The relationship between anaphylaxis and anxiety in children and youth was studied by psychiatric professionals at the University of Toronto.
The researchers concluded that kids with anaphylactic conditions can function well despite anxiety if the following four aspects of anxiety are addressed:
- Physiological (physical anxiety symptoms)
- Cognitive (psychological distress, worry)
- Behavioral (usually avoidance or activity restriction)
- Parental (involved in a constructive way)
Successful management of a child’s anxiety requires treating the aspect, or aspects he or she most demonstrates.
Physiological Anxiety Aspects
Some children develop physical anxiety symptoms such flushed skin, difficulty breathing, hyperventilation, a sense of panic, or loss of consciousness. These symptoms can mimic an anaphylactic reaction—when in doubt the child must be treated for anaphylaxis. However, in situations where risk of allergen exposure is low, anxiety should be suspected.
Kids with physical symptoms of anxiety benefit from learning relaxation techniques such as slow, deep breathing, mindfulness meditation, or progressive muscle relaxation. “Belly breathing,” for instance, can easily be learned from a delightful children’s book, Sea Otter Cove: A Relaxation Story, by Lori Lite.
After using a relaxation method to calm their anxiety, it is recommended children return to their usual activities soon as possible. This distracts them from dwelling on any lingering symptoms, and prevents the establishment of avoidant behavior habits.
Cognitive Anxiety Aspects
Children with or without physical symptoms of anxiety can experience cognitive anxiety, or distressing worry. Because anaphylaxis is a life-threatening event, reassurances that minimize the risk are seldom helpful.
To reduce worry, education and planning should focus on a child’s ability to manage the risk and increase their own safety. Children are helped by engaging in age appropriate practices such as reminding care givers to read product labels, and helping to eliminate allergens from the home. Knowing when and how to ask for help is a skill that children can learn and practice.
Parents can help diminish worry by making sure that the same allergy precautions taken at home are followed at school and other family member’s homes. The use of epinephrine auto-injectors may also allay children’s fears.
Regular reviews of anaphylaxis risk, precautions, and emergency management are recommended with adolescents to reduce typical teen risk-taking behaviors, and it facilitates the inevitable transition from parental allergy management to young adult self-management.
Behavioral Anxiety Aspects
Though some worry about anaphylaxis is natural and can be protective, too much may cause children to restrict their activity. This behavioral aspect of anxiety usually involves excessive reliance on the parents, or the avoidance of certain situations or foods.
Children with anaphylactic conditions may, for instance, severely restrict their food intake beyond what is necessary, avoid specific foods despite a negative food challenge, or avoid social situations where food is served - even when precautions are in place.
Addressing anxiety behaviors generally requires the daily practice of taking a small step toward the problematic food or situation. For example, to address unnecessary food restriction, children can assist with food preparation before being asked to eat an anxiety producing food. Taking small steps causes cognitive desensitization to the anxiety producing stimulus.
Once the initial small step can be accomplished with confidence, the child is ready for a second, slightly more anxiety provoking step—and so on. A mental health professional can help plan and implement a desensitizing process, when necessary.
Parental Anxiety Aspects
If children will manage the behavioral, physical, and cognitive symptoms of anaphylaxis anxiety, the researchers caution that parents need to channel their own anxiety in constructive ways.
What is meant by “constructive ways” are the things many of you are already doing, such and educating yourself about food allergy, making sure your child is safe at school, learning to use an auto-injector, and helping older children transition into allergy self-management.
However, parental anxiety can run high when a child is at risk for anaphylaxis, and using that anxious energy constructively may not be enough to manage it. Consider seeking professional help if your anxiety is interfering with concentration, sleep, or is depleting your energy.