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Anxiety and Depression in Adults with Celiac Disease on a Gluten-free Diet

Anxiety and Depression in Adults with Celiac Disease on a Gluten-free Diet 07/13/2010 - More and more, researchers are showing connections between inflammatory diseases, like celiac disease, and complex disorders, such as anxiety and depression. There's also a good amount of anecdotal evidence to suggest that people with celiac disease have higher rates of anxiety and depression than the general population.

A study of the German population is the first to show that female adults following a gluten-free diet for celiac disease show higher levels of anxiety than do members of the general population.

The researchers are recommending that female celiacs on a gluten-free diet be screened for anxiety. The researchers included W. Häuser, K. H. Janke, B. Klump, M. Gregor, and A. Hinz of the Department of Internal Medicine I of the Klinikum Saarbrücken, Winterberg in Saarbrücken, Germany.

The team set out to examine levels of depression and anxiety between adults with celiac disease following a gluten-free diet (GFD), and in control subjects drawn from the general population.

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For their study, the team used the Hospital Anxiety and Depression Scale to measure levels of anxiety, depression, and likely anxiety or depressive disorder, in 441 adult patients with celiac disease recruited by the German Celiac Society. They then conducted the same assessments on 235 comparable patients with inflammatory bowel disease (IBD), either in remission or with slight disease activity. They did the same for the cross-sample control group of 441 adults from the general population.

The team used regression analysis to test possible demographic and disease-related predictors of anxiety and depression in celiac disease. Demographic predictors included age, sex, social class, and family status. Disease-related predictors included latency to diagnosis, duration of GFD, compliance with GFD, thyroid disease.

The team found that female gender (P = 0.01) was the main predictor (R(2) = 0.07) of anxiety levels in patients with celiac disease. Female patients had a higher risk for a probable anxiety disorder (OR = 3.6, 95% CI: 1.3-9.4, P = 0.01)  Patients who lived alone (OR = 0.5, 95% CI: 0.2-0.9, P = 0.05) enjoyed a lower risk of anxiety disorder. None of the demographic and medical variables for which the team screened predicted either depression levels or risk for a probable depressive disorders.

Patients with celiac disease showed anxiety levels of 6.6 +/- 3.4, and those with IBD, anxiety levels of 6.9 +/- 3.7, both higher than the general population's level of 4.6 +/- 3.3 - (both P < 0.001). Depression levels were similar for people with celiac disease (4.2 +/- 3.4), IBD (4.6 +/- 3.4) and the general population (4.2 +/- 3.8) (P = 0.3). Rates of likely anxiety disorders in people with celiac disease were 16.8%, and 14.0% for IBD, both higher than the rates of 5.7% in the general population (P < 0.001). All three groups showed similar rates of probable depressive disorder (P = 0.1).

Their results provide strong indications that adult women with celiac disease on a gluten-free diet suffer higher rates of anxiety than persons of the general population. They encourage clinicians to provide anxiety screens for adult women with celiac disease on a gluten-free diet.

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17 Responses:

kelly fordon
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said this on
19 Jul 2010 5:33:46 AM PST
I'm surprised by this. I think following the gluten-free diet lowers anxiety levels rather than increases it. I would like to know if their anxiety levels were higher before they started following the diet, or if they decreased over time....

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said this on
19 Jul 2010 11:29:00 AM PST
Good question, yet, I still can identify with the researcher's analysis. Following a gluten-free diet brings about dietary and social demands that non-celiacs never need to imagine. Unfortunately, this way of life is quite demanding for young females wanting to "fit in". Note that those living alone did not display similar results.

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said this on
19 Jul 2010 1:59:53 PM PST
I had a very high level anxiety disorder before getting the Celiac diagnosis and going gluten-free. While my anxiety levels did get better on some levels (no more panic attacks, no free-floating anxiety), I have certainly noticed a level of anxiety that in some ways is worse and hits me harder, although I can usually find a trigger. I don't have it all the time anymore, but when I do have it, it seems to be a deeper anxiety than I usually had before getting my diagnosis and going gluten-free.

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said this on
19 Jul 2010 6:19:19 PM PST
My experience is that gluten-free diet helped depression and anxiety. Four years later I can say that dairy-free added to that. What else are these people eating? Lots of gluten-free specialty foods,with empty calories and no nutrients? Healthy fats? Do they have kids w/their own undiagnosed neurological disorders? That increases anxiety.

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said this on
19 Jul 2010 8:37:35 PM PST
These numbers are confusing to me.
But, I agree with the anxiety piece. Most of the time, I can link it to when I eat out so I could guess it was cross contamination and I ate a trace of gluten. Other times, I can't find a trigger to it.
But, my anxiety definitely only started when I started a gluten-free diet.

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said this on
20 Jul 2010 6:45:29 AM PST
I had much less anxiety while living alone. No contamination worries. Didn't eat out as much. I usually consume gluten containing foods, mistakenly, while eating out, being social. People/restaurants say their food is gluten-free, but many times it's not, or contaminated. This challenges my trust, which can cause anxiety. I have to have very strict boundaries, decide what is really best for me.

