Does a Gluten-Free Diet Help Relieve Depression in Celiac Patients?
If the patient's depression is related to malabsorption of nutrients, then being gluten-free can help, because the intestines heal and nutrient absorption improves.
Some researchers believe that malabsorption can interfere with the body's handling of neurotransmitters that regulate mood. In particular, malabsorption-related deficiencies of tryptophan appear to contribute to depression in celiac patients. Tryptophan is necessary for the body’s production of serotonin, which is the central neurotransmitter involved in regulation of mood and anxiety.
In untreated celiac patients - and even in some celiac patients on gluten-free diets- deficiencies of vitamin B6 can also have a role in depression. In one Scandinavian study, for example, patients with celiac disease and depression reported no improvement in their depression after a year on the gluten-free diet. After 6 months of vitamin B6 therapy, however, their depressive symptoms were dramatically improved.
Other side effects of malabsorption can cause symptoms that can be mistaken for depression. For example, a deficiency in folic acid due to malabsorption can cause fatigue, apathy and forgetfulness. Iron deficiency, with or without anemia, can produce feelings of tiredness and easy fatigue.
In one study of 12-to-16-year-olds with celiac disease in Finland, kids who were depressed before going on a gluten-free diet had certain hormonal biochemical derangements associated with depression. After 3 months on a gluten-free diet, these same adolescents had improved hormone biochemistries and a significant decrease in psychiatric symptoms.
A gluten-free diet is not always the fix for depression, however - for reasons that are sometimes understood and sometimes not. At least two Italian studies have attributed higher rates of depression in gluten-free celiac patients to difficulties in adjusting to the disease and the diet. Celiac patients in these studies were more anxious and felt their quality of life had gotten worse.
In several other large published studies, including one from Sweden involving more than 13,000 patients with celiac disease, the authors found higher rates of depression among gluten-free celiacs but were not able to identify specific reasons.
What Should You Do If You Are Depressed?
- If you have celiac disease, ask your doctor whether you need to be tested to make sure you're not accidentally ingesting gluten, which might be causing your depression. Also ask your doctor whether you should be evaluated for vitamin deficiencies.
- In the meantime, ask your doctor, or someone else you trust who has experience in mental health - for example, a nurse, social worker, or religious counselor - for advice about getting treatment. Don't try to struggle on without help.
- Visit the website of the National Institute of Mental Health for help in locating affordable mental health services in your neighborhood.
- Visit About.com's excellent website on depression.