Anaphylaxis Aftermath

From battling typical teen anxiety to navigating the complex world of food allergies and anaphylaxis, our journey through being teens with food allergies is likely anything but ordinary. My name is Amaris Ruiz, and I'm involved in FARE’s Teen Advisory Group (TAG), where I am now beginning to get thoroughly involved in raising awareness about food allergies. A quick personal overview: I thrive on staying physically active, finding myself lost in books, diving into new languages, and cherishing time with my family. Regarding the future, I have my sights set on a career in the government.

Given that I was diagnosed at eight months old, food allergies have played a significant role in my life. I was diagnosed with allergies to tree nuts, sesame, eggs, dairy, peanuts, and numerous environmental items at the time, along with asthma. I have been fortunate enough to outgrow eggs, tree nuts, and sesame, but I have received two replacements: beef and shellfish. I have decided to take part in the Just Allergy Things magazine to give a voice to myself, and hopefully many others, on experiences that are less highlighted in the allergy community.

Throughout my life, I’ve experienced about eight anaphylactic allergic reactions. The mental toll these reactions have taken on me has been no joke. Like the majority of us with food allergies, I’ve begun to learn how to navigate the aftermath, and I’m hoping to bring light to what happens behind the scenes. Remember, you’re not alone.  I’ve been there, feeling completely alone and discouraged, but to my surprise, I wasn’t, and you aren’t either.

Before I review the logistics and science of trauma, I want to give you a brief background on me, so you have an idea of where this information is coming from. My family and I? We’re pros at stress, although I’m not complaining. I have had a solid support system through my food allergy journey and battling my own teenage hormones, which I am so grateful for. Being a teen is anxiety central, especially when you’re hypervigilant about every bite you take. The recent few years have been a whirlwind of reactions, which only ramped up my hypervigilance game even more.

I’ve been through about eight anaphylactic reactions. Some have been mere instances with just an EpiPen, in-and-out, and no significant symptoms after. Though there are the ones that knock you straight onto your back. The last time I was in the hospital, I needed four doses of epinephrine just to stabilize me, all thanks to an English muffin. I was quite terrified, and there was a moment where I felt unsure if I would make it out okay.

Looking back, those days coming off of steroids were mostly a shaky mess for me. Even the sight of an English muffin practically scared me back to the hospital. I would smell something that reminded me of the hospital, and suddenly, I was back there. My first severe reaction, when I was just ten, threw me into hypervigilance mode. For about the next year and a half, I didn’t eat anything anyone offered me, including my parents, unless I checked the label myself. I even caught a few mistakes, reinforcing my hypervigilance! Pancakes? Forget it, they were on my no-go list (sorry, baked goods, you got the short end of the stick). 

All of those reactions caused a form of post-traumatic stress for me. Many times, it felt as though my body and mind were at war, and even now it feels like a battle to push through those moments. I wish someone told an anxious ten-year-old me that I definitely am not alone in my rollercoaster of emotions and feelings. I know now that many children suffer with similar symptoms, and I believe we can support each other by reaching out and providing support, as it may make all the difference.

What exactly is “trauma”? We often label certain events "traumas," when really, trauma is best defined as someone’s experience of a particular event that renders them feeling helpless and overwhelms their average capacity to cope. When this occurs, various processes in the body occur. The brain, particularly the amygdala, kicks off the body’s emergency response system by identifying danger. Once this begins, the threat system (SNS, or sympathetic nervous system) is alerted and essentially takes over the body’s functioning to preserve energy and focus on survival. Subsequently, parts of the brain that drive decision-making and logical thinking essentially fall “offline.” This poses a challenge for the person experiencing trauma, as their ability to understand the situation and make reasonable decisions is decreased. The body focuses on breathing and escaping danger, whether that means shutting down, fleeing, or fighting, or more commonly known as the fight-flight-freeze response. Fear is the main emotion at play during this time. 

It is easy to see why. When you experience an allergic reaction as a traumatic event, you may not be able to respond appropriately, may fight against help, or completely freeze up. Once the traumatic event has subsided and the individual’s parasympathetic nervous system kicks on and returns them to stability, they may experience extreme exhaustion as a result of the cortisol and norepinephrine released in the body. Yep, your body accordingly releases a certain amount of norepinephrine when it perceives danger. While the event is resolved and the individual is now physically safe, the experience can leave a profound lasting effect.  Since the thinking parts of the brain weren’t properly functioning during the traumatic experience, the memory of the event is held in the body on a sensory level and not in the brain as an orderly story. The sensory memory of fear and danger is sometimes then linked to the sights, tastes, smells, sounds, and feelings that were part of the traumatic experience. Because the brain does not properly process the event, exposure to the sensory elements of the event can become triggers, which can then cause a trauma response even when danger is not present. Essentially, the brain can’t tell the difference between time, and the body responds to the present out of the past experience of trauma.

For someone who has experienced a traumatic anaphylactic reaction, the trauma response may be triggered by hospitals, the restaurant the reaction occurred in, the plate the food was served on, etc. The person may begin to irrationally avoid those triggers because they are linked to the traumatic event. They might also experience flashbacks and nightmares of the event and may remain hypervigilant (or hyper-aware) because the brain is on the lookout for more danger. They may struggle to sleep, avoid things associated with the traumatic event, and begin to struggle on a daily basis. When these symptoms do not resolve and begin to significantly impact the person’s functioning and daily life, they will require professional help to work through what has now developed into post-traumatic stress disorder (PTSD). 

Dealing with PTSD or any lingering symptoms after an allergic reaction can feel incredibly daunting, but it’s extremely crucial to recognize that there are numerous avenues for support and effective coping mechanisms available to you. It’s natural to doubt your ability to do so, but remember, you’re not alone in this journey. As a community, we need to shed more light on this topic and begin to increase our understanding and support of the mental health impacts of food allergies. While my perspective is based on my own experience, I’ve strived to offer objective insights while maintaining a personal touch. It’s important to acknowledge that symptoms following an allergic reaction can greatly vary from person to person, and what works for me as an individual may not necessarily apply to another. Living with food allergies poses great challenges, often invisible to outsiders, but internally, it’s a battle that only we can truly understand. Let’s continue to foster understanding and compassion for navigating the complexities of anaphylactic allergic reactions and their undeniable aftermath.