Living with celiac disease doesn’t just affect your gut – it can impact your mental health too.
A growing body of literature suggests that people living with celiac disease may be more likely to be diagnosed with mental health and neurodevelopmental conditions like depression, anxiety, mood disorders, eating disorders, autism, and attention deficit hyperactivity disorder (ADHD), compared to the general population (1–4). Of the conditions associated with celiac disease, anxiety and depression have been the most studied, with studies finding a higher prevalence of people presenting with symptoms or being diagnosed with anxiety and depression (4–8).
The higher prevalence of mental health conditions among people who live with celiac disease remains unclear; however, researchers have proposed several theories.
While it appears that most of the focus for newly diagnosed patients is on the gluten-free diet, physicians reported that patients appeared to be the least prepared to manage the emotional and mental health adjustments of a new diagnosis, highlighting the mental toll celiac disease and the gluten-free diet can have.
Collectively, these factors may contribute to the developmental of mental health conditions among individuals living with celiac disease.
Little is known about the treatment for psychiatric conditions among the celiac disease population and how pharmacological treatments may change over time. In a recently published study from Alberta Canada (12), the authors aimed to characterize patterns in psychiatric medication use in individuals before and after receiving positive tTG serology. Specifically, the study looked at over 14,000 children and adults who tested positive for celiac autoimmunity between April 2015 to March 2023. Researchers examined administrative healthcare data to identify the dispensation of psychiatric medication before and after the celiac autoimmunity results. The authors specifically looked at three medication types commonly used for mental health conditions:
After people were found to have celiac autoimmunity, the study found:
These findings were found to be statistically significant, meaning they were unlikely to be due to chance.
2. People were more likely to start psychiatric medication after positive testing for celiac autoimmunity.
The study found that people had 1.22 times higher odds of being dispensed psychiatric medication after tTG testing.
These odds were higher among females (1.29 times higher odds) and those diagnosed before 25 years old (2.50 times higher odds). tTG levels at diagnosis were not found to be a significant modifier in medication dispensed.
3. For people who already had healthcare encounters for anxiety and depression, the odds for medication dispensed decreased. (45.1% à1%)
These odds were not modified by factors like sex and tTG levels at testing; however, the associations for age remained, with a decreased odds for those under 25 years old.
This study highlights that being diagnosed with celiac disease may be a vulnerable time, especially for young adults and women. While we can’t say for certain that celiac disease directly causes mental health conditions, we are mindful that the stress, dietary restrictions, and lifestyle changes can take a mental toll.
If you or someone you know is struggling with mental health after a diagnosis, know that you are not alone and support is available. Talking to a healthcare provider or mental health professional can be helpful in managing both the physical and emotional aspects of celiac disease.
References
News, hot topics, tips, education & more.
