Not All In the Mind

When food allergy meets mental health

Posted Nov 12, 2012

An interesting thing happened to me the other day. I had been asked, in my capacity as a BBC/AHRC New Generation Thinker, to give a talk for BBC Radio 3’s Free Thinking Festival, a wonderful showcase for intellectual curiosity in Gatehead (just south of Newcastle on the banks of the River Tyne). The theme of the festival was ‘Them and Us.’ Now, if I had been smart, I would have given a talk about the history of ADHD, having two books out on the subject, but with that theme, I just had to go with another one of my research projects: the history of food allergy.

Now, although there are plenty of Them and Us aspects of ADHD and its history, Them and Us almost defines allergy to a tee. That’s because allergies are what happen when the body - Us - mistakenly identifies foreign proteins - Them - as dangerous, and then launches an excessive, possibly cataclysmic, defence. In the case of food, the relationship is almost literal. Food becomes Us, so when the body sees it as a threat, it is most certainly Them. Them and Us confusion also causes other immune system diseases. In autoimmune arthritis the body mistakes connective tissue for a threat and attacks it, resulting in terrible joint pain.

You’re probably why I am blethering on about food allergy on a Psychology Today blog. Well, there are a few good reasons. First of all, during the middle part of the twentieth century, allergy was often seen as a psychosomatic illness, a physical manifestation of psychological problems. In the case of asthma, the asthmogenic (or asthma-producing) home, often featuring a smothering, overbearing mother, was often seen as the cause of children’s asthma, to the extent that so-called parentectomies were suggested as a possible cure.

In the case of food allergy, the relationship between mental illness and food allergy symptoms were even more complicated, and controversial. On the one hand, many prominent food allergists stressed that food allergy could trigger mental disturbances, ranging from depressive and psychotic episodes to hyperactivity in children. The solution to many a person’s mental illness, argued the food allergist, was a thorough elimination diet to determine the food that was at fault.

On the other hand, food allergy critics - and there were many of them - argued the very opposite: the symptoms of food allergy were nothing more than the physical manifestations of psychological problems. So-called food allergy sufferers, they argued, would benefit more from the counsel of a good psychiatrist, rather than an unscrupulous food allergist, who would merely encourage their delusions.

As in many instances of medical controversy, it is likely that neither side was completely correct, nor completely incorrect. While food, and especially food chemicals, are most likely the cause of mental disturbances in some sensitive individuals, and particularly children, the intensity of an allergic reaction can certainly be exacerbated by heightened levels of stress. There is most certainly a psychological component to not only allergy, but many other aspects of our immunity.

But after I gave my talk at the Free Thinking Festival, it became clear that there was also another psychological aspect of allergy. As I stepped down from the dais, a crowd quickly assembled in front of me, asking all manner of, well, fairly personal questions about their food allergies. Now, while I always provide the disclaimer that I am not a medical doctor, I quite enjoy hearing the stories people have to tell, which are often quite poignant. And sometimes I feel I can give a small amount of advice, if it is only to suggest that a second opinion be sought. In this particular instance, I could tell that many of the people asking me were fairly desperate. They had not received a great deal of sympathy from their doctors and simply wanted someone to talk to. It was if I was the first person with a Dr. in front of their name who was willing to listen. But time is not always on the side of the listener. After about 10 minutes, a BBC producer herded us out the door, to allow for the next speaker to warm up. On the stairs outside of the auditorium, however, the conversations continued, until I was hauled away to be interviewed by some student reporters.

What struck me was that there was something missing in the relationship these people had with their various physicians. Dealing with disturbing, unexplained symptoms, many food allergy sufferers simply want someone to take the time to listen, to hear their story, to trust what they’re saying, to treat them with respect. The excuse often given is that physicians no longer have the time to provide such a receptive ear. If so, this is terribly unfortunate. But it does help to explain why food allergists have been so successful attracting patients, despite their often eccentric theories about food allergy. Food allergists listened. Not only that, they had to rely on their patients’ testimony and experiences to diagnose their allergies. The relationship between food allergists and patient was more of a partnership, with each party playing an essential role. Some psychiatrists might even learn something from this approach.

If you’ve enjoyed this little foray into food allergy, have a listen to my talk this Friday the 16th on Night Waves, BBC Radio 3 at 2245 GMT, available afterward on the BBC website: