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CHILDHOOD ALLERGIES: UNDERSTANDING ANXIETY

Imagine you are out walking and come across a snake. What might your reaction be? You might feel anxious and scared, adrenaline rushing into your bloodstream, both of which are our bodies’ normal response to threat or danger. As a consequence of this, we are likely to experience sensations such as increased heart rate and blood pressure, butterflies in our stomachs, shortness of breath, sweating and dry mouths. Our bodies are programmed to respond in one of three ways; fight, flight or freeze. Because our bodies have been so well programmed, sometimes we respond in this way even if we don’t really need to, for example, when the threat or danger is in our heads rather than in real life.

It is this fear of a potential threat or danger, or the thought of something negative happening in the future, which is the essence of anxiety. We all feel anxious from time to time and a certain amount of anxiety can be helpful in focussing our minds or helping us prepare (e.g. think about a job interview). In the context of allergy, having a certain amount of anxiety also helps to keep us and our children safe.

However, anxiety can become intense for some, leading to restrictions in daily life. Those of us who feel anxious are more likely to be hypervigilant meaning we are constantly on the look out for threat and danger or for signs of those bodily sensations. When we notice those anxious feelings, both the psychological (such as feeling scared, worried or frightened) and the physical (such as increased heart rate, butterflies or sweating), we question our ability to cope which makes us feel more anxious. This is usually referred to as the vicious cycle of anxiety (see example below for common thoughts, feelings and behaviours for parents who might be trying to wean).

STOPPING THE VICIOUS CYCLE OF ANXIETY

We now understand that avoidance and safety behaviours maintain our anxiety, so how could we put an end to the vicious cycle of anxiety?

Identify our triggers - If we can understand and see a pattern to what, when or with whom we are more likely to feel anxious, we might be able to respond differently

Confront our avoidance and safety behaviours - Make a list of things or places you have been avoiding. Start off small and work your way up (see our Weaning Your Food Allergic Baby guide, page 30, for information on graded exposure and fear ladder/hierarchy). Also, make a list of your safety behaviours and begin to drop these in situations where you would normally feel anxious. Again take a gradual approach working through these over time. It is normal to feel uncomfortable whilst you are using these approaches, but over the longer term it will help you take control and feel less anxious.

More balanced thinking - Another technique used in cognitive behavioural therapy is called cognitive restructuring. As seen in the vicious cycle of allergy, our thoughts feed into our feelings and together they drive our behaviour. Negative thoughts, such as “I’m a bad parent because I can’t get my child to eat” often stay with us because we stop checking them. To combat these negative automatic thoughts, we can ask ourselves questions such as “what is the evidence this thought is true or real?”. After reviewing the evidence, consider an alternative thought which is more balanced such as “just because my child won’t eat a certain food, doesn’t mean I’m a bad parent”. Coming up with some coping and positive self- statements may act as a helpful reminder.

Manage the physical sensations of anxiety - Shallow breathing and tense muscles are linked to stress, worry and anxiety so try the following techniques to try to combat these. The more you practice these, the more effective and quicker they will work. Also try using these techniques when you are not anxious – the goal of these relaxation techniques is not to avoid or eliminate anxiety but to diffuse the bodily sensations:

• Try mindful and calm breathing – consciously slowing down your breath and breathing deeply and gently
• Muscle relaxation - try squeezing or tensing muscles in your body
• Exercise – try going for a walk, run, swim, cycle or yoga. Or something which exerts some physical effort such as gardening or housework

AVOIDANCE AND SAFETY BEHAVIOURS AND HOW THESE MAINTAIN ANXIETY

Whilst we know that avoiding things (such as avoiding weaning our child or avoiding certain social situations), might help us cope in the short-term and make us feel less anxious at the time, this doesn’t help our general feelings of anxiety and may contribute to longer term feelings of guilt and stress. By not challenging those anxious thoughts, we are unable to disprove our negative or catastrophic predictions. Safety behaviours also serve to keep our anxiety going. Because we depend on them to make us feel better, we do not learn that distressing emotions (such as anxiety, worry and fear) will reduce and go away on their own.

DID YOU KNOW

Weaning an allergic baby
From fear, to anxiety to guilt, research shows parents undergo some degree of trauma during this process, up to and including diagnosed PTSD.¹ 

Nearly 1 in 12 children live with a food allergy and they seem to be getting more and more common.

References: 

1. Allergy UK’s survey of people who have experienced the challenges of weaning a food allergic baby (2019).