Mental Health and Living with Food Allergies
Living with food allergies involves uncertainty, unpredictability, and worry over accidental exposures. It also requires a balance of vigilance and preparedness. So, it’s no surprise that people with food allergies develop anxiety and stress. For many, living with the condition can be overwhelming.
When adapting to a food allergy routine, ensuring safety can feel like a struggle. You must determine how to balance fear and health-related quality of life. Ideally, families develop a relaxed readiness approach to life with food allergies. This means they are vigilant and ready to address emergencies – but also able to function well. They can engage in meaningful experiences, too.
Avoidance can help prevent allergic reactions. However if you engage in avoidance beyond what’s needed, it can impact mental health. In some cases, excessive avoidance can affect your ability to function. It can cause:
- extreme isolation;
- extreme restrictive eating patterns;
- anxiety about possible future reactions.
It’s important for children, teens, and young adults to develop food allergy management skills. These skills should be age-appropriate, so they meet normal development milestones. Adults must learn to navigate life experiences while maintaining connections with others.
Mental Health and Well-Being of Living with Food Allergy
Here’s what research tells us about living with food allergies and the balance between fear and quality of life:
Children with food allergy do not have higher rates of anxiety disorders than those without food allergy. But children with food allergy do experience higher levels of distress and worry about food allergy. They may also have anxiety about allergy safety when not with their parents.
Post-traumatic stress symptoms (PTSS) may occur after anaphylaxis. They may also occur when the stress of an unpredictable exposure to food allergens is too great.
Parental anxiety and a child’s attitude toward food allergies may function as risk and resilience factors.
It’s helpful for parents to be mindful of the messages they convey about food allergies. Are you:
modeling anxious behavior?
restricting my child’s ability to explore situations independently (beyond what is necessary)?
Transitions to adolescence can be difficult due to developmental changes. These changes may include:
- increased independence
- peer pressure
- potential risk-taking behaviors
Each of these changes can cause parents to worry more about their teen’s food allergy safety. Meantime, teens tend to internalize stress. Their perception of how food allergy affects their life can differ from parents.
Adolescents and teens 10-16 years old with food allergy are more likely to have symptoms of generalized anxiety. They may also have separation anxiety, anorexia nervosa, and depression. Adolescents with food allergies report lower self-esteem.
Nearly 1 in 5 adults in the United States believe they have a food allergy. However, only 1 in 20 are estimated to have a diagnosed food allergy. This suggests many adults may be engaging in unnecessary avoidance behavior.
In addition, many adults with food allergy who are at high risk of anaphylaxis do not have an epinephrine prescription.
Mental Health and Well-Being of Parents/Caregivers and Families
Parents often experience food allergy anxiety, general anxiety, worry, fear, sadness, and depression.
- 92% say they are always or occasionally fearful for their food-allergic child’s safety.
- 75% report fear and anxiety for their family.
- 25% report that food allergy causes strain on their marriage.
The stress particularly affects mothers. They are often managing the day-to-day aspects of food allergies. They report more anxiety, stress, and impact on their quality of life due to their child’s food allergy.
The severity of a mother’s anxiety, stress and depression is linked to a child’s ability to function and health-related quality of life. Doctors should routinely screen for maternal stress. This can identify children who are at higher risk for psychological distress.
Food Allergy-Specific Anxiety
Anxiety is a normal human emotion that everyone experiences. It often causes people to experience stress and future-focused worrying. Most people consider anxiety to be a negative emotion and try to avoid it as much as possible.
Even though anxiety feels uncomfortable, it can be useful. Anxiety encourages people to plan and prepare. These are key aspects of staying safe with food allergies. When anxiety starts to impact your daily life, that’s when you may feel overwhelmed.
Food allergy-specific anxiety tends to focus on specific phobias and fears. These often include:
- needle phobia
- allergen safety
- eating out
- allergic reactions and anaphylaxis
- using epinephrine
Mental health therapy can benefit people with food allergy anxiety. Cognitive Behavioral Therapy may be particularly helpful. It involves safe exposures to stress situations to reduce anxiety and increase confidence.
Children and adolescents who manage multiple anxiety disorders and medical conditions at the same time are at higher risk of mental health problems in adulthood. They may also have poorer health outcomes and more limitations in social activities.
Social Health Impacts of Living with Food Allergy
So much socialization happens around food. As a result, food allergies can impact social health. Social health is our overall well-being related to connection with others and community.
Food allergy-related bullying is common. Approximately 20-32% of children report experiencing food allergy-related bullying. Food allergy-related bullying includes:
overt bullying (such as forced exposure to or being forced to eat allergens)
covert, non-physical bullying (such as humiliation, teasing, and highlighting the food allergy)
Food allergy bullying is often under-reported. This may be due to uncertainty about what experiences fall into the bullying category.
In addition, 40% of parents report hostility from other parents when trying to accommodate their child’s food allergy.
