A wide range of psychological problems can arise for those with untreated celiac disease or non-celiac gluten sensitivity. Initially, there may be a misdiagnosis of psychiatric illness due to some of the neurological and psychiatric symptoms that can manifest in untreated celiac disease. Once diagnosed, there may be difficulty adjusting to a new diagnosis of chronic illness and adherence to a gluten-free diet. In patients with celiac disease, a 10-22% increased risk of neurological disorders is reported.

When a Mental Health Referral is Necessary

Difficulty adjusting to a new diagnosis of chronic illness, adhering to a strict gluten-free diet, and other aspects of disease management can affect a patient’s mental health. 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

When a Medical Evaluation is Necessary

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

  • Mood changes
  • Anxiety
  • Fatigue
  • Difficulty concentrating
  • Sleep difficulties
  • Decreased appetite