The information in this article is not medical advice. It is a selection of tips and strategies that I developed through personal experience as someone living with food allergy.
Revised and updated
The original post, Reaction PTSD and the Coping Strategies I Really Use, has continually been one of the most popular posts on EAF. As I recently have made great strides in managing my anxiety, I have decided to update the guide. Recently, I consumed something that had cross-contact with one of my allergens. I broke out into very angry purple hives, something that would have sent me into a downward spiral of panic only months ago. I knew that the hives were bad enough that if a second symptom developed, I would need to take my Epi Pen. Instead of panicking and acting out of fear, I implemented some of the strategies below (stop and control my breathing, affirmations, simple actions to pass time) and was able to determine that I needed antihistamines, water, to call my husband, and to monitor the situation while being prepared to act if necessary.
Find ways to relax while experiencing food allergy anxiety
For a long time, food allergies and mental health were not often discussed in the same sentence. Whenever I had a serious reaction over the years I'd be left with a lot of heavy feelings, I was developing obsessive habits and patterns, and I felt socially isolated and uneasy. As a teen I remember searching online for social studies done on people with food allergies; I wanted to know if others were feeling this way and if there was any research available on the topic. I wanted to be "a participant in a study" just so I could see the results. At the root of it I longed for validation from the medical community for what I was feeling.
What is reaction PTSD?
In this article I specifically want to talk about reaction PTSD. In January 2015 I suffered my most severe anaphylactic reaction and it changed my life forever. I'd had 5 reactions previously but none of them have affected me so deeply. It's even one of the reasons I started blogging; because I felt compelled to share my reaction story. I had eaten a piece of bread, the same bread I had bought weekly for the past several years, and suddenly went into anaphylactic shock due to undeclared casein (dairy). Whether the ingredients were contaminated or the recipe changed and was not updated on the packaging, I'll never know.
Once the drugs at the hospital wore off I immediately felt a sense of dread, fragility, and vulnerability. That feeling stuck with me for a long time. I couldn't bring myself to enjoy food anymore. I felt claustrophobic, anxious, and nervous every time I took a bite of something. I started looking at every meal like it could be my last, amplifying the risk to exorbitant proportions. I looked at anything packaged or from a restaurant as a death threat rather than just something to be careful around. And every time I was in traffic, on transit, or on a plane, I felt extremely claustrophobic and would feel faint. What if I had a reaction and couldn't get out?
There was a distinct line marking before the reaction, and after the reaction. Before the reaction I was able to enjoy restaurants regularly without being completely overwhelmed with fear. I didn't avoid social situations as often, I didn't skip travel, and I wasn't claustrophobic.
After the reaction I felt uncomfortable in any place that I could get "stuck"; the subway, airplanes, on the highway in traffic, elevators. Alcohol became a trigger for nervousness and worry. I completely lost trust for anything packaged that wasn't made in a dedicated allergen-free facility. I ate boiled potatoes and spinach for breakfast, lunch, and dinner for about a month. I was too scared to eat anything else. I'd buy a loaf of bread and let it go bad on my counter without taking a single bite. I felt like if I were the one to suggest we eat in a restaurant, then bad luck was more likely to strike and I'd have another reaction. I was suddenly superstitious.
It's now been several years since that reaction and I have made significant improvements mentally. I had a job that required frequent travel, and I feel in control of the situation, not anxious. I dine out with my family more often, I buy the occasional packaged safe treat, and I don't panic and think I'm having a reaction every time I eat. There were a number of things I did to help myself get to this place...
Ways to find calm
Meditation: Learning to meditate has been extremely valuable on my road to recovery. You can listen to guided meditations online (Spotify, Sound Cloud, Youtube) or visit a meditation studio. The classes at Hoame, the meditation studio I frequent, go for about the same price as a yoga class. What I like about this practice is that it returns me back to “home base”; it grounds me, and helps me feel mental clarity and awareness of my body.
ASMR: Not everyone can experience ASMR, but if you can, you will appreciate how relaxing it is. ASMR videos have exploded on Youtube. Admittedly, some of them are quite odd, but once you get over it they can be very relaxing. There’s a misconception that they are sexual in nature, which they are not. Many people use ASMR to calm their anxiety. Each person has their own unique triggers too, so make sure you sample many videos until you find the ones that are right for you. Not sure what ASMR is? Think of it as simple visual and audio triggers that ignite goosebumps on your brain. The host of a video might tap a keyboard or a bottle of nail polish, whisper gently, or chop vegetables. My favorite channel is Gentle Whispering ASMR, hosted by Maria.
Breathing Exercises: Learning to control your breath is a helpful skill for when you feel an anxiety attack coming on. Anxiety can cause heavy and quick breathing, leading to panic and not thinking clearly. Gaining control of your breath allows you to recenter yourself and clear your mind so that you can think logically. Learn this skill through yoga or meditation practice.
