This article was written by: Tamara Hubbard, MA, LCPC, Licensed Clinical Professional Counselor; CEO, The Food Allergy Counselor
Living with a life-threatening food allergy often feels unpredictable and uncertain. Navigating thoughts of “Will I have an allergic reaction? Will it be anaphylactic?” can trigger food allergy anxiety, which for some, leads to over-avoidance of life experiences. Parents of kids exhibiting food allergy anxiety often reach out to behavioral healthcare providers when that anxiety gets in the way of functioning. Some common examples are:
Do any of these statements sound familiar to you? Especially if you’ve noticed your child is anxious about their food allergy, these five general anxiety reminders for parents will be useful to incorporate in order to effectively address and manage food allergy anxiety.
Wouldn't it be great if we never felt anxious or worried? It sure would! However, that's not a realistic goal, so don't try to remove or avoid everything that produces anxiety for your child. The best way you can help your child navigate anxiety is to help them learn to accept its presence, better understand it, and develop skills to manage it.
Part of understanding anxiety is not only learning about our thoughts and feelings, but also the physiological sensations often associated with the emotions. By gaining this understanding, it allows for the development of more personalized skills that will help your child manage their own anxiety. Additionally, focusing on managing the anxiety (rather than avoiding it) often demystifies these thoughts and feelings, which leads to decreased frequency and intensity of anxiety over time. It's also important to teach our kids that anxious feelings can be a positive tool, reminding us to assess risk, and motivating us to cope in order to make it through uncomfortable situations.
Your natural instinct when you see that something makes your child anxious may be to remove them from the situation, and maybe even avoid similar situations in the future.
While it's important to avoid unsafe situations when managing food allergies, if you find that you and your child are shying away from most activities, you may need to explore perceived versus actual risk levels with your allergist. Do all of the situations you’re avoiding truly have high enough risk that they need to be avoided completely, or can you reassess the risk levels for some situations?
Why is it important not to simply avoid all situations that evoke anxiety? Because it can actually increase anxiety, and sends a message to your child that the solution to anxiety is to avoid, leave, or simply ignore the feelings. Approaching anxiety this way robs them of the opportunity to learn how to navigate these feelings, build tools to become more resilient, and eventually gain confidence in handling tough situations - all of which helps decrease anxiety.
It’s important not to make promises to your kids that aren’t possible, as this can impact trust in the parent-child relationship. Therefore, you can't promise your kids that they will never be faced with anxiety-provoking situations, and that they won’t come face-to-face with their allergen. You also can’t promise them that they won’t ever experience an allergic reaction. But you can promise them that you are prepared with your emergency action plans and epinephrine, and have educated those around them (such as teachers). You can also promise them that you won't put them in situations they feel nervous to navigate without preparing them and getting their permission first.
When they express fears or worries, promise them that you are there to deal with these feelings together as a team. Remind your child that they will learn how to navigate their worry and in time, will likely even become braver than it!
When your child (or you, for that matter) feels a lack of control, it can fuel anxious thoughts and feelings. Therefore, it's crucial to emphasize the skills your child has in their allergy management tool kit to navigate and cope with situations, rather than focusing on the fear.
Practicing food allergy safety skills often with your child will increase their confidence in their ability to handle anxiety-provoking situations. If your child presents with the "What ifs" often, use these as opportunities to talk through the scenarios with them. By exploring situations ahead of time, it reminds kids which tools they can use to navigate worrying situations, and which skills they have to manage their emotions.
Parents also need to learn how to reinforce skills and not fears in those crucial real-time moments. Rather than responding to your child's anxiety with phrases like "Don't worry" or "Everything will be fine", use messages that reinforce your child's ability to manage the uneasy feelings. When faced with that upset tummy, rather than trying to reassure them with "I'm sure it's nothing" or even joining right in with their worry, use a skills-focused approach. Try saying, "Upset tummies are no fun! Let's use our private investigator skills to figure out why it might be bothering you?" (And then follow up with a team investigation together).
When your child won't eat at the restaurant, instead of focusing on and inadvertently fueling the emotion by saying "Are you worried? Is your tummy upset?", focus on using skills by saying something like "I wonder if we should review our safe restaurant eating tools again to make sure we've used them all? Remember when we ate at [insert restaurant] - we used all of these tools and we ate safely." (You can even have a safety checklist handy for your child to use at restaurants).
There's no way around this one - your child watches how you manage (or don't manage) your own fears, worries, and anxiety. They key into your words, your tone and body language, and your actions. Most kids are typically skilled enough to pick up on the discrepancies, too. If you say you aren't worried, yet your child always overhears you talking to a friend about how anxious you are that a reaction will happen, it sends mixed messages.
Does that mean parents aren't allowed to have anxiety or fears? Absolutely not (refer back to #1, which applies to kids and adults alike!). Parents, especially those with kids managing food allergies, often have elevated levels of anxiety, especially in certain triggering situations. It's okay to be honest about feeling anxious or worried as a parent, but learning how to cope with these emotions and practicing what you are preaching is absolutely crucial. Showing your child that you're tolerating and accepting your own stress and using healthy skills to manage your own anxiety will help them learn and adopt these skills, too.
If you feel you or your child are not managing food allergy anxiety and fear well, please consider reaching out to a behavioral healthcare professional for support. You can locate a food allergy-informed therapy provider via the Food Allergy Counselor Directory. You can also find allergy-specific therapeutic worksheets on The Food Allergy Counselor website.
[This article was also published in the Fall/Winter 2019 edition of Coping with Allergies & Asthma Magazine, both online and in print]