%. I mean, we do know, through lots of research, particularly research that comes through cycle immunology, that the stress response produces inflammation, but there’s other sources of information that there is a direct causal link between mental health conditions and neurodevelopmental disorders and brain inflammation. There was a research study 2019 The first of its kind that looked at post more than brains of individuals with autism. And they found that over 70% of the brains actually had inflammation. You know, that’s a really big deal. This is not speculative. This is saying that 70% of individuals who live clinical diagnosis of autism had brain inflammation.


So we’re not addressing it on for the most part.

Dr. Roseann Capanna-Hodge:

No, no. And you know, and autism brings a variety of other comorbid conditions, including sensory issues, and which can bring about restricted eating, and then the diet, they can start getting restricted, obviously, in your food choices, which then limit nutrients. And that’s one of the biggest I know you’re a nutritional practitioner.

You know, people have a hard time accepting what you put in your mouth has an impact on your brain in your body. But food gives us nutrients and nutrients power, the body, and science.


Yes, it is.

Dr. Roseann Capanna-Hodge:

And it cracks me up every time like we need to be in Cardenas, and I’m sure you know, it’s a shocker to people to realize that. Up until recently, no physician programs limited physician programs had nutritional training for doctors. It’s only something that in modern times, some of the physician training programs have that. So they’re not by lack of training, imparting that knowledge to parents, but it is something I’m all about, you know, empowering parents parents absolutely have the tools to make a difference in their child’s physical and mental health. They really do. One of the biggest ways they have nutrition.


Absolutely, yeah, thank you for saying that. Going from neuro inflammation to pans and pandas, which is kind of in my mind on on the end of the spectrum of neuro inflammation. I’m sure that you’re seeing more and more children with pans and pandas walking into your office. But can you give us a short description of what this is? What what pans or pandas is and what does it look like when a child with pans and pandas walks into your office? I have more questions like how do you know if it’s pan’s pandas or autoimmune and, and encephalopathy which I have trouble pronouncing? And even important to know the differences or do you just treat the inflammation?

Dr. Roseann Capanna-Hodge:

Yeah, so it’s a great question. And you know, I can talk about Panda Panda all day because it really is dramatically on the rise.

The estimation is that one in 150 200 children actually have pans and pandas are a misunderstood Canet condition. For some reason it’s been challenged, even though Susan suite worked for the NA H Did you know really discovered it and has beautiful research on it? And you know, I work with people flying in from all over the world to come and have them help them with the behavioral, psychological, emotional, and brain components of pans and pandas.

We work with them to a program called 360 depots where people come for two weeks and work with me intensively. And sometimes I work with people remotely for half a day of training that way. So but let’s talk about pandas and pandas, and what it is. So pandas and pandas, you know, essentially they’re two different conditions, but it’s, it’s really the same behavior, not necessarily physiologically, physiologically. So, both have typically an infectious disease trigger that causes sudden, overnight behavioral changes, typically sudden, overnight, we’ll go into that, and, you know, causes brain inflammation that results in these changes.

There’s a whole bunch of other physiological kinds of nerdy stuff in that and pandas results from the strep infection in pans can be a long list of multiple types of infection, as well as often mold can be a trigger. And so even though the difference between pans and pandas and autoimmune encephalopathy which we call AAP, is that pans and pandas there will be a sudden acceleration or an overnight sort of dramatic increase. And he is sort of a very slow waxing and waning there.

There isn’t a sudden overnight in there. So but what I want to make is a really big distinction that that that is a source of why many people don’t get diagnosed. So in both situations pan’s panda’s autoimmune encephalopathy, you can have a pre-existing condition. So if 50% of the US population has a physical or mental health problem, one out of two, are going to have something else. And so what can happen is somebody already they’ve got a mood disorder or they’ve got eczema. They’ve got X y&z OCD. And then there is an infectious disease trigger or other things could be flu shot could be all different kinds of components.

I’ve seen a lot of different variations. And typically, there are multiple infections doesn’t mean that that’s the case, I’m just saying, This is what I see. Then many times people have, you know, strap the flu, Mano boom. And then you get a complete destabilization and sudden on pans, pandas or pans in that case. So what happens is somebody could have a low level of anxiety, or infectious disease, and trigger the next thing you know, the anxiety is literally stopping them from walking out the door. Maybe it’s OCD, maybe it’s rage. It could be you know, a cognitive issue can present itself. So a lot of times kids get missed, because they’re like, well there.

