Celiac Disease and Anxiety

Living with celiac disease means constant vigilance about food. This vigilance is necessary, but it can tip into anxiety that affects quality of life.

Here’s how to find the balance.

Why Celiac Breeds Anxiety

Constant Threat Assessment

Every eating situation requires assessment:

• Is this food safe?
• What’s in it?
• How was it prepared?
• Can I trust the source?

This is exhausting. Your brain is always scanning for danger.

Real Consequences

The anxiety isn’t irrational. Eating gluten causes real harm:

• Physical symptoms
• Intestinal damage
• Long-term health consequences

Unlike some anxieties, this one is based in reality.

Unpredictability

You can’t always control your food environment:

• Traveling
• Social events
• Restaurants
• Other people’s kitchens

The unpredictability feeds anxiety.

Past Bad Experiences

If you’ve been glutened despite being careful:

• Your brain remembers
• You anticipate it happening again
• Trust becomes harder

Healthy Vigilance vs. Unhealthy Anxiety

Healthy Vigilance

Necessary and appropriate:

• Checking labels
• Asking questions at restaurants
• Declining food you can’t verify
• Having safe food available

This keeps you safe without consuming your life.

Unhealthy Anxiety

When it crosses a line:

• Unable to eat anywhere but home
• Panic attacks around food
• Avoiding all social eating
• Excessive worry even in safe situations
• Inability to trust any food even from trusted sources
• Checking and re-checking safe items compulsively

This impairs your life beyond what’s necessary.

The Physical-Mental Connection

Anxiety Causes Physical Symptoms

Anxiety can cause:

• GI distress
• Nausea
• Stomach pain
• Diarrhea

These mimic glutening symptoms, creating a feedback loop.

Is It Gluten or Anxiety?

Sometimes it’s hard to tell:

• You ate something questionable
• You feel sick
• Was it gluten? Or anxiety about gluten?

This uncertainty can increase anxiety further.

Breaking the Loop

Tracking symptoms helps distinguish:

• Document what you ate (objectively safe or questionable)
• Document symptoms
• Look for patterns

Over time, you may notice symptoms appearing when food was definitely safe, indicating anxiety contribution.

Managing Anxiety While Staying Safe

Accept the Baseline

Some vigilance is permanent. You’ll always need to:

• Read labels
• Ask questions
• Be thoughtful about food

Accepting this as normal rather than fighting it reduces some anxiety.

Create Systems

Systems reduce anxiety by reducing decision-making:

• Standard safe products you always buy
• Go-to restaurants you’ve vetted
• Standard questions you ask
• Routines that work

When you have systems, you’re not reinventing safety every meal.

Build Trust Gradually

Learn what you can trust:

• Your own cooking is safe
• Certain products are reliably safe
• Certain restaurants have proven reliable
• Certain people prepare food safely

As trust builds, anxiety can decrease in those contexts.

Challenge Catastrophic Thinking

Anxiety often involves catastrophic thoughts:

• “If I get glutened, I’ll be sick for weeks”
• “I can never eat out again”
• “No one can keep me safe”

Challenge these:

• Glutening is unpleasant but survivable
• Many restaurants are safe with proper vetting
• Some people can and do keep you safe

Focus on What You Can Control

You can’t control everything. You can control:

• What you cook at home
• Whether you carry safe snacks
• What questions you ask
• Which invitations you accept
• How you respond to mistakes

Focus energy on what’s in your power.

Allow for Imperfection

If you’re doing your best, occasional glutening may still happen:

• It’s not a moral failure
• You’ll recover
• It doesn’t mean you did everything wrong

Perfectionism feeds anxiety.

When to Seek Help

Signs You Need Support

• Anxiety significantly impairs daily functioning
• You’re avoiding necessary activities due to food fear
• You’re losing weight because you’re afraid to eat
• You’re having panic attacks
• Your quality of life is severely impacted
• You recognize your fear is disproportionate but can’t stop

Types of Help

Therapy: Especially CBT (Cognitive Behavioral Therapy), which addresses anxiety patterns.

Medication: Anti-anxiety medications can help some people.

Support groups: Connecting with other celiacs who understand.

Mindfulness: Techniques to manage acute anxiety.

Don’t wait until it’s unbearable. Getting help early is better.

Techniques for Acute Anxiety

When Anxiety Spikes

Grounding:

• 5 things you can see
• 4 things you can touch
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

Breathing:

• Slow, deep breaths
• Exhale longer than you inhale
• Focus only on breath for 2 minutes

Self-talk:

• “I have eaten safely many times”
• “I can handle this”
• “This feeling will pass”

Action:

• Can you verify the food is safe? Do that.
• Can you not verify? Don’t eat it.
• Then let the decision be made and move on.

A Prayer for the Anxious Heart

Lord, I’m carrying more than vigilance today. I’m carrying fear.

You know what I need. You know the real danger and the imagined danger. Help me tell the difference.

Give me wisdom about what’s safe and what’s not. Give me peace when I’ve done my due diligence. Give me courage to live fully despite the risk.

Calm the storm in my chest. Quiet the racing thoughts.

I’m doing my best. Help me trust that my best is enough.

Amen.

Living, Not Just Surviving

The goal isn’t to eliminate all anxiety, some is appropriate. The goal is to live fully while staying safe.

That means:

• Eating out sometimes
• Attending social events
• Traveling
• Saying yes to experiences

With appropriate precautions, these are possible. Don’t let anxiety steal more than celiac disease requires.

Stay safe. And stay alive, really alive.