A wide range of psychological problems can arise for those with untreated celiac disease or non-celiac wheat sensitivity. Initially there may be a misdiagnosis of psychiatric illness due to some of the neurological and psychiatric symptoms that can be seen in untreated disease. Once diagnosed, there may be difficulty adjusting to a new diagnosis of chronic illness and adherence to a gluten-free diet.

When a Mental Health Referral is Needed

A wide range of psychological problems can arise for patients with untreated celiac disease or non-celiac wheat sensitivity. These can include difficulties adjusting to a new diagnosis of chronic illness as well as dealing with adherence to a gluten-free diet and other aspects of disease management. Protracted duration of emotional or behavioral symptoms, greater severity of symptoms, and/or significant impairment in functioning are indicators of potential need for mental health treatment. These include:

  • Finding little or no pleasure in life
  • Feeling worthless or extremely guilty
  • Crying a lot for no particular reason
  • Withdrawing from other people
  • Experiencing severe anxiety, panic or fear
  • Having big mood swings
  • Experiencing a change in eating or sleeping patterns
  • Having very low energy
  • Losing interest in hobbies or pleasurable activities
  • Having too much energy, having trouble concentrating or following through on plans
  • Feeling easily irritated or angry
  • Experiencing racing thoughts or agitation
  • Hearing voices or seeing images that other people do not experience
  • Believing that others are plotting against you
  • Wanting to harm yourself or someone else

Case Examples

The following are three case examples of children and adolescents with diagnosed celiac disease who would benefit from mental health evaluation and treatment.

When a Medical Evaluation is Needed

Initially those with celiac disease or non-celiac wheat sensitivity may be misdiagnosed with a psychiatric illness due to some of the neurological and psychiatric symptoms that can be seen in untreated disease including:

  • Mood changes
  • Anxiety
  • Fatigue
  • Difficulties with concentration and attention
  • Sleep difficulties
  • Decreased appetite

Case Examples

The following are three case examples patients seen for mental health treatment, for whom a referral for evaluation of celiac disease or non-celiac wheat sensitivity is recommended.