As it's both Coeliac Awareness Week and Mental Health Awareness Week, I decided to write about the effect coeliac disease can have on mental health.
Coeliac disease is a lifelong autoimmune condition where the body has an immune reaction to gluten causing damage to the lining of the intestine. This prevents the body from absorbing essential nutrients which keep the brain healthy such as B vitamins, zinc and tryptophan. Doctor James M. Greenblatt has studied the link between depression and coeliac disease. He says "These nutrients are necessary for the production of essential chemicals in the brain such as serotonin, a deficiency of which has been linked to depression."
The only treatment for people with coeliac disease is following a 100% gluten free diet. Many of the symptoms for undiagnosed coeliac disease are physical such as bloating, abdominal pain, diarrhea and unexpected weight loss. But of course being malnourished and fatigued can lead to all kinds of emotional difficulties too. There is ongoing research to suggest the link between our brain and the gut with studies that say coeliac disease doesn't just damage the digestive tract but can also have an impact on the psychological health of sufferers. Some of the psychological symptoms for untreated coeliac include anxiety, depression and panic attacks.
One study found that anxiety but not depression in patients with undiagnosed coeliac disease decreased after one year following a gluten free diet. Another concluded that autoimmune disorders increased the risk of mood disorders by 45% and having coeliac disease increased the risk of developing a mood disorder by 91%.
It's important that we break the stigma so because I believe we all need to be more open about mental health, I'm going to share a bit about my own personal experience even though it feels like a scary thing to do.
Personally, talking openly about the physical side of my coeliac disease has always been far easier to do than discussing my experience of depression and anxiety. I have difficulty even using these labels, I've previously opted to use terms that play it down like "low mood" or "feeling fragile". These phrases barely even begin to cover the debilitating reality of panic attacks and feeling hopeless or being smothered by complete despair. However mental health and physical health are so interlinked that it makes little sense to talk about one without the other.
As a teenager I was underweight, constantly fatigued, incredibly anxious and went through periods of depression. I struggled with self-harm in various forms. I felt sick all of the time, especially after eating. I had skin rashes, candida overgrowth, dizziness, a few episodes of fainting and a general feeling of being unwell. When I was 18, three years after my first trip to the doctors complaining of the above symptoms, I was finally tested for coeliac disease by a GP who couldn't believe he was the first to think of it! Following the endoscopy I was officially diagnosed.
I'd just moved a 10 hour train ride away from home to go to university so I began my gluten free life at the same time as becoming independent for the first time. It took years for the physical and emotional symptoms to ease up. The damage caused to the intestine from eating gluten can't be repaired overnight. It takes time for the gut to heal and the body to slowly start to level out. I still struggle at times with depression and anxiety, but going gluten-free to treat my coeliac disease eased the severity of my anxiety significantly.
The interesting thing I have noticed is that every time I get "glutened" (the term for accidental ingestion of gluten due to cross contamination or mistaking something for being gluten free that's not) my mood drops dramatically. All the physical symptoms come back in a tidal wave knocking my system out completely and it takes days or maybe weeks to feel balanced again emotionally and physically. This is why it's so important that food handlers and restaurants understand the severity of a coeliac's reaction to even the smallest amount of gluten, making it absolutely essential that there is no risk of gluten cross contamination when preparing a meal for someone with coeliac disease.
The link between coeliac disease and mental health cannot be ignored and it is of the upmost importance that people are offered tests for coeliac disease so that they don't go undiagnosed, risking the damaging physical and psychological effects. 1 in 100 people in the UK have coeliac disease, you can find a list of symptoms here so please get tested if you have any of the symptoms and remember there is support out there for those going through mental health difficulties, you can check out Mind and Samaritans.
Going gluten-free changed my life. I am so grateful to have caught my coeliac disease sooner rather than later so that I could focus on getting my physical and mental health back. I now run a gluten-free travel blog called Coeliac on The Road to celebrate that being coeliac doesn't have to hold you back and it can actually lead you to some unique, unexpected places.
Photo: author's own