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What Uncertainty Is and How it Impacts You.
The simplest definition of uncertainty is: Being uncertain or unsure about something.
The reality is that we navigate lots of uncertainty on a daily basis, whether you're managing food allergies or not. And because none of us have a crystal ball that tells us what will happen in the future, we have to learn how to deal with it.
Some navigate uncertainty without much distress, while others struggle to deal with uncertainty, and as a result, experience increased anxiety, particularly when things feel too uncertain.
Within anxiety and emotional disorder literature, one's inability to tolerate uncertainty has been associated with experiencing worry and panic, as well as diagnosable conditions including Generalized Anxiety Disorder (GAD), other related anxiety disorders, and even Posttraumatic Stress Syndrome (PTSS).
Someone who is able to effectively deal with uncertainty is probably able to:
Cope with the fact that they don't know how things will turn out
Accept the fact that they don't have control over everything
Be willing to take calculated (e.g. safe enough) risks
Adapt to new experiences and environments
Feel reasonably confident in their decision-making capabilities
That doesn't mean that someone who navigates uncertainty well doesn't feel anxious or nervous about things; after all, those are emotions that we ALL experience throughout life. Instead, a person who deals well with uncertainty is able to move forward with things in life even when facing uncertainty and feeling anxious or worried.
On the contrary, someone who doesn't effectively deal with uncertainty probably:
Struggles with accepting they can't know every outcome ahead of time
Wants complete control in most (or every) situation or experience
Often second-guesses decisions and choices, or needs approval from others
Experiences excessive anxiety which often leads to over-avoiding situations
Engages in ongoing rumination (thinking) to try to gain certainty and feel in control
Yet, just because someone may not deal with uncertainty well doesn't mean that it automatically becomes a problem or that they have an anxiety disorder. Still, how someone navigates uncertainty clearly impacts well-being and ability to function in daily life.
Now, let's look more specifically at uncertainty and living with food allergies.
While food allergy management guidelines offer guideposts and a basic level of predictability when living with food allergies, there's still lots of uncertainty to navigate on a daily basis.
If you're reading this article, you're likely already well-versed in the uncertainties associated with navigating life with food allergies, so let's explore how that impacts how you live with food allergies, and more specifically, why learning how to deal with uncertainty is a key coping strategy when living with food allergies.
Why it's Important to Learn How to Deal with Uncertainty When Living with a Food Allergy
I recently came across a 2021 article from the Journal of Pediatric Society titled "Parental Anxiety and Posttraumatic Stress Symptoms in Pediatric Food Allergy".
The article looked at data from a study that explored anxiety, worry, and posttraumatic stress symptoms in parents of kids with food allergies, and evaluated whether psychological outcomes could be predicted by allergy severity, intolerance of uncertainty, and food allergy self-efficacy.
This key point about intolerance of uncertainty was shared in the discussion section:
"It may be that intolerance of uncertainty is a barrier to increasing parents’ confidence, or that parents’ perception of threat may be too great to be counteracted by their confidence in allergy management. This is an important clinical finding, as whilst confidence is important for medical management, this study indicates psychological interventions may be more effective if they focus on factors that impact on parents’ threat perception (e.g., intolerance of uncertainty)."
This suggests:
There's a correlation between intolerance of uncertainty, the perception of food allergy-related threat levels, and parental mental health and well-being.
That a parent's inability to tolerate or deal with uncertainty can negatively impact their food allergy management confidence.
That a parent's confidence in their food allergy management skills may not always be able to help them adjust their perception of food allergy threat (which should be assessed in each situation).
That a greater intolerance of uncertainty was a consistent significant predictor of worry, anxiety, and PTSS.
That psychological or therapeutic interventions might be more effective if they focused on building skills to help parents understand threat perceptions, tolerate uncertainty, and accurately assess food allergy risk levels.
(Even though this study focused on parents, I would predict these themes could be relevant for adults managing food allergies, too).
I've seen similar findings and outcomes in my own caseload. When someone parenting a child with food allergies or living with food allergies isn't able to cope with or navigate uncertainties effectively, they often perceive situations to be more unsafe (even if they're not) and underestimate their ability to navigate anxiety-inducing situations well.
It's probably no surprise that this would eventually impact quality of life and daily functioning, so let's look at how to more effectively deal with uncertainty when living with food allergies.
4 Tips for Dealing with Uncertainty When Living with Food Allergies
Notice and Name It.
When facing uncertainty, notice how it makes you feel, what thoughts it stirs up, and then name the emotion(s) you're feeling. It also helps to observe your initial response to the uncertainty.
This might look something like this: "Going to a new restaurant is making me feel anxious and stirring up all sorts of "what if" worries. My initial response is wanting to avoid going to that restaurant and just eat at home even though I want to go out with my friends."
Noticing that you feel uncertain and naming the uncomfortable thoughts and emotions that the uncertainty brings up helps you recognize what's going on inside your mind and body. Doing this then helps you choose HOW you want to respond (rather than automatically letting the fear of uncertainty determine your choices).
Focus on What You Can Control and Influence.
This might look something like this: "I have my questions ready to ask the manager and chef. I can always choose not to eat anything if I don't feel it's safe enough. I can also bring my own food in case that happens. Plus, I have my emergency plan and epinephrine autoinjectors, which I and my friends know how to use if needed."
Focusing on what you can control and how you can positively impact outcomes helps you unhook from unhelpful rumination, or the non-stop focus on "what if" thoughts, and focus on actions you can take.
Explore Uncertainty With Your Allergist.
Uncertainty will always be part of life, especially with food allergies, so talk with your board certified allergist about it.
More specifically, ask your allergist how to accurately assess food allergy risk or threat levels in various situations. Remember, with uncertainty often comes anxiety, which can lead to over-avoiding situations that might be safe enough, so learning how to determine what's safe and not safe enough is one skill that will help you cope better with uncertainty.
As a parent, you should also talk with your allergy care team about how your fear of uncertainty and food allergy anxiety impacts the decisions you make about your child. Especially if you're noticing that your worries may be holding your child back from developmentally-appropriate tasks and experiences, it's important to discuss this with your allergy care team in order to gain evidence-based information and learn skills that will help you make beneficial adjustments to how you manage food allergies. [I'll be talking about this in my upcoming book due out next year!]
Get More Support From a Therapist.
Especially if you notice that you struggle to navigate uncertainty in multiple areas of your life, it may be beneficial to work with a therapist to build skills and learn coping strategies to help you more effectively deal with uncertainty.
If you're looking for a food allergy-informed therapist, visit the Academy of Food Allergy Counseling's Food Allergy Counseling Directory to locate a therapist in your state. [I am the founder and chief advisor of both of these resources].
Finally, remember that when it comes to dealing with uncertainty, the goal is to learn how to navigate it effectively because no matter how hard you try, you can't completely eliminate uncertainty or have complete control over every aspect of life -- when living with food allergies or not.
Don't let uncertainty hold you back from living a full and meaningful life!