But now there’s something traumatic acceleration, where were the autoimmune encephalopathy, you can have sort of like literal waxing and waning. Like I said, it’s sort of up and down and up and down, on but in both cases, a lot of the times, you do see sort of the soft signs, where there’s maybe not a dramatic behavioral change. But there might be, for example, a really common scenario was the child was really pretty healthy.

The next thing you knew that they had a series of urine infections and that they got whammy with the strep, and then boom, the onset of pandas. So I like to paint the picture so people can understand. But I think one of the most important things parents need to understand and they need to be just an incredibly vocal advocate for this is that the sudden onset of a mental health problem at any age is completely abnormal.

You are not, you are not crazy, and you will look for answers. And you will find the answer if you know that your child had an infection, and this even could be six months before. And sometimes the full destabilization takes quite a bit of time, you know, you want to find somebody who is a specialist you can go to, you know, aspire, which is a national organization, you can go to epidemic answers, which is, you know, my sisters and I wrote brain under attack you go to these organizations and find that IT professionals, why are you going to do that, because you go to a nonpan’s pandas literate professional, and you’re just going to be the dog chasing its tail, you’re going to be frustrated, you’re going to not get the answers and the longer we let that inspection, get into the brain and other organs in the body, the harder it is to treat.


Thank you for that doctors. And that’s excellent information. And as you were saying that another talk was forming in my mind, before we started the podcast, we were talking about the financial or economic inaccessibility of many of the interventions.

I was thinking that there are probably many parents out there that know that their child has had an infectious trigger, and they’re seeing I personally know many people that cannot, they don’t know where to go next. Okay, and they probably think that a functional doctor of pans or pandas expert is going to be very expensive or not covered by insurance, which may be true.

I was thinking if there are three or five things that a parent can do by themselves before they have to meet an expert, what would that be? What would be the non-negotiables for a parent that is working with a child with inflammation, symptoms of brain inflammation symptoms after an infectious trigger?

Dr. Roseann Capanna-Hodge:

Yeah. So before we dive into what you do want to say about finding a practitioner. First of all, you do want to try if finances are an issue, you can go if your child has Lyme disease, which Lyme and tick-borne infection is one of the biggest triggers of pans and pandas and Lyme is in every state in the United States, and it’s almost on every continent. So, but one so it is there. Is that


Antarctica? Yeah. And our

Dr. Roseann Capanna-Hodge:

but it’s all the way up into Ontario. I mean, it’s, it’s there. It’s moved into these cold states. And in certain states, there are it’s called endemic or basically it’s at like a really high level like I’m in Connecticut. If I went out right now and rolled on the grass, I’m gonna have checks on me. Oh, god, okay, there’s no, no, maybe it’s gonna be odd. So, um, so you have to just treat it like I always say it’s like, I’m like an Atari video game.

Like, when I walk out on the lawn, I’m just like, oh my gosh, there’s not too and everybody knows, he knows I’m like, super chill. But when it comes to that, where we just really are, we follow line connections, blast protocol, you can look that up. And you know, we’re just very proactive, because prevention is the number of wave-wave control.

Diseases are presented to prevent it. And the number one way you can prevent, not Lyme disease is immediately after going outside, on any surface, not just in the woods is to take a shower and reduce your chance of Lyme disease by 51%. Wow. So on that, you can see that online connection.org. So what I want to say is you want to try to find a network provider. So naturopathic physicians are a great place to start is a licensed in your state, many of them do take insurance. And there are organizations like lining, and you could put in line grants and see if there’s some funding available to you to get in.

If your child is in a pan’s pandas crisis, you know, they could be literally, you know, if anybody’s seen the video, my kid is crazy, they could be acting, it’s such a high level of behavioral distress, that you may not need to manage any of these things at home. And the psychiatric facilities are completely ill-equipped at supporting these kids because they should be running, you know, tests for tick-borne infection and strep. And I can tell you story after story of kids being, you know, just horrifically abused in hospitals being taken away from their parents, I mean, just lots of things. And I and I don’t want you to not get care.

