Celiac disease is a digestive disorder that occurs when the body can’t properly process a grain protein called gluten. People affected by the disorder develop damage in their small intestines and lose some of their ability to absorb the nutrients in their food. Current evidence indicates that people with celiac disease have increased risks for developing the symptoms of major depression, the eating disorder anorexia nervosa and/or the eating disorder bulimia nervosa. According to a study published in 2011 in the journal Chronic Illness, female celiac disease sufferers, in particular, have higher risks for these mental health-related issues.
Celiac Disease Basics
Gluten occurs naturally in a number of grain species, including various strains of wheat, rye, and barley; it also occurs naturally in a manmade hybrid grain called triticale. In addition, a number of common non-food consumer items also frequently contain gluten, the National Digestive Diseases Information Clearinghouse explains, including things such as lip balms, vitamin supplements and medications. Celiac disease occurs when the presence of gluten triggers a mistaken reaction in an affected individual’s immune system, which activates abnormally and starts attacking the lining of the small intestine. These immune system attacks partially or fully destroy structures in the intestinal lining called villi, which are needed to pull nutrients through the intestinal wall and into the bloodstream. Without the normal supply of healthy villi, the body fails to absorb the nutrients it needs and the affected individual develops malnutrition.
Celiac disease typically has a genetic origin. People who inherit a tendency toward the disease frequently experience their first attacks in the aftermath of events such as viral infections, surgeries, episodes of extreme stress, pregnancies and childbirth. In older and younger children, common symptoms of celiac disease’s damaging effects include constipation, recurring diarrhea, a bloated abdomen, unexplained weight loss, vomiting, and abnormally smelly or pale bowel movements. Common symptoms in adults include unexplained fatigue, mouth lesions called canker sores, unusual tingling or numbness in the extremities, bone loss, arthritis, seizures, menstrual disruptions and a form of anemia called iron-deficiency anemia. Celiac disease-related malnutrition can lead to problems such as a miscarriage or osteoporosis; other serious conditions associated with the disorder include intestinal cancer and liver disease.
Links to Depression
A number of studies link celiac disease to increased risks for depression. For instance, Johns Hopkins Medicine reports the results of a large-scale Swedish study that connects the presence of the disease to an 80 percent increase in a given individual’s depression risks. In the study published in Chronic Illness, a multi-university research team examined the depression risks in a group of 177 American women with previously diagnosed cases of celiac disease. These researchers concluded that women with celiac disease have higher risks for depression than members of the general population. The risks were highest in women who didn’t follow gluten-free diets; however, women with celiac disease who closely follow gluten-free diets also have higher risks for depression than people without the disease.
Several factors may help explain celiac disease’s role in depression. First, people with the disease typically have a hard time absorbing a dietary substance called tryptophan; the body needs dietary tryptophan to create an internal chemical called serotonin, which helps prevent depression by preventing unusual mood swings. Depression may also be the result of a B vitamin deficiency that commonly damages the nervous systems of people affected by celiac disease. In addition, depression may appear as a result of the emotional wear-and-tear associated with coping with celiac disease’s daily effects.
Links to Eating Disorders
The study published in Chronic Illness also linked the presence of celiac disease in women to increased risks for developing the disordered eating behaviors found in people with anorexia or bulimia. Another study, published in 2007 in the European Journal of Gastroenterology and Hepatology, also tied celiac disease to both anorexia and bulimia. Both of these studies note the complex relationship between eating disorders and celiac disease. The authors of the study published in Chronic Illness add depression to this complex equation, and point out the fact that no one knows exactly how these conditions affect each other. In one possible explanation, people (especially women) with celiac disease develop an eating disorder and eventually become depressed. In another possible explanation, people (especially women) with celiac disease become depressed and subsequently develop an eating disorder.