Celiac Disease (or Coeliac Disease) and gluten intolerance create such fundamental changes in our biology and physiology that one can’t help but wonder how far these effects reach.
Since I began my site and began more exhaustive research into gluten intolerance, I’ve met many people who struggle with the psychological weight of celiac disease and conforming to such a strict diet. So naturally this led me to research the association of celiac disease and depression. Does such a thing as a celiac depression really exist? Do celiac and depression go hand-in-hand?
Depression — as well as some other mood and behavioral troubles — may occasionally be related to gluten intolerance symptoms. In several studies, children and adults with celiac sprue disease experienced greater rates of clinical depression than patients without celiac disease. Occasionally these surveys were comprised of subjects with untreated celiac sprue (so they were still consuming gluten in their diet).
With other cases, even as the research specifically concerned celiac subjects on gluten-free diets, they still experienced sharper rates of clinical depression compared with non-celiac subjects. This seems to indicate some kind of celiac disease depression.
But the larger question becomes… does a gluten-free diet help people suffering from depression? How related, clinically, are a gluten-free diet and depression?
If the patient’s clinical depression is associated with malabsorption of nutrients, than being gluten-free may facilitate treatment, as the bowels heal and nutrient assimilation increases.
A few researchers think that malabsorption may interfere with the body’s managing of the neurotransmitters which govern mood. Particularly, malabsorption-related insufficiency of tryptophan seem to add to depressive disorder within coeliac subjects. Tryptophan is essential for the body’s output of serotonin, which is the primary neurotransmitter required for mood regulation as well as anxiety tolerance.
In untreated celiac subjects — as well as in a few celiac subjects on gluten-free diets — being vitamin B6 insufficient may also exhibit a role within clinical depression. In a recent Scandinavian study, for instance, subjects with celiac disease as well as clinical depression described no improvement in their clinical depression after a year on the gluten-free diet. After six months of vitamin B6 treatment, however, their depressive symptoms had distinctly improved.
Additional side effects from malabsorption may induce symptoms which may have been misidentified as clinical depression. For instance, an insufficiency of folic acid ascribable to malabsorption may induce weariness, indifference as well as absent mindedness. Iron deficiency or low ferritin symptoms, with or without anemia, may provoke feelings of fatigue as well.
In one study of individuals aged twelve to sixteen with gluten intolerance in the Republic of Finland, children who were depressed prior to subscribing to a gluten-free diet had specific hormonal biochemical imbalances affiliated with clinical depression. After 3 months on a gluten-free diet, these same young teenagers had restored hormone biochemistries while exhibiting a substantial decrease in psychiatric symptoms.
A gluten-free diet isn’t always the best reparation for clinical depression, nonetheless, for reasons which are occasionally understood yet occasionally unknown. At least two separate Italian studies have ascribed greater rates of clinical depression in gluten-free celiac subjects to difficulties in adapting to the disease as well as the diet. Celiac patients within these studies were to a greater extent anxious because they sensed their quality of life had been challenged and made more difficult.
The psychological root, or the depression cause in this case isn’t directly a result of the celiac disease but an indirect result of facing the lifestyle changes and restrictions required by celiac disease.
I believe these are the individuals whom I’ve met the most.
In numerous additional published studies, including one from the Kingdom of Sweden observing more than 10,000 subjects with celiac disease, authors have discovered greater rates of clinical depression amidst gluten-free celiacs yet weren’t able to identify particular causes.
So you’ve read all these stats and figures and you’re still wondering… what does this all mean?
In short, we don’t know everything we can about celiac depression for certain just yet. While it seems likely celiac disease has the potential of invoking a more depressive state, researchers haven’t been able to narrow down exactly why this is the case. We can’t with certainty attribute it to celiac disease itself because it could be a second level side-effect of malabsorption. And furthermore we can’t yet define with certainty whether depression develops in celiac cases because of our biology or because of the increased difficulty of living with the perceived lifestyle and dietary restrictions of a gluten-free life.
So is there such a thing as a celiac depression? Apparently so, but we can’t quite identify why or how just yet.
This may not have been the clear conclusion you sought, but I hope it empowers you to appreciate how you must take a positive and proactive approach to your lifestyle or the lifestyle of your loved ones when you adapt to gluten-free living. Celiac depression is a real possibility as one of many celiac disease symptoms and it is better to be healthy and thoughtful about it then to pretend it can’t happen to you or your loved ones.
Thanks again for visiting Gluten Intolerance School and I hope this helped.