I also like to believe that education is really important. And going to a provider who can help treat the medical source of a mental health problem is essential. So and I also want to say someone who doesn’t take insurance, while many of us don’t take insurance is because when you do, the insurance regulates what you do, and you cannot provide proper treatments, you also have to give access to the insurance companies to the records.

There are a lot of issues in that. And, you know, it’s why I’ve never taken insurance, and many people have added our state out-of-network insurance is mandated for any, any employer over 50, who has 50 employees. And so people have a really good ad network in my seat. So and I do think the last five years at a network are good. So what are the top things people can do? So obviously, find a literate provider, and, hopefully, there is somebody that you can start with. But what you can do is you got to do those in-a-day inflammatory things. And I have a, I actually have four books coming out, I wrote four books in COVID.

The first book is a teletherapy toolkit for professional mental health providers. And that comes out this fall, but I also have a whole series called, it’s going to be okay. And I walk parents through the pillars on how to reduce a reverse their child’s mental health. And you can do it. People do it all the time. And I work with people all the time who do it. And so there is a magic sauce in so what can you do one, the first pillar is nutrition. So I think it’s really hard when your kid has super active hands, then you’re not going to have a lot of wiggle room. But if your child has some stability, I’m not saying any more range or your post-treatment, you know, you know, you have to do an anti-inflammatory diet.

It’s a proven diet. And, you know, why do you do the anti-inflammatory diet, hello reduces inflammation, but it’s power-packed with nutrition, so nutrients, fat, and protein, which is clinically proven to change and improve brain function. So we have to start with that. And people often say to me, and this is one of the big things in my it’s going to be okay. And our unstuck Parent Program, which comes out in November, is that you’ll people say me all the time. I’ve done this, I’ve done this. I’ve done that. It hasn’t worked well.

I want to tell you, it’s not one thing. It’s the combination, it’s the right treatment at the right tribe in the right order that creates that synergy. And so when we pull these things together, we can have a compounded positive effect. Because of what calming the nervous system, we’re creating what we call neuroplasticity in the brain, which is, you know, getting that brain to be more flexible.

When we are in an inflammatory response, our nervous system is so jacked up. It’s so hyper. And so when we start using nutrition when we start doing the breathing exercises, and you know Neurofeedback and biofeedback and meditation, we’re getting you out of this really heightened sympathetic state and putting you in a parasympathetic state. And so what does that mean for you is that your child isn’t so agitated, and it’s not willful if their nervous systems for signs of every piece of stimuli.

Changing your diet, incorporating in daily, daily, this is not once a week or twice a week, you must put in some type of nervous system calmer, and you know, absolutely doing breath work, you know, I love a 478 breath in, you know, in, in deep breathing, for four seconds, holding for seven, and then out for eight. And that exhalation really gets you into that calmer, parasympathetic state, you know, meditation. And I know people will say to me, my kids don’t do this, and my kids do this. And kids do this, I’ve autistic kids do this, I have all kinds of kids, you role model it, you do it with your kids, you make it part of your life.

I think during this time of the pandemic, people silver lining, are realizing, boy, they need these things. And these are really, really essential, essential things to help calm. And then I think the third best thing a parent can do is probably, you know, really just get a lot of psychoeducation. You know, this book, brain under attack, this is written for a nonprofit, you know, I mean, zero proceeds as all those academic answers.

It’s basically pan’s pandas 101. And get that information, you know, hop on to Dr. Rosianna, calm, or free blog, hands on the rise, you know, there’s all kinds of things get that information, because I’m going to tell you, you’re going to have to be your child’s medical CEO, and you’re gonna have to be in charge of this. And unless you have an amazing provider, who connects the dots and tells you all these things, it’s incredibly overwhelming. And the path is not the same for everybody.

These foundational pieces, you know, as I always say, and that’s why many folks call it’s going to be okay is it’s going to be okay when you really put these pieces in and, and these are things that everybody in your family can benefit from, I certainly have them in my life. And they’re really, really helpful. And then I’d say the last tip for parents is just loving limits, that your child will be dysregulated.

