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PostPosted: Wed Oct 25, 2006 11:31 pm 
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Joined: Sun Aug 27, 2006 8:53 pm
Posts: 21
Location: Vancouver
When you first started having allergic reactions - maybe before you were properly diagnosed - were you afraid to eat? Or, after you've had some major reactions, do you ever avoid food for fear it might happen again?

I am a regular contributor to Allergic Living Magazine (as well as a CBC Radio reporter/producer and a writer for several other magazines and newspapers), and I'm working on a story about they psychological side of food allergies - in particular the phobias that can easily (and often do) develop after major reactions.

If you would be willing to share your story, it would be very much appreciated - and would undoubtedly mean a lot to others who have had the same experience. Feel free to contact me at jve@wimsey.com.

Thanks!

Jennifer Van Evra

(btw, I'm anaphylactic to shellfish, nuts, and peanuts, and highly allergic to many other foods, so I know the feeling!)


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PostPosted: Thu Oct 26, 2006 12:38 am 
Hi Jennifer,
I have celiac disease (so not quite an allergy), so if you don't get anyone please let me know - I can help you out, if you're willing for a little deviation!


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PostPosted: Wed Nov 01, 2006 1:18 pm 
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Joined: Mon Jul 03, 2006 8:23 pm
Posts: 190
Hi, Jennifer.

I run the Montreal Anaphylaxis Support Group, and have worked as a medical writer. Your topic is very interesting, and has piqued my curiosity.

I don't consider myself to have food phobia, but I know many people who are aversive to eating new foods due to anaphylactic reactions, and I myself approach new foods with caution. I hope you don't mind if I comment, however briefly, on the article's topic. I should add that I'm doing so as an individual, and that my opinions don't reflect those of any particular group.

I don't know how you will be approaching the topic, though I'm certain it will be with great sensitivity. I hope that you will be open to my comments.

One caution I'd like to suggest is that the definition of 'phobia' is one that's fairly well established in the DSM-IV. One of the main criteria for a true phobia is that it is clearly known to be 'unreasonable', both by others and by the sufferer him or herself. However, in the case of life-threatening food allergies, the definition of 'unreasonable' may not apply.

For example, one online reference, emedicine.com, defines phobias as follows: "Specific phobia (SP) is characterized by extreme and persistent fear of specific objects or situations that present little or no real threat."

I don't believe that psychiatry has fully caught up with developments in allergy and immunology. However, in general, within the DSM, many criteria for disorders specify that the symptoms must not be related to another cause, such as a physical condition. Else, it is difficult to diagnose the patient as being 'phobic'.

Another reason for this caution is that mental health professionals who are not well versed in allergic disorders might well mislabel patients presenting with phobia-like symptoms to a food with a psychiatric disorder, which could affect things such as their insurability and their treatment by other physicians. I would suggest that this is a very real danger, and that mental health professionals should be encouraged to fully consider the organic basis for any food-avoidant symptoms and not be quick to diagnose.

Another caution concerns the DSM-IV criterion that in order to be diagnosed as a true phobia, the symptoms must persist for at least 6 months. I would suggest that when referred to a licensed allergist for testing and a food challenge (obviously to a food which the patient has been shown not to be allergic to), many patients would be likely to begin trusting a given food again within a 6 month period. As a result, if a patient has not had -- or doesn't have access to -- such tests, and is food avoidant, a diagnosis of 'phobia' should likely be avoided until the food has been shown not to be allergenic for that individual.

Finally, in the case of a food to which a person has been shown to be anaphylactic, varying degrees of anxiety are normal and protective. As such, I'm uncertain as to whether any 'phobia' diagnosis would be appropriate in this case, as there is a fully organic basis, encompassing both the allergic reaction itself (which causes anxiety-like reactions as a normal, expected symptom) and the aftereffects, in which the body has been conditioned to avoid the food in an almost visceral way.

This said, however, if the anxiety is so severe that an allergic individual cannot function, it's obvious that the anxiety should be treated so that the person can life a normal life. However, in this educated layperson's opinion, the goal of such treatment should not be identical to the treatment for true phobias. That is, it should not be to eliminate the normal levels of vigilance and anxiety that serve to protect the allergic individual.

In addition, I would be hesitant to describe any individual with anaphylaxis as food phobic, if only because anyone who is aware of such a label may come to minimize the importance and reality of the food allergy itself, thereby bolstering the view that is still prevalent in society that 'one little bite can't hurt', and that allergic reactions are psychosomatic.

I hope that you will consider taking the above into consideration while researching and writing the article. Thanks very much!


Last edited by Andrea_MASG on Wed Nov 01, 2006 2:23 pm, edited 2 times in total.

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PostPosted: Wed Nov 01, 2006 1:56 pm 
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Joined: Mon Feb 07, 2005 6:39 pm
Posts: 2948
Location: Toronto
Andrea, Rest assured, the article will be sensitive and we are aware of the concerns that you mention.

Because Allergic Living is aimed at an audience dealing with anaphylaxis, our starting point would never be to diminish the very real issues of living with food allergies (e.g. by suggesting this is in anyone's head). As someone with multiple allergies, Jennifer definitely appreciates such issues.

But as you'll see in the posts on this thread that Jennifer also started - http://www.allergicliving.com/forum/vie ... ght=#11013 - it is not uncommon to go through periods of fearing what you put on your or your child's plate when living with allergies. I think those experiences, the consequences of diminished diet and some answers on coping strategies will make for a strong article.

Hope you understand, that that is what we're after. Jennifer was simply looking for some inidividuals with stories to share of such experience. We will watch the terminology.

Thanks for your concern.

_________________
Allergic to soy, peanut, shellfish, penicillin


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PostPosted: Wed Nov 01, 2006 2:10 pm 
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Joined: Mon Jul 03, 2006 8:23 pm
Posts: 190
Hi, Gwen.

Thanks for your reply. Rest assured, my posting wasn't intended as a critique, as I think this will be an important article, and I enjoy your magazine. Simply an advance voicing of my concerns as an allergic individual who has read too many other articles (not in 'Allergic Living' -- an aware magazine) that use the word 'phobia' with great licence and without reference to the DSM-IV criteria.

I look forward to reading the article! Thanks again.


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