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Celiac Disease and Mental Health: Support

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What are some mental health options for depression and anxiety?

Psychotherapy involves an individual working with a licensed and trained mental health professional to help him or her work through factors and situations that provoke the depression or anxiety. In general, it helps a person gain better insight and understanding of the thoughts, emotions, and behaviors that contribute to the disorder; regain a sense of control and pleasure in life; and learn coping techniques to help manage the disorder. A person may be in individual therapy, group therapy, marital/couples therapy, or family therapy (Grohol, 2011).

Are there any lifestyle changes that can alleviate depressive and/or anxiety symptoms?

Eat a well-balanced, healthy diet that is high in essential vitamins, minerals, and nutrients may help alleviate symptoms that can cause depressive and anxiety related symptoms.. The B-complex vitamins are essential for mental health. They cannot be stored in the body, so it is important that we take in these vitamins through diet and supplementation. A balanced diet may improve sleep, increase energy, reduce fatigue, and help improve gastrointestinal related symptoms. A diet that includes antioxidants, lean meats, a variety of fruits and vegetables, and gluten-free whole grains is not only heart-healthy, but will also help you achieve a good nutritional status. Interestingly, in the September 2011 study of women with celiac disease, those who reported strong adherence to the gluten-free diet also reported higher overall mental health and lower stress.

Incorporate exercise as a regular part of your schedule: Engaging in exercise helps improve self-esteem, which is a psychological benefit of regular activity. Exercise helps release endorphins, which helps trigger positive feelings in your body and reduces the perception of pain. Regular exercise has been shown to help reduce stress, decrease anxiety and feelings of depression, increase self-esteem and self-confidence, and improve sleep. Any form of moderate exercise may help improve depression and anxiety. Some examples include running/jogging, dancing, biking, swimming, and walking (Mayo Clinic, 2011).  

What are other ways I can cope or receive support?

  • Keep a daily journal or diary. This can help improve your mood by allowing you to express any stress, anxiety, emotions, or sadness instead of keeping it internalized. It can also allow you to reflect and process some of the feelings that may have been difficult to deal with or handle when you were down.
  • Set reasonable goals. Keep goals that are attainable and realistic. If you are feeling depressed or anxious, make goals that help reduce these symptoms in order to improve your mental health. Goals may include getting more sleep, increasing energy or combating fatigue.
  • Read self-help books. Reading books about depression, anxiety, or celiac disease may help you gain insight into these conditions. In addition, reading about another person’s experience may help you cope, find support and reflect about your experiences.
  • Join support groups. Finding other people going through similar things as you can help increase your ability to cope and decrease feeling as if you are alone or isolated. In fact, the NIH Consensus Development Conference Statement on Celiac Disease includes “Access to an advocacy group” as one of the six key elements in successful celiac disease management. Support groups for celiac disease and gluten sensitivity are available in many communities as well as online and in social media. Talk to your doctor or therapist about a referral or group recommendation, and join online communities like NFCA’s Facebook page to meet others and share your experiences.
  • Learn ways to relax and manage your stress. Take time for yourself to make sure you have time to rest and recuperate from daily events, triggers, and stressors. Listen to music, take a walk, meditate, draw a picture, practice yoga…find out what keeps you relaxed and work this into your daily schedule. Self-care is very important in managing depression, anxiety, and keeping stress at bay!
  • Do not isolate yourself. Try to participate in activities that you enjoy with your family and friends on a regular basis. Social activities and interactions with other people will increase your sense of well-being and improve mental health.

What are some websites that will provide further information about mental health?

References

American Psychiatric Association (2000). Diagnostic and statistical manual for mental disorders, Fourth Edition, Text Revision.  Washington, DC: American Psychiatric Press.

Arigo D, Anskis AM, Smyth JM. (2011). Psychiatric comorbidities in women with Celiac Disease. Chronic Illn., 7(3).

Carta, M.G.,  Hardoy, M.C., Usai, P., Carpinello, B., & Angst, J. (2003). Recurrent brief depression in celiac disease.  J Psychosom Res., 55(6), 573-574.

Ciacci C, Iavarone A, Mazzacca G, De Rosa A. (1998). Depressive symptoms in adult celiac disease. Scand J Gastroenterol33(3), 247-250.

Grohol, J. M. (2011). Psychotherapy.  Retrieved from http://psychcentral.com/psychotherapy/

Hadjivassiliou, M., et al. (2002) Gluten sensitivity as a neurological illness. Journal of       

Neurology, Neurosurgery & Psychiatry, 72, 560-563.

Häuser, W., Janke K. H., Klump, B., Gregor, M., Hinz, A. (2010). Anxiety and depression in -adult patients with celiac disease on a gluten free diet.  World J Gastroenterol, 16(22), 2780-2787.

Hallert, C. & Aström, J. (1982).  Psychic disturbances in adult coeliac disease. II. Psychological findings. Scand J Gastroenterol, 17(1). 21-24.

Hersen, M. Turner, S., & Biedel, D.C. (2007). Adult psychopathology and diagnosis (5th ed.).       New York: Wiley.

Leyse-Wallace, Ruth. (2008). Linking Nutrition to Mental Health: A Scientific Exploration. iUniverse, Inc. Lincoln NE.

Mayo Foundation for Medical Education and Research.  The Mayo Clinic Digestive System page. Available at: http://www.mayoclinic.com/health/celiac-disease/DS00319/DSECTION=1.  Accessed September 8, 2011. 

Mayo Foundation for Medical Education and Research. Depression and Anxiety page.  Available at: http://www.mayoclinic.com/health/depression-and-exercise/MH00043. Accessed September 8, 2011.

Mazzone et al. (2011). Compliant gluten-free children with celiac disease: an evaluation of psychological distress BMC Pediatrics, 11:46 http://www.biomedcentral.com/1471-2431/11/46

National Institute on Mental Health (September, 2011).  Anxiety Disorders.  Retrieved from             http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

National Institute on Mental Health (September, 2011).  Depression.  Retrieved from             http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml

Schuppan D, Dennis M, Kelly C.  (2005).  Celiac disease: epidemiology, pathogenesis, diagnosis, and nutritional management.  Nutrition in Clinical Care, 8:54-69.

Thompson T, Dennis M, Higgins A, Lee R, Sharrett M.  (2005).  Gluten-free diet survey: are Americans with celiac disease consuming recommended amounts of fiber, iron, calcium, and grain foods?  Human Nutrition and Dietetics, 18:163-169. 

Whiteley, P., Haracopos, D., Knivsberg, A.M., Ludvig Reichelt, K., Parlar, S., Jacobsen, J.,          Seim, A.,Pedersen, L., Schondel, M., Shattock, P. (2010). The ScanBrit randomized,    controlled, single-blind study of a gluten- and casein-free dietary intervention for children   with autism spectrum disorders. Nutritional Neuroscience, 13(2), 87-100.

 
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