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Managing Food Allergy Anxiety: 2 Conversations to Have with Your Allergist


Doctor taking to patient

Some people have told me that they feel intimidated about speaking up and asking questions at medical appointments for fear of feeling stupid or coming across as though they're questioning the doctor.


When I've shared these thoughts with my allergist and advanced practice provider friends, most tell me that they highly encourage people to ask any and all questions - even if they seem silly, because this leads to conversations that help families learn strategies for managing food allergies in a balanced way (that is - balancing fear and living fully).


Like my medical practitioner friends do, I encourage people to be proactive in getting their needs met at medical appointments, too.


More specifically, I encourage people to be empowered patients. Being an empowered patient includes thinking about what information would feel helpful to gain from your allergist, and then creating a list of topics and questions to explore at upcoming appointments (or even making an appointment specifically for those discussions).


After all, the information you gain from conversations with your allergist and allergy care team sets the foundation for how you'll navigate life with food allergies, so don't be shy about speaking up and advocating for the information you feel you need!


So, are you talking with your allergist about the following 2 topics, which will help you with managing food allergy anxiety?


  • Learning how to accurately assess allergen risks so that you can determine what experiences are safe enough or too risky.


  • Learning how to differentiate between anaphylaxis and anxiety.


Your allergist has likely taught you basic food allergy management skills, including label-reading and how to use your emergency action plan and epinephrine autoinjectors, but the skills you'll learn from discussing these two topics will help you feel even more confident about navigating life with food allergies.


Maybe your allergist has already discussed these topics with you and taught you these skills - and if they have, I'm thrilled!


However, if these two topics aren't already being discussed, I highly recommend that you bring them up with your allergist because the information you'll gather from these conversations can directly help with managing food allergy anxiety and fear.


Let's explore each in more detail...


Friendly doctor talking with patient

Conversation 1: How can I accurately assess allergen risks so that I can determine what experiences are safe enough or too risky?


Based on some of the things you read online, one might assume that people living with food allergies are constantly living in fear and that every experience outside of the home is very risky and unsafe. Yet, neither are accurate since things, especially with food allergies, are rarely "always" or "never" - and research data backs that up even if social media might suggest otherwise.


Even if those living with food allergies aren't living in constant fear, they can and do experience food allergy anxiety and fear in various situations. That's understandable.


And yes, there are going to be food allergy safety risks associated with life experiences, particularly ones that involve food. That's why it's important to learn how to accurately assess allergen risks - so that food allergy anxiety and fear don't take control and push you to avoid experiences beyond what is necessary.


Managing food allergy anxiety involves:

  • Recognizing it and noticing how it impacts your functioning and quality of life

  • Learning skills and strategies to help you manage it

  • Practicing these skills and strategies to increase your competence and confidence


Sure, there are basic food allergy safety guidelines to follow that will help keep you safe, but when food allergy anxiety and fear enter the picture, everything can suddenly seem unsafe - even things that you know are safe enough.


What's more, not everyone with the same food allergy as you has the exact same allergy profile. Also, they may choose to manage their food allergy differently than you do. In fact, there are lots of variables that impact how people manage and navigate life with food allergies, including:

  • Allergic reaction history and triggers

  • Risk tolerance and avoidance preferences

  • Anxiety and fear levels, and their impacts on daily functioning

  • Lifestyle and/or level of desire to enjoy a variety of life's experiences

  • Willingness to (safely) step outside of comfort zones

As such, assessing allergen risks is a very individualized and nuanced process. That's why it's crucial to ask your own allergist how you should determine risk levels in various scenarios rather than making your risk assessment decisions based on information you may find online. (Even if the information is from evidence-based sources, you should still discuss it with your own allergist to determine if it's useful information for you specifically).

Discussing with your own allergist how to accurately assess allergen risks and determine what's safe enough or too risky is important because it:

  • Ensures you're receiving evidence-based guidance

  • Allows you to receive personalized guidance based on your allergy profile

  • Teaches you skills to evaluate various scenarios and situations so you're less likely to assume everything is too risky (and then avoid experiences beyond what's necessary)

Not sure how to approach this topic with your allergist? Here are 4 helpful strategies:

  • Discuss a specific scenario or upcoming experience and ask your allergist how to determine if it's safe enough or too risky.

  • Create a list of experiences you perceive (assume) to be unsafe or not safe enough, and ask your allergist for guidance to help you determine if your anxiety is making you believe the experiences are unsafe or if they're actually unsafe.

  • Ask your allergist for the latest research data on experiences that are commonly perceived to be unsafe (e.g. eating out, airplane travel, just being near allergens).

  • Ask your allergist to address your fears about anxiety-inducing topics such as airborne and contact reactions so that you can discuss your specific allergy profile and determine whether you're at high risk for airborne or contact reactions.



Compassionate doctor talking with patient

Conversation 2: How can I differentiate between anaphylaxis and anxiety?


The topic of how to differentiate between anaphylaxis symptoms and physical sensations of anxiety comes up frequently within the food allergy community.


The truth is, differentiating between the two can be difficult and confusing since symptoms sometimes feel similar. Differentiating between the two requires consideration of a number of factors, which is why having this conversation with your own allergist is so important.


Your allergist will be not only be able to share evidence-based information about the differences/similarities between symptoms of anaphylaxis and physical sensations of anxiety and panic, but they'll also be able to offer you individualized guidance on navigating the uncertainty.


Other benefits of having this conversation with your allergist includes:

  • Having a personalized discussion about how anxiety physically shows up in your body

  • Strategies for determining which you're experiencing, and specific guidance on when to use epinephrine

  • Exploring whether you'd benefit from a referral to a mental health professional to learn strategies for managing anxiety


Since anything that includes or even touches on medical guidance is outside of my professional scope as a licensed therapist, and because I feel so strongly that people need to have this conversation with their own allergist (rather than basing their assessment on online content, even from evidence-based sources such as The FAC), I'm not going to attempt to share specific guidance about anaphylaxis versus anxiety.


Rather, I will once again encourage you to have a personalized discussion about this with your allergist. I will also share an important disclaimer that many of my board certified allergist friends have shared:


If you're unsure if what you're experiencing is anaphylaxis but think it could be, don't hesitate to use your epinephrine autoinjector and contact your allergist and/or emergency services.


With that said, I will share (2) helpful questions to ask yourself if you're trying to determine if what you feel is anxiety-related or not:

  • Did I recently eat, and if so, was it a new-to-me food?

  • How does anxiety show up in my body, even in situations that have nothing to do with food, and does this feel similar to those sensations?


This last point is important - knowing how anxiety physically shows up in your body.


It's very helpful to understand how your body responds to stress and anxiety, so take time to notice this even outside of a potential anaphylaxis scenario. Notice what happens within your body when you think about something that makes you feel nervous at work or at school, and take note. The more insights you have on this, the better able you'll be to accurately assess what you're experiencing. These insights will also be very useful in your discussions with your allergist.


One final note on the topic of anaphylaxis versus anxiety symptoms: I'm excited to share that I'm leading an educational project on this very topic at the national level which will result in evidence-based and practical information for the community in the future. Be one of the first to learn when it becomes available -- and get all of my other important updates and tips -- by signing up for my emails via the link below!



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