Food allergy can impact people from racial and ethnic groups differently. It can cause increased symptoms of social anxiety, particularly in children of lower socioeconomic status.
Managing the Stress of Food Allergy
It’s normal to experience stress when managing a food allergy. It’s especially prevalent…
- during the months after a food allergy diagnosis;
- after a food-allergic reaction;
- any time you or your child enters a new age and stage of development.
What is stress and how does it feel?
The American Psychological Association shares the following about stress:
- Stress is a normal reaction to everyday pressures. Stress can become unhealthy when it upsets your day-to-day functioning.
- Stress involves changes affecting almost every system of the body. It can influence how people feel and behave.
This means that when you experience stress, you may notice that emotions feel more intense. Others may notice that you seem more irritable, angry, impatient, tired, or overwhelmed.
You may notice uncomfortable physical sensations. These sensations may include:
- upset stomach
- low energy
- muscle tension
- rapid heartbeat
- sweaty hands
You might notice having racing thoughts, constant worry, poor concentration and a negative attitude about life. This may lead to not engaging in good self-care. It may lead to procrastination on work or school assignments.
Tips for Managing Stress with Food Allergy
Here are practical strategies to help you manage stress and reduce overwhelm:
Engage in Conversations
Talk with your allergist and/or food allergy care team about:
- Managing the food allergy on a day-to-day basis
- Understanding and learning how to consider safety risks
- Navigating food allergy anxiety and the feeling of overwhelm
- Identifying knowledge you need, but don’t currently have
- Identifying reliable sources of food allergy information online
Talk with your child or teen about:
- Their feelings about living with food allergies
- Allergy management for their age/stage of development
- Age-appropriate food allergy management skills
- How to identify and treat an allergic reaction
- How to navigate social scenarios within your child’s age/stage of development
- How to develop self-advocacy skills, especially if your child is shy
- What information or skills can help you manage food allergy effectively and confidently?
- What life situations cause food allergy-related stress? What possible solutions are available?
- Do you often find yourself searching online for answers to food allergy questions? If so, then it’s worth asking the question to your allergist.
Engage in Perspective-Taking
Consider where you’re at in your food allergy journey. Are you recently diagnosed? Are you undergoing a new major life transition? With time and experience, you’ll feel more confident about managing your food allergy.
In addition to food allergy safety, identify what else feels important to you. Think about ways to be safe and do these other important things.
For parents: consider your child’s age and stage of development. Remind yourself that it can feel harder to manage food allergy in some stages than others. Meet yourself with self-compassion and kindness.
Simplify, Educate, and Delegate
- Educate others in your family so they can offer support.
- Break allergy management tasks down into smaller tasks. This can make them feel more manageable.
- Delegate tasks to others whenever possible. Decrease your mental load. This can also help others work on their allergy management skills.
- Set boundaries that help you stay safe. Focus on what’s most important to you.
Practice Stress-Management Strategies
Try the following breathing and mindfulness exercises to help calm the mind and body:
When to Talk with a Mental Health Professional
Reach out to an allergy-informed mental health professional when…
- You are newly diagnosed and want to learn how to manage food allergy anxiety.
- You are not able to adjust well to life with food allergies.
- Living with or worrying about food allergies impacts your daily functioning.
- Food allergy-related anxiety is keeping you from enjoying things.
- Your anxiety levels aren’t decreasing months after an allergic reaction.
- Fear and worry interfere with your sleep and eating patterns.
- You engage in avoidance and restrictions beyond what is necessary.
- You have thoughts of harming yourself or others.
How to find a therapist who can offer guidance on food allergy? Visit The Food Allergy Counselor Directory. You can also locate a mental health professional by:
- asking your allergist for a referral
- checking with your local food allergy support group
- using the American Psychological Association’s Psychologist Finder
- using the Anxiety and Depression Association of America’s Therapist Finder
Other conditions that may look like food allergies or co-exist with food allergies?
See Related Pages
- Food Allergy Treatment & Management
- Mental Health and Living with Food Allergies
- Living with Food Allergies
- Food Allergies and Food Insecurity in America
- What Can You Do If You Can’t Afford Allergen-Free Foods?
- Planning for School with Food Allergies
- Peanut Allergy Treatment
- Alpha-Gal Syndrome and Meat Allergy
- Milk Allergy: Causes, Symptoms, Diagnosis & Treatment
Tamara Hubbard, MA, LCPC
Licensed Clinical Professional Counselor
Founder & CEO, >The Food Allergy Counselor, Inc.
Allied Health Member of AAAAI and ACAAI
Purvi Parikh, MD, FACAAI, is an adult and pediatric allergist and immunologist at Allergy and Asthma Associates of Murray Hill in New York City. She is on faculty as Clinical Assistant Professor in both departments of Medicine and Pediatrics at New York University School of Medicine.