In this process, I’m not saying forever, and I do see people who go into remission or cured whatever you want to say, in us. And there’s no one set path, everyone takes a different path because they incorporate those eight pillars is that you have to be flexible, what you expected from a neurotypical child beforehand is not going to happen during cans. And a lot of it is because they have these flares. So one of the biggest parts of psychoeducation is to understand that any infection or stressor can cause what we call a flare.

It can mean that whatever viral or bacterial component, you have look it can rise in the system. And then there is some level of a behavioral just compensate, you know, decreased and their behaviors or I should say, increase the behaviors, apologies, and then this flare period, all of a sudden, your kid didn’t have any texts, or was an increase and then all sudden you see a slight uptick, sometimes, like sometimes big. And so this can be highly stressful for everybody.

It’s all about when you understand what you have to do and you have a great provider, you come back in and you use those things that worked like so a lot of my families who use like PMF or biofeedback neurofeedback, they come back in and then they use whatever anti viral or anti-material, or homeopathy, whatever it is that worked for them, there is no one set thing.

We do know that you have to address the infection, you have to support the immune system, and you have to support those deficiencies. But if the nervous system is not regulated, physiologically, we know through psycho immunology, that it is not possible for the body to heal itself. And when a pan’s pandas hit is just in this hyper-stress state, and they are their nervous system is so hyper, you’re never going to get any wiggle room.

That’s why a lot of people come to me a lot of like exciting things, and wonderful healing happens because we support that nervous system, and then we’ll and then the actual treatments that a physician does, works. So it’s, you know, we know we need to calm the nervous system, and then come into those interventions, medical and behavioral and then that’s where a lot of healing and change happens.


Well, thank you. And I can see that there are two phases to what you talked about. It’s, what you do during the flare and what you do when there’s not a flare, and we’re and you’re saying that we’re constantly trying to bring down the fight or flight response to calm the nervous system, even when they’re not in a flare, which is probably when a lot of people ease up and just okay and relax. And, and but if you don’t work during that time, and when if you do work during that time, you’re supporting the chance that there might not be a flare, or there might be a less lesser of a flare or the inflammatory response might be less than what it would be normally.

I hope that after listening to your podcast, I hope that your voice reaches many, many, many more 1000s of people and that people who it recognizes that these so-called psychiatrist symptoms are rooted in biology are rooted in infection are rooted in inflamed inflammation and that people can actually find the support that they need because there’s information out there, it just has to reach the people. So thank you, thank you for coming to this podcast. I hope you go on many more podcasts and TV shows that many people listen to this and other podcasts it just and the word spreads.

Dr. Roseann Capanna-Hodge:

Yeah, thank you so much for helping so many. Because, you know, I know so many people do find out about pandas and pandas by doing their own research. And, you know, I’m a big fan of being a Google MD, you know, day, look for the answer. Always listen to your instincts.

You know, each professional is there to give you advice. And you have to, you know, check in with yourself to see if that feels right. But this is a long road. And when you choose a treatment, you’ve got to really try to stick it out. And that becomes something that really calls therapists treatment. But you really have to give it time because it didn’t, you know, this may have happened overnight for some of these kids.

When the infection gets in there, you know, it is a process, you know, multi-part process, but you absolutely can help your kid get better. And infectious disease and brain inflammation is a more common source of mental health issues than genetics. So, you know, so that’s surprising people. So thank you for letting me share this message. And I wish everybody you know, good luck on their healing journey and parent empowerment because you really can help your child.


Thank you. You can reach Dr. Roseann at Dr. roseann.com and Roseann.com. Dr. Roseann on Facebook and Instagram. And that’s Dr. Rosen and ACC OC for associates Correct?

Dr. Roseann Capanna-Hodge:

Yeah, yeah, you can just Google Doc for them to come up anywhere pretty much.


Thank you for listening. This was our 48 episode. Can you believe it? Now hold your horses and hang on until our 50th episode with special guests Soma Mukhopadhyay. On the Rapid Prompting Method, I’ve had so many requests from listeners about this, so don’t miss it. Don’t forget to check out a freebie document on focus hacks on my website.

Again, this document goes away this week. So this is the opt-in it’s a window that pops up when you go to functionalnutritionforkids.com. Until then, until next week, until I see you again for the 49th episode. I’m your host, Vaish Sarathy, and the music today was very Maitri Gosh.