What is important to understand is that the OCD behavior is not easily recognized. People associate OCD with rituals that are performed over and over again. Actually, compulsions can often occur in a mental capacity and people with obsessive thoughts present with many psychiatric symptoms i.e., anxiety, depression,oppositional, impulsive, eating disorders etc. Oftentimes a child is terribly anxious and cannot express him/herself and consequently acts out for no apparent reason. They are frustrated. As much as they try they cannot quiet those ominous thoughts that are going round and round in their heads. And what’s more? A person cannot run from their own thoughts.
Many times a child that has/had PANDAS has a tendency to it and any infection, be it viral or bacterial, not just strep, can trigger a reoccurrence. I can often predict such a child getting sick before actual physical symptoms based on their emotional behavior. Therefore, if it were my child, I would get hold of a good therapist that specializes in CBT or ERP to teach the child conditioning skills necessary to help them cope. It’s hard work but with siyata dishmaya there’s hope that psychiatric meds can be avoided altogether.
I don’t know your child nor do I know if s/he has PANDAS or OCD. But from what you describe s/he’s suffering badly. The most helpful thing you can do is to try to understand him/her. Once you do, your halfway there. You can be proactive and avoid triggers to unwanted behavior until this all settles down thereby lessening the amount of discipline needed and lead to a better atmosphere at home.
Most of all, refuah shleima bekarov. Make sure to take breaks when you can so that you can be strong for those that need you. Daven for guidance and Hatzlacha.