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said this on
20 Jul 2010 8:09:00 AM PST
This diagnosis of Celiac disease is the worst thing that has ever happened to me. I believe that living alone would make this a lot easier. Being married means conflicts with your spouse over the Celiac not wanting to bring food to a barbecue/party where you do not know the hosts. Even if you do know the hosts it still is very awkward and not fun at all. Traveling is really stressful also.

Everyone says to me that there is a lot of Gluten-Free food now. Well most of it is awful. Before being Celiac I could buy bread that is 40 calories a slice and the average caloric count of gluten-free bread is about 150 calories a slice.

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said this on
23 Jul 2010 12:01:09 PM PST
I have followed a gluten-free diet for 13 years and felt physically and personally healthier every year up until the past 3 years. I am now married and have 2 little kids. I often have a hard time eating well (I sometimes avoid eating simply because it is so much effort to find healthy, quick gluten-free foods, or I eat questionable foods out of necessity) and uncharacteristic anxiety affects some areas of my life quite noticeable.

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said this on
28 Jul 2010 10:31:31 AM PST
I am 60 years old and got diagnosed 1 year ago. I fully agree that the celiac diet tastes awful. It is no wonder women living with a spouse are depressed and have anxiety. They must make two types of meals everyday and smell it cooking knowing that they cannot eat it. Eating out is so frustrating when you have to pick and choose what you can and cannot eat from the menu or tying to find a restaurant that is gluten-free and will not cross-contaminate food. Family gatherings are the worst, watching everyone having what you cannot have.

Vesta Coffey
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said this on
25 Jul 2010 3:27:02 PM PST
I think if you wanted to you could blame alot of things on the celiac disease. I was diagnosed one - half years ago. I feel much better and my anxiety level is almost nothing, since I have been eating gluten free.

If I eat badly (gluten-free junk) I don't feel as well. Also, most of the gluten free bake goods are not that good for you.

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said this on
03 Aug 2010 11:51:07 AM PST
Interesting article, but it leaves a lot of unanswered questions -- let's hope for more studies on this.

My anxiety levels spiked too on the gluten-free diet (although I also had anxiety before). My anxiety has slowly gone down over the past 6 month (I have been gluten-free for 2 years). I was found to have really weak adrenals, probably from the years of inflammation and pain from Celiac. Since supporting my adrenals over the past 6 months I have improved a lot.

I think gluten contributes to anxiety, but I am very curious as to why. I have heard that the serotonin receptors in your gut can become damaged with Celiac, which can increase anxiety. I also wonder why it seems to have gotten worse when I first went gluten-free, detox reaction maybe? I have also heard that wheat can act as an opiate sometimes, so maybe it was a withdrawal of some kind?

Lots of interesting possibilities -- let's hope that more research can help with this problem that so many of us have.

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said this on
30 Aug 2010 6:27:19 PM PST
I can testify that my anxiety and depression were significantly reduced after being diagnosed. It was seriously like having a brand new life once I had been correctly diagnosed. I had been living with this since childhood and had been diagnosed with numerous other diseases; however, once I had been diagnosed, all of the other things went away. Yes! I'm not anxious at all. Happy as a new born lamb and a lil adjustment is all I needed.
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said this on
11 Dec 2010 10:41:40 AM PST
I know I am feeling Blue in regards to my celiac. My family eats normal and we have active social lives but I feel like just not eating at all because the only things I can eat seem to be either gross, or too expensive to buy, or the same boring thing I eat day after day. So I feel like just starving myself or giving up. I hate the feeling! I don't have or know celiac friends so I am struggling through this alone and its not fun. I have a dinner to attend today, and tomorrow and I will have to bring all my own food and I don't want to eat... I don't feel like eating at all.

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said this on
24 Mar 2011 12:53:38 PM PST
I am just starting a gluten free diet to see if it will help before I do all the expensive testing. So far I am seeing amazing results. I have incredibly high anxiety levels and they have subsided dramatically. Also my gastrointestinal problems are going away in a hurry. This may be the best thing I ever do for myself.

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said this on
03 Nov 2011 12:11:14 AM PST
Anxiety attacks can happen to anyone. Exercise is one other thing that you can do to improve your mental state. Exercise helps to increase the serotonin levels in your brain's chemistry. These serotonin levels enhance a sense of well-being. Finding an exercise routine and sticking to it will enable you to better your day-to-day anxiety levels. It will also help you to feel better about yourself and your body in general.

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said this on
23 Apr 2012 6:20:18 AM PST
I'm a male diagnosed with social anxiety disorder after I quit school because of it, I've also suffered with depression for most of my life. I recently discovered I have celiac too.

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said this on
18 Mar 2015 7:57:30 PM PST
Due to malabsorption in the gut, and diagnosed with celiac after years of anxiety and depression (GAD), I recently came across articles related to 5-MTHFR Deficiency. Folic acid as we all know it, is not metabolised properly by some individuals. Latest research is showing that we need the more active form folic acid - and bio-identical form of folinic acid. Unfortunately, the high dose form of this folate is only available in certain countries in high doses - the product is called Deplin. Battling with anxiety and depression and celiac including borderline iron deficiency all relates back to inefficient absorption. It's not easy exercising when your high homocysteine levels cause chronic fatigue and very low energy which makes you more susceptible to inflammation.

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