On Tuesday night’s episode of the Real Housewives of Beverly Hills, several of the women traveled to Berlin for a girls’ trip. Naturally, there was Drama. But Kyle Richards recently revealed that not everything that happened made it into the trailer for next week’s Berlin-centric episode—including a scary medical situation that she experienced.
Richards told People this week that she “had a little medical situation” due to a horse allergy on the trip. According to Richards, the group went horseback riding “out in the middle of nowhere” where she says she had “almost an anaphylactic reaction.” Anaphylaxis is a severe allergic reaction in which your airways narrow, making it difficult to breathe. The condition is a potentially life-threatening emergency.
“I didn’t have my EpiPen, so I had a panic attack,” she said. “And it’s really fun to have a panic attack with cameras in your face. Some man came up and he was like, ‘Take this.’ And I have a phobia of medicine—one of my many phobias. I cannot just take a random thing someone hands me. But then I got so desperate because the whites of my eyes were blood red. I took them and I was like, ‘Dear God, get me home in one piece. I do not want to die in Berlin.’” Luckily, Richards ended up OK.
Allergic reactions and anxiety can both be terrifying in their own right, and it’s actually not uncommon for someone to experience both.
“We hear this very commonly” in patients with severe allergies, Purvi Parikh, M.D., an allergist/immunologist with Allergy & Asthma Network, tells SELF. And it makes sense: Severe allergic reactions are terrifying. It makes sense that you’d be anxious about the possibility of encountering your allergy triggers and experiencing serious symptoms. On top of that, if you also have clinical anxiety or panic attacks, the threat of severe allergic reactions can exacerbate those conditions.
“Allergic reactions can be life-threatening and very scary to experience,” Jonathan Ting, M.D., an otolaryngologist with Indiana University Health, tells SELF. “Whether it is a new reaction or a recurring reaction, it can be anxiety provoking.”
Also, the physical symptoms of allergic reactions can mimic those of panic attacks. Symptoms of a severe allergic reaction vary from person to person, but people may notice itching in the nose, throat, mouth, and ears, along with swelling in the throat and face that can cause difficulty breathing, Dr. Ting explains. If someone has an allergic reaction to something they ate, they can also experience nausea, vomiting, and cramping, he adds. The symptoms of a panic attack can include tightness in the chest and throat, shortness of breath, and extreme fear (including thoughts like, “I’m dying”).
Unfortunately, this can become a vicious cycle: You become anxious over the fact that you’re having an allergic reaction, which only makes your physical symptoms worse, which then makes you even more anxious. So, if you start to feel like you’re having an allergic reaction, you might think you’re having a panic attack, and that fear can trigger an actual panic attack, the Mayo Clinic explains.
Finding ways to manage your allergies and your anxiety is crucial. But the first step is knowing how to distinguish one from the other.
Are you scared and anxious about the fact that you’re having an allergic reaction, or are you in the midst of a full-blown panic attack? It’s tough to know in the moment. But figuring it out can ensure that you get the right kind of care you need as quickly as possible. That’s why Dr. Parikh and her colleagues specifically teach patients how to recognize the difference between an asthma attack, allergic reaction, and panic attack ahead of time. For instance, although a panic attack and allergic reaction can cause a feeling of tightness in the throat, an allergic reaction is also likely to come with itchy sensations or a rash, but a panic attack is not.
It’s also important to make sure you’re always prepped for the possibility of having a severe allergic reaction. That might include carrying an epinephrine injector (e.g. an EpiPen) and also telling your family, friends, and coworkers how to use it. “Feeling prepared and ready in the event of a reaction helps most feel some reassurance and comfort to hopefully prevent panic attacks,” Dr. Parikh says.
And if you have severe anxiety or panic attacks, it’s worth checking in with a mental health professional to help you find ways to manage it, Simon Rego, Psy.D., chief psychologist at Montefiore Medical Center/Albert Einstein College of Medicine, tells SELF. They’ll likely recommend cognitive behavioral therapy (CBT), a form of psychotherapy that helps people change negative thoughts and behavior, Mayra Mendez, Ph.D., a licensed psychotherapist at Providence Saint John’s Child and Family Development Center in Santa Monica, Calif., tells SELF.
“If someone starts thinking catastrophically, like, ‘I’m going to die,’ and yet they have an EpiPen, they’re being blocked from thinking in a way that can help them help themselves,” she explains. So the goal of therapy would be to increase their awareness of their own thoughts and behaviors and give them strategies to do what needs to be done in the worst case scenario and not let their anxiety cloud the moment.
So if you have both severe allergies and anxiety, talk to your doctor or a board-certified allergist. They can work with you to create a preparedness plan that may include help from a therapist to ensure you have all the tools you need.