There was a time when Marnie Miller’s heart would race anytime the phone rang. Her son, Luke, had been diagnosed with life-threatening allergies to peanuts and tree nuts at only eight months old, and for years every phone call could only mean one thing: bad news.
Before having even picked up the phone, Marnie would have figured out how quickly she could make it to the hospital, who to notify and how much gas was in the car. Fortunately, she never got that scary call, but it wasn’t until her son was halfway through elementary school that she stopped expecting the worst each time the phone rang.
It's not uncommon for parents of kids with food allergies to live with some form of anxiety. Jennifer G. McKechnie, a social worker who specializes in children’s mental health, says anxiety can manifest in physical symptoms, like a pounding heart or an upset stomach, or it can be experienced inwardly, with intrusive thoughts or an inability to focus. But while symptoms of anxiety range dramatically from person to person, the trigger tends to be the same: fears about future events you can’t predict. If and when your child will have their next anaphylactic reaction is a universal worry for parents of kids with food allergies.
So many things can trigger this anxiety to rise up: mysterious crumbs on park benches, unwashed hands, ambiguous labelling, servers who are too quick to assure patrons a food is “safe,” flights that have allergens onboard, and birthday parties with unmarked foods.
Megan Crowley, a clinical therapist with a focus on children’s mental health, says that reading labels, educating friends and family, having an emergency plan in place, and always having EpiPens on hand gives parents of kids with allergies a feeling of control, which in turn helps minimize uncertainty and ease anxiety.
In Marnie’s case, she and her husband avoided high-risk activities, such as going out to eat or flying on an airplane. Luke didn’t step foot inside a restaurant until he was five years old, and rather than risk travelling by air, they invested in a travel trailer so that they could prepare their own safe meals during family road trips.
Of course, you can never control a situation completely, and taking extreme precautions could be a sign that the anxiety is getting out of hand. McKechnie says it’s time to see a professional if you are experiencing constant worry that is impacting your ability to function on daily tasks, or if you’ve lost interest in taking part in activities or social outings you once enjoyed. Crowley does not recommend regularly opting out unless the risks are too high to safely participate. She encourages parents to take steps to reduce their anxiety because anxious behaviours can be passed on to kids. “Children’s behaviour is often modelled after their parents, especially younger children,” says Melissa Lieberman, a psychologist at the SickKids Eating Disorders Program.
For parents, journalling, meditation, yoga, nature walks and exercise can help minimize stress. Food-allergy therapist Samara Carroll says that parents who are struggling with anxiety could benefit from cognitive behavioural therapy, which challenges unhealthy thinking patterns. For example, if a parent’s fear of their child having an anaphylactic reaction means avoiding a previously safe eating spot, she’ll have them weigh probability versus possibility (where they determine the likelihood of a reaction occurring based on previous experiences).
To prevent passing on fears to your child at mealtimes, commit to chatting with your spouse and asking your kids about their day rather than looking for signs of a reaction. If you find this to be difficult, Crowley recommends giving yourself an internal pep talk: Go over the list of safe ingredients in your head, notice where the nearest EpiPen is located, and remind yourself that you have life-saving medicine in the event a reaction does occur.
Carroll says that if you let anxiety dictate your actions, such as choosing not to attend a get-together for fear of encountering an allergen, your child may end up following suit and miss out on socializing with their peers.
Don’t beat yourself up if your child does end up with some food-related anxieties. “It’s not uncommon for children living with this sort of additional stress to be affected physically, mentally, and emotionally,” says McKechnie. “Kids don’t necessarily have the verbal skills to talk about how they are feeling, but they may show signs of stress through behaviour, physical symptoms, or emotional regulation.”
Some behavioural red flags may include hesitation at mealtimes or a flat-out refusal to eat, while physical manifestations of anxiety can show up as a sore tummy or headache. Carroll sees this in many of her young patients. Some are too anxious to eat unless their meal is prepared and served by one of their parents (usually the mother), while others have experienced panic attacks with symptoms that are similar to an allergic reaction. This can happen before a meal, after eating out, or if they see unknown or new foods in the cupboard.
For children who are having a hard time regulating their emotions, this may be exhibited through sudden outbursts, difficulty sleeping at night, or social withdrawal. Many of Carroll’s patients are “avoidant eaters,” and are too fearful or anxious to join their friends in the cafeteria at lunchtime.
If you notice physical, behavioural or emotional changes that are of concern, your child might benefit from talking to a therapist. Carroll uses cognitive behavioural therapy to help children with food allergies overcome anxiety that is spiralling out of control. Techniques like belly breathing, visualizations (where they visualize their anxiety and begin to recognize it as separate from them), and fear ladders (where they rank fears from mild to severe to devise steps for confronting those fears) arm these children with the tools they need to cope, and in turn, participate in daily life. The good news is that therapy doesn’t necessarily have to be long-term. “I usually notice an improvement after six to eight sessions,” says Carroll.
Parenting a child with food allergies comes with its fair share of worries, no question. But if you’re starting to feel like anxiety is taking over, for yourself or your child, give yourself permission to put mental health first, whether that means carving time out for self-care or investing in some counselling sessions.