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Sunday, January 28, 2018

A Surprising Side Effect of Children’s Allergies: Anxiety

From Children's National
via The Washington Post

January 16, 2018

New research shows allergies take a toll on kids’ mental health.


“I can’t breathe.”

That’s the last thing 8-year-old *Alexander told his mother the night he went into anaphylactic shock so severe he had to be airlifted from his local emergency room to a children’s hospital.

Alexander, who has both asthma and a peanut allergy, recovered from the physical symptoms of his reaction in a few days. But the psychological ones lingered.


His mother, *Jennifer, recalls that her son’s personality changed. He went from upbeat and easygoing to inflexible and controlling. He would be left off birthday-party invitation lists. He stopped playing soccer and baseball. Playdates dried up.

“He pulled back. He no longer knew how to be part of the group,” said his mom. The school guidance counselor asked what might be happening at home. She wanted to know if there had been a divorce or a death in the family.

“It turned out that he was thinking about death,” said Jennifer. ”There was constant anxiety. He would accuse people of not being careful enough [with food]. He was scared something could happen and that he could have a reaction and go into anaphylaxis.”


Alexander’s fears weren’t wildly irrational. Unlike an imaginary monster under the bed, his worries couldn’t be easily dismissed. For him, ingesting even a trace amount of peanuts could be fatal.

There’s Help

Alexander’s story is not one of a kind. New research shows that children with food allergies are more likely to suffer from anxiety than children without them. Studies also reveal that symptoms of anxiety are relatively common in kids with anaphylactic conditions.

What can be done to help the 5.9 million children in the United States with food allergies, specifically those that struggle with anxiety? That’s the question the medical professionals in the Division of Allergy and Immunology at Children’s National Health System are devoted to answering.

“Throughout different developmental stages, it’s entirely normal for children with food allergies to experience fear, anxiety, and uncertainty as they begin taking more autonomy over their allergies,” said Dr. Hemant Sharma, the clinical chief of the Division of Allergy and Immunology at Children’s National.

“But when it seems anxiety is interfering with activities that a child would normally enjoy engaging in, that’s an indication to us that we’d want to have that family start seeing a psychologist,” said Dr. Sharma.


Children’s National is one of a handful of hospitals in the country having a dedicated psychologist on staff with a specialty in food allergies. Dr. Linda Herbert oversees the hospital’s psychosocial food allergy research team and works with patients and families to help them cope with the stress and anxiety that may be associated with a food allergy.

When working with a new patient, Herbert begins with “basic” allergy education. “I have found that since a lot of kids are diagnosed when they’re very young, they don’t necessarily have all of the information their parents had when they were diagnosed,” she said. “They were too young to understand it.”

Herbert may then engage in a variety of strategies with patients, including relaxation techniques as well as cognitive behavioral therapy, to help them recognize and challenge troubling thoughts as they occur.

Alexander, now 12, was a patient of Drs. Sharma and Herbert; his mother says she is grateful to them both. “[Treatment] gave us a language and an understanding of why all of the sudden he was so nervous. He learned to say, ‘Mom, I’m feeling worried,’ instead of acting out,” she said. “He is lighter. He is not isolating himself from his friends. He got his power back."

A Brighter Future

There have been a number of headline-making advances in the food-allergy world in recent years. One in particular—a treatment called ‘immunotherapy’—is showing promising results in trials throughout the United States. In immunotherapy, patients are gradually given larger amounts of foods to which they are allergic to desensitize them to the allergens.


In addition, new guidelines from the National Institute of Allergy and Infectious Diseases advise parents to give peanut protein—in puree or paste, but not nut, form—to infants as early as 4 months old to help prevent the development of an allergy. (Parents with infants who have an egg allergy or severe eczema should first talk to their healthcare providers.)

Remarkably, even for those babies who may have positive allergy tests to peanut, there’s hope to reverse it through this early exposure.

“It’s an exciting time,” said Dr. Sharma. “I think all of us have a lot of hope for what the future holds.”

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