LISA B. ROSENBERG
M.Ed., MSW, LSW, CSSW
As a licensed child and family therapist, Lisa provides food allergy counseling*, education, and support to individuals, families, and caregivers. She is the founder of Safe & Included, LLC and co-founder of the Food Allergy Behavioral Health Association (FABHA).
*under supervision of a licensed clinical social worker (LCSW)
Researchers estimate that 32 million Americans have food allergies, including 5.6 million children under the age of 18.1 A food allergy diagnosis can feel overwhelming and scary but it doesn’t have to be. As a licensed child and family therapist, I help individuals overcome their fears associated with food allergies so they can feel safe and included in all aspects of life.
Education plays a critical role in this—if we aren’t educated about food allergies, the fears associated with them can quickly add up and make a mountain out of a molehill. Whether a food allergy has impacted your own daily life, or you are helping your child navigate a new diagnosis, here’s what you should know about food allergy anxiety and how to get help if you are experiencing it.
Food allergy anxiety happens when the fear of coming in contact with an allergen and/or experiencing an allergic reaction interferes with a person’s ability to function on a daily basis. Food allergy anxiety can appear in anyone who has been diagnosed with a food allergy or suspects they may have a food allergy. Another aspect of food allergy anxiety involves the caregivers of food-allergic individuals who may be afraid to let their children do everyday activities, like go to school.
A key indicator of food allergy anxiety is if an individual is choosing to avoid certain things in an attempt to “stay safe” from their allergen, whether that’s not going to a friend’s house or avoiding playing sports. There are a few simple questions I like to ask to help determine if someone with a food allergy is experiencing food allergy anxiety:
If the answer to any of these questions is “yes,” it warrants further exploration into the symptoms a person may be experiencing.
The difference between food allergy anxiety and generalized anxiety disorder
Examining food allergy anxiety requires a holistic approach, especially when we look at the differences between food allergy anxiety and generalized anxiety disorder. From a psychological perspective, someone with generalized anxiety may say, “I’m so afraid of spiders, I don’t want to go outside.” You can often look at this situation and identify the irrational fears to talk them down. That’s a lot different than someone saying, “I’m afraid of food, I don’t want to eat.” While the fear of food may be rational for someone with an allergy, it can also be fatal simply because we cannot live without food.
As for symptomatic differences between anxiety and an extreme allergic reaction, such as anaphylaxis, these can be bucketed into six primary categories: onset, breathing, pulse, blood pressure, skin/mucosa, and abdomen/GI.
If you are wondering if you may be experiencing a panic attack or an allergic reaction, take a look at the physical symptoms you are experiencing. While in the moment, an anxiety attack might make you feel like you can’t breathe and you might die, but medically speaking, anxiety attacks are not fatal—whereas anaphylaxis can be. It’s important to differentiate as best you can and if you do recognize it’s anxiety, it’s a matter of calming down and taking steps to decrease that anxiety.
If it’s anaphylaxis, this is where preparedness matters and an emergency action plan comes into play. Even if the initial symptoms are mild, there is a risk that they may quickly turn into a serious and severe condition. You’ll want to use your epinephrine auto-injector immediately and then call 9-1-1 so you can be taken to the hospital to monitor additional reactions. Knowing what anaphylaxis might look like is important, so if you feel these symptoms come on, don’t be afraid to administer epinephrine and call for help. Research shows that it can’t harm you to unnecessarily use epinephrine if you feel you need it, but a delay in administration of epinephrine can be fatal.2
If you are experiencing symptoms of food allergy anxiety, there’s a wealth of information out there, but you must look in the right places. Googling information or seeking out answers in social media groups can often increase our anxiety. When we use these sources, we aren’t getting the most valid or credible information, and it’s typically information of the extreme. When we expose ourselves to extreme case after extreme case, we tend to start thinking that’s the “norm” which can substantially increase our anxiety.
Educational resources presented at the time of diagnosis can help relieve a lot of this anxiety and can often prevent it from starting in the first place. Food Allergy Research & Education (FARE) and The Food Allergy & Anaphylaxis Connection Team (FAACT) are reliable organizations that offer helpful information on their Newly Diagnosed pages as well as through their Food Allergy Field Guides. I also offer educational handouts on my website, including tips for how to reduce anxiety and how to read a food label. This type of information is critical for anyone navigating a new food allergy diagnosis and seeking answers to questions such as:
If you feel that you may need additional support for food allergy anxiety, The Food Allergy Counselor Directory is a state-by-state listing of food allergy-knowledgeable licensed clinical counseling professionals. NOTE: If none are listed in your area, look for a clinician who has experience with child anxiety and/or chronic illness and ask potential clinicians if they use Cognitive-Behavioral Therapy (CBT).
Diagnostics can also play a role in increasing anxiety or decreasing anxiety depending on how the results of the diagnostic are explained to the family, caregiver, or allergic individual. When my daughter received component testing for a peanut allergy, it was bittersweet. I was glad to be able to look at the peanut protein components and review the data, but I also asked myself, “Now what am I going to do with this information?” That’s why follow-ups are important. Once an individual knows the exact protein(s) they are allergic to, they can work with a healthcare provider to establish a plan for managing their allergy and living their life without fear
I often remind myself and my clients that, “Even though your food is limited, your life doesn’t have to be.” Whether you are learning how to navigate a new food allergy or sending your child to camp, kindergarten, or college, the most important thing we can do is stay educated. And it’s not just on the parents to do this—healthcare providers play an important role in easing our fears and setting up allergic individuals for a happy, healthy life today and tomorrow. When healthcare providers share up-to-date, reliable information on how to actually LIVE with this diagnosis, they empower and inspire hope in individuals and families living with food allergies. Because once you know how to navigate life with food allergies, you can do anything.
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