Sudden Onset

It seems like a nightmare. You're the parent of a six year old boy. He's friendly and outgoing and active. Recently he's been sick with strep throat but in the last couple of days he's been feeling better, until you wake up early in the morning to the sound of him screaming and you can't do anything to calm him down. From what you can gather, he's terrified of something crawling into his nose and his ears and his mouth and his eyes. Spiders or centipedes or germs. He's inconsolable, and constantly in fear. Over the next few days things just get worse. He refuses to eat because he's afraid there's things living in his food, and that they'll go inside of him. He's afraid to leave his room and his fits become more violent. Eventually he has to be hospitalized. Infections like strep can cross the blood-brain barrier and inflame delicate parts of a child's brain. It's called Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep and it's able to cause severe symptoms of OCD in children. But the sudden onset of mental illness in children can occur in a number of ways. Underlying issues sometimes surface during a period of extreme stress or after an injury. Issues that can sometimes never be fully resolved. Hopefully, an unnamed 14 year old boy will learn to manage his obsessive behavior, but he's struggled to for years. His mother writes that he's seemed like a completely different person since his head injury. The boy was injured at a sleepover party, in the bathroom. Where the children were playing bloody mary in the mirror one at a time. The others held the door shut. He'd panicked and fell back into the tub, banging his head hard off the tap. He was found unconcious and didn't wake up until the next day, but when he did he couldn't stand to be around any reflective surface. He has since suffered from the debilitating paranoid delusion that he is being watched through every mirror. The fear is very real to him. He suffers from immobilizing panic attacks and has to be medicated for his constant anxiety. The medication helps but only way he'll ever be able to truly manage his fear is through cognitive behavioral therapy: by training himself to recognize that his fears are irrational and misplaced and that he can work past them. But his paranoia is deepy rooted and he struggles hard to shake the belief that the faint, moving shapes he believes he can make out in every reflection are watching, waiting until he's completely alone to come back out through the glass.