Get involved in food preparations: If having to trust others to prepare your food makes you uncomfortable and anxious, put yourself in the kitchen. If at someone else’s house, don’t be shy about reading labels, asking what’s in recipes, or talking about cross contact. If you are comfortable enough, volunteer to help cook. The goal is to make yourself feel a sense of control in this situation, instead of being at the mercy of the cook who may or may not be familiar with food allergy. For kids, involve them in grocery shopping and food prep. Show them how you select ingredients, read labels, identify safe vs unsafe foods, and how to navigate the grocery store. Encourage them to sit and watch while you cook and give them small tasks to do, like peeling an orange or ripping lettuce. This will help them feel a sense of control while educating them about how to manage their allergies independently.
Reduce caffeine intake: I hate to admit it, but getting my daily coffee intake down to only one in the morning was a game changer for my anxiety. I use to consume countless cups of tea and coffee per day and my nerves were always fried. I gave up caffeine altogether for a few weeks (painful, but worth it) and then reintroduced one cup in the morning. It’s very rare that I break my rule and have a second cup, because I know that I am so much more relaxed without it. Reducing caffeine intake has helped with regulating my breath, panicking less, and feeling mental clarity.
Carry a chef card: The small act of carrying a chef card can help you feel in control when dining in a restaurant. One of my anxiety triggers is that after telling my allergies to a server, I always questioned if I forgot something or was clear enough as soon as they walked away. Handing over a chef card means you don’t have to worry so much about whether they heard everything or if it was all written down. It also communicates the severity of the allergy; I find servers and managers take my allergies more seriously when I present my card. On it, I outline common examples of the allergens and details about avoiding cross-contact. I keep a stack of printed cards in my purse at all times.
Conquer something that matters to you: Give yourself a boost of confidence by climbing your mountain. For me, it was that I always felt physically feeble and frail. My family and friends often joked that I was like Mr. Burns because I strained to carry groceries upstairs, and I once struggled to carry a cabbage home from the grocery store (my brother will never let that go). I decided that I would do eight weeks of barre class so that I could feel more physically powerful. After conquering those eight weeks, I felt like a new woman; grounded, in control, and strong. Your personal mountain doesn’t have to be physical. Think about what challenges you face or fears you want to overcome, and which ones you can conquer.
Connect with others in the allergy community: Talking about it helps. I used to feel like I was alone in this, but by connecting with others in my community I no longer feel socially isolated.
Exercise: I started taking spin class at least once per week, and doing yoga more often. Prior to the reaction I had already been an active person but I became much more dedicated after. Exercise is a great way to clear your mind, stay focussed, and feel in control. For you it might be jogging, swimming, or pilates. Whatever your flavor, exercise can help you regain the feeling of confidence.
Have a bath: Allow yourself time to relax alone. I like to have a bath every day or every other day. Whether I'm travelling or at home, it's my nightly ritual.
Read: Try reading in the bath (that's what I do). It's amazing how quickly time can pass when you're reading a good book. I find that getting really into a good book leaves me with more mental clarity. Specifically I like reading either a book about the restaurant industry (try Sous Chef) or anything by David Sedaris.
Essential oils: There is so much you can do with essential oils. Burn them in an oil burner (you can get these at The Body Shop or home accessories stores) before taking a nap, take a bit of eucalyptus or lavender oil and rub it into your temples and all across your scalp. The scents will help relax you when you're coming down from an anxiety attack.
Simple rituals like making tea: Personally I find that simple rituals help me feel calm. Heat the water, warm the cup, steep the tea, sip, relax. The warmth of the cup is comforting too. By the time this ritual is over I can affirm to myself that I've been sitting here for 20 minutes and have not had a reaction.
Podcasts: Have you ever tried an ASMR podcast or Youtube video? They're a little strange at first but if you just go with it they can really help you calm down. I also search for mindfulness meditations and deep sleep podcasts to listen to at any time. Just make sure you have headphones on to get the full effect.
Affirmations: If you start having an anxiety attack use logic to talk yourself down. Does my mouth feel itchy? Am I swelling up anywhere? Can I close my hands easily? Is my throat sore? Has anything happened to cause a reaction? Do I have hives? Did I read the label? Take a deep breath.
Alone time: Even if I'm in the middle of a party sometimes I just need a moment to be alone and repeat some affirmations. Step out of the room, go outside, or pop into the washroom. Give yourself space to be alone with your thoughts for a few minutes. I like to find a mirror to check my face quickly for hives or swelling. I'm always pleasantly surprised to see I'm not covered in hives. It's interesting how your mind can amplify your worries; sometimes you need to just see yourself so you can say wow I know I'm being ridiculous, then move on.
Therapy: Last year I told my allergist that I was interested in seeing a therapist to talk about my reaction anxiety. Honestly I thought he was going to say I was overreacting. I hadn't known any of my other allergic friends to ever seek out help, or maybe they just didn't talk about it. He told me that kids as young as 3 were going to therapy to learn how to manage their anxiety and that he could refer me to a few people who specialized in this type of treatment. I still haven't booked an appointment, but I know that if things get bad again I have somewhere to turn for professional help.
I hope you find these strategies helpful in dealing with your own anxiety.