Food Allergy Anxiety – When Is It Time to See a Therapist?

Paige L. Freeman, PhD, PLLC, is a psychologist that has navigated her child's food allergy for the last 14 years. She provides telehealth services in 16 states to support others managing food allergies. To learn more, visit paigefreemanphd.com. 

Whether you have a food allergy yourself or are parenting a child who has a food allergy, I would like to take some time to commend you and acknowledge how hard it is. Please look over the following list of stressors you may have already dealt with. Chances are you also have additional stressors based on your particular situation.

• Food allergy reactions, including anaphylaxis
• Food allergy diagnosis
• Oral food challenges (OFCs)
• Repeatedly explaining the seriousness of the food allergy
• Extended family members not understanding the seriousness of the food allergy and refusing or neglecting to accommodate the food allergy
• Disagreement among immediate family members as to the degree of vigilance necessary
• Checking food labels, which can change without warning
• Repeatedly gauging whether a restaurant is safe
• Oral immunotherapy (OIT)
• Navigating food-centric holidays such as Thanksgiving, Halloween and Easter
• Planning vacations with the allergy in mind
• Feeling left out or not fitting in
• Missing out on activities because of worry about potential unsafe food situations
• Navigating conflicting information about how to keep yourself or your child safe
• Family system adjustment

Parents of children with food allergy experience additional stressors:

• Navigating school snacks, lunches, parties, and other food-centric activities
• Entrusting your child to others during childcare, birthday parties and play dates
• Sibling adjustment
• Family system adjustment
• Your child’s fears, anxieties and worries
• Your child’s transitions to new developmental stages
• Bullying of your child

This is quite a list. And many of these stressors are chronic, that is, they are ongoing issues.

Learning to navigate a food allergy is very hard, and it is not anything society has prepared us to deal with. Our brains are hard-wired to predict, analyze and be on the look-out for things that can harm us. It is how we stay alive. Having a food allergy is legitimately dangerous, and so it is expected and completely understandable that when you have a food allergy you will probably experience at least some degree of fear, worry and anxiety. But when your food allergy anxiety interferes with the person you want to be and the way you want to live your life, it becomes a problem.  

Here are some helpful questions to ask yourself:

1. Is my food allergy anxiety causing me to lead my life in a way that is not consistent with my values?*
2. Has my anxiety regarding food allergies triggered anxiety in other parts of my life?
3. Do I have the general mindset that I have the competency to handle my food allergy, or do I doubt my ability?
4. Do I find myself ruminating over “what ifs?” regarding the food allergy?
5. Am I living a rich and fulfilling life despite my (or my child’s) food allergy?
6. Is my anxiety about my child’s food allergy impacting my relationship with my child or other people?
7. Am I modeling a fear-based approach for my child?

^{*For example, you value social interaction and your anxiety surrounding your allergy has caused you to cancel social commitments. Or if you are a parent, you value patience and your anxiety has increased your irritability.}

When you may need some help from a food-allergy-informed therapist:

1. You are newly diagnosed, or your child is, and you would like to touch base on how to best navigate the allergy psychologically. 
2. Anxiety is increasing as time goes on.
3. Fear or worry is happening on a daily basis.
4. Your fear or worry is interfering with eating.
5. Your fear or worry is interfering with sleep.
6. You are finding it hard to concentrate on other things.
7. You are restricting food that does not contain (or have the possibility of containing) your allergen.
8. Your anxiety is disrupting your ability to live in a way that honors what you value. 
9. The anxiety is bleeding over into other areas of your life.
10. You feel overwhelmed by the thought of managing the food allergy.

Ideally, as your knowledge surrounding your food allergy increases and as time goes on, you will progress from a fear-based approach to your food allergies to a competency-based approach. In other words, as you gain experiences navigating the world with a food allergy, increasing your knowledge and skill set, you will begin to have confidence that you are competent to deal with what the food allergy may bring you. This does not happen overnight, and it is a process that can have setbacks when new stressors arise.  

If you have determined it is time for therapy, treatment with a food-allergy-informed therapist is important. Allergy-informed therapists understand the seriousness of food allergies and the unique stressors associated with food allergy management. They are well versed in effective strategies to help you manage your anxiety. If you're looking for an allergy-informed therapist in your area or state, visit the Food Allergy Counselor Directory, which has a growing list of therapists ready to help you.

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