Food Allergy Meets the Teenage Brain
In adolescence, teens face peer pressure — all the while their brains are developing and their hormones surging. Adding food allergies to the mix ratchets up the risk-taking potential, since not all teens willingly speak up about their food triggers. But as Allergic Living finds in this special report, there is much that parents and peers can do to help allergic teens navigate the sometimes treacherous path to adulthood.
SYDNEY Harris, a self-assured, 19-year-old college student, wasn’t always so comfortable with her food allergies. When she was diagnosed with severe allergies at the end of eighth grade, she had to “navigate through a whole new world of challenges.” The following year, she had a tough time finding the support she needed at her high school in Barrie, a city north of Toronto. This was in part because her triggers were not among the top eight allergens, and many people found it difficult to understand her particular allergies. “I didn’t want to be different,” she remembers. “I would leave the house without an EpiPen, or put myself in situations where I was at risk. I didn’t want to accept that I had food allergies.” As a result, Sydney experienced several allergic reactions, at school, home and work.
The day that changed her perspective came right before winter break in 11th grade. During lunch, she walked to a Chinese restaurant with a group of friends. She didn’t check any of the ingredients or mention her allergies to the staff, and by the time she returned to school, she was in “a full-blown anaphylactic reaction.”
Fortunately, one of Sydney’s friends rushed for a teacher, and the school called an ambulance. After three shots of epinephrine and the rest of the day at the hospital, she recovered – but the episode terrified her. “It was the most severe reaction I’d had and the one where I felt closest to death,” she says now, calling this her “food allergy wake-up call.” You don’t need me to tell you that Sydney was lucky.
Yet Sydney’s story is instructive. It illustrates the many challenges faced by food-allergic teens: strong social pressure to fit in; increasing amounts of time spent with friends and away from adults; environments that don’t always support them in the ways they need; and questionable decisions that don’t always fall in line with what these kids actually know. It’s hard enough navigating adolescence, but simultaneously managing a serious health condition adds an extra layer of complexity.
Parents of food-allergic teens – and parents of soon-to-be teens, like me – have reason to worry. While deaths from severe anaphylactic reactions are uncommon, when they do occur, we know it’s most often among adolescents and young adults, particularly in reaction to peanuts and tree nuts. Certainly not all teenagers take risks when it comes to their allergies, but several commonalities emerge among those who do.
A 2006 survey of adolescents and young adults with food allergies determined that 17 percent of its participants were at “high risk” because they did not always carry epinephrine and ate foods that “may contain” their allergen. Three years later, a bigger survey of food-allergic college students at the University of Michigan, Ann Arbor found that only 21 percent of participants said they owned an auto-injector. Also concerning was the large number of students – 60 percent – who reported a previous allergic reaction (though not anaphylaxis) but also said they continued to willingly consume their food allergen.
Of course, it’s not just teens with food allergies who take dangerous risks. We know adolescents are more likely than other age groups to experiment with alcohol, cigarettes and illegal drugs. Teen drivers are nearly three times more likely than those over the age of 20 to be in a fatal crash, according to data from the Centers for Disease Control and Prevention. As developmental psychologist and Temple University professor Laurence Steinberg writes in Age of Opportunity: Lessons from the New Science of Adolescence, “In virtually all arenas, adolescents take more risks than either children or adults, and the incidence of risky behavior usually peaks somewhere during the late teens.”
Is this because teens have “lost their minds” or “gone crazy”? Despite how our culture tends to view teenagers, the answer is “no.” To understand what’s actually going on, it’s helpful to turn to research in neuroscience, which has been rewriting our understanding of adolescence and the incredible changes that take place in the teenage brain.
Inside the Teenage Brain
Advances in scientific knowledge about brain development during adolescence have shown us that the human brain continues to grow for much longer than we previously thought. In fact, the years of adolescence – which many experts now define as starting at age 10 and lasting until the mid-twenties – is marked by “heightened neuroplasticity,” a term used to describe the brain’s potential to change through experience. During puberty, the brain has a far greater sensitivity to the influences of social environment than during middle childhood or adulthood.
It’s a time when the brain is not growing as much as it’s being reorganized. Steinberg explains that nearly all of the changes take place in the “regions that regulate the experience of pleasure, the ways in which we view and think about other people, and our ability to exercise self-control.” During adolescence, these areas are highly responsive to stimulation, and it also takes time for them to learn how to work together.
This research suggests that teenagers tend to view risks differently than adults; they weigh potential rewards much more than possible dangers. And often these perceived rewards are social in nature, tied to peer approval and belonging. So a teen, desperate to fit in with peers who don’t have food allergies and aren’t inclined to support a friend’s difference, might be pushed toward underestimating the risk involved in being exposed to, or potentially consuming, an allergen. Combine this with impulsiveness, and the results can be a dangerous mix.
However, the better news is that teens are far more capable than we often give them credit for. Abigail Baird, a developmental neuroscientist and psychology professor at Vassar College, objects to the stereotypical characterization that teens lack all self-control. “Watch teens at school, hanging out together,” she says. “They have amazing impulse control. But they don’t have a lot of it. They use what they have for their peers, and then they come undone at home.” Impulse control improves with age, and external factors (such as stress, exhaustion or hunger) can cause it to unravel. For parents, the trick is to figure out how to harness the impulse control that adolescents do have and to encourage them to find supportive peers.
This is a significant shift from earlier childhood, when parents tend to focus on protecting kids from potential dangers. To complicate matters, simply talking to teens about risks won’t necessarily change their behavior. “Educating teens is not just giving information,” says Baird. Parents need to give teens room to make more decisions about their lives.
Rather than try to control them, a better approach is to find the incentives to motivate adolescents to act on what they already know. At the same time, Baird says, serious health conditions – such as food allergies or diabetes – should be treated as “non-negotiable logistics”. Parents can help their kids to manage their food allergies responsibly by giving them a more active role and allowing them to decide how they will take care of these logistics.
Respect is fundamental in this process. Baird, who spends a lot of time with teens, suggests parents convey a supportive but firm attitude in conversations: “I don’t want to control you. I want you to control you, but I am ultimately responsible for you.”
Next: Learning to ask for what they need