Don't Let Food Allergy Anxiety Decide Your Holiday Plans

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Do you know that children's book, If You Give a Mouse a Cookie by Laura Numeroff?

The story starts off with a boy giving a mouse a cookie, who then asks for a glass of milk. This then leads to a series of other requests and fun activities, eventually coming full circle with the mouse asking for another glass of milk.

The “if that happens, then this happens” flow of that story reminds me of how allergy parents’ minds often zig and zag their way through the anxiety and stress of making decisions about attending holiday gatherings.

“If we go to Grandma’s house for the holiday dinner, then we’ll have to be around our allergens, which feels unsafe.”

“If we’re around our allergens, then we’ll have to be on guard the whole time, which will feel very stressful.”

“If it feels very stressful, then why are we even going? Maybe we should just stay home.”

When navigating life with food allergies, it often feels easier to avoid experiences that make you feel anxious and include any degree of risk, such as eating at someone else’s house. After all, safety and predictability are what the mind wants in order to feel more secure and less anxious. That’s why it feels like a relief when your mind settles on the thought, “Maybe we should just stay home.”

Yet, even though it feels safer to automatically opt out of holiday gatherings that make you feel anxious, ask yourself how the decision to avoid them just to calm your own food allergy anxiety impacts your family’s quality of life and relationships.

It often negatively impacts both when overgeneralizing that most experiences outside of the home are too risky and unsafe just because they make you feel anxious.

This is why I encourage families managing food allergies to make decisions about holiday gatherings (and all life experiences) on an individual basis, and by mindfully evaluating risk levels based on a number of factors, rather than automatically deciding that experiences are too unsafe because they feel anxious about attending.

The following three tips will help families with food allergies navigate the decision-making process about attending holiday gatherings in a way that’s based on thoughtful reflection rather than anxiety.

Explore actual versus perceived risk levels.

Anxiety likes to overestimate risk levels, assume worst-case outcomes, and underestimate your capability to navigate challenging situations effectively and safely. That’s why it’s important to evaluate the actual risk level of each individual holiday gathering rather than letting your anxiety’s risk perception drive your decisions.

To help you explore actual versus perceived risk levels of holiday gatherings:

• Consider if and how these experiences can be made safe, or at least safe enough, for your family to attend.

• Discuss your food allergy safety protocols with the host to explore if they can safely accommodate them, and if so, decide if you feel comfortable enough with those accommodations.

• Think about ways in which you can decrease risk levels and increase safe outcomes while still taking part in the event, such as by eating beforehand, bringing food for your child to eat, and developing rules about eating outside of the home.
• If you’re unsure how to accurately assess allergy-related risk levels, reach out to your allergist or healthcare team to discuss and get clarification on evaluating risk levels for both non-ingestion exposures (e.g. being near or touching allergens) and accidental ingestion. This information often helps calm anxiety and shapes effective safety preparation and planning.
  

Shift your perspective to focus on both safety and skill-building.

When navigating life with food allergies, it’s understandable to primarily focus on food allergy safety. After all, preparing and planning are important safety strategies that help keep those with food allergies safe.

Yet, it’s also helpful to consider how safely navigating challenging situations, such as attending holiday gatherings, creates important food allergy management skill-building opportunities for you, your child, and the whole family.

To help you focus on both safety and skill-building as values when making these decisions:

• Think about how engaging in decision-making about holiday gatherings will help your family learn how to determine what’s safe, safe enough, and not safe to be doing.
• Consider how age-appropriately talking through these decisions and creating food allergy safety rules for these gatherings helps to model important critical thinking and planning skills, which your child will need to learn.
• Consider how practicing how to safely navigate uncomfortable or new situations, such as eating at someone else’s house, will help you create a more functional relationship with your food allergy-related anxiety that doesn’t allow it to take charge of your family’s decisions.

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Have coping skills and navigation strategies ready to use.

Let’s say you’ve determined that the upcoming holiday gathering at Grandma’s house is safe enough to attend. Even when you’ve made your decision and it’s based on mindful reflection and risk evaluations, chances are, you’ll still experience elevated anxiety, especially if you don’t eat out of the home often – or at all.

What’s more, that elevated anxiety probably won’t just show up while at Grandma’s house; it will be there before the event, too, since it’s common to experience anticipatory anxiety or to have excessive worry about a stressful upcoming event.

To help you navigate the anxiety and stress before and during the gathering:

• Engage in good self-care in the days leading up to the event, since you’ll be better able to effectively manage anxiety and navigate stressors when you’re well-rested.
• Practice mindfulness-based grounding strategies such as belly breathing (with a longer exhale than inhale), sensory activities (noticing what you see, hear, smell, touch, taste), and unhooking from your anxious thoughts by noticing them and responding with “Thanks, mind - I know you’re just trying to help, but we have a plan in place to stay safe and will have our epinephrine with us.”
• Have prepared responses that you and your child can use when well-meaning family members ask uncomfortable questions such as, “Would you like one of these cookies?” or “Can’t you just have a bite?” These are great opportunities to practice self-advocacy skills. Responses might include, “That’s not safe for me since I have a food allergy” or “No thank you, I have my own dessert.”
  

Hopefully, these tips will help you mindfully explore your holiday plans or reinforce your thinking about the upcoming holiday season so that your decisions are made based on food allergy safety needs and the goal of connecting with loved ones rather than on avoiding experiences due to anxiety.

One final recommendation I’ll share is the importance of checking in with yourself the day of the gathering and being flexible if needed. Maybe everyone got poor sleep the night before, someone is now sick, or you don’t feel you have the energy or the emotional capability to navigate a challenging and stressful family gathering that day. That’s okay! Having walked through the decision-making process and preparing a plan to navigate things safely means you’ll be able to do that again for the next holiday gathering.

Here’s to a happy and safe holiday season for all families managing food allergies and allergic conditions!