Talking to Your Therapist About Celiac

Mental health support can be invaluable for living with celiac disease. But many therapists don’t know much about celiac. Here’s how to make therapy work for your specific situation.

Why Therapy Helps

Living with celiac disease involves:

• Chronic illness stress
• Dietary restriction
• Social challenges
• Anxiety about food
• Grief and loss
• Identity changes
• Possible depression

These are mental health issues. Therapy can help.

Finding the Right Therapist

Ideal: Chronic Illness Experience

Look for therapists who have:

• Experience with chronic illness
• Work with dietary restrictions or eating issues
• Understanding of autoimmune conditions

Acceptable: Willing to Learn

Many good therapists haven’t encountered celiac but:

• Are curious and willing to learn
• Can apply their skills to your situation
• Will take your concerns seriously

Red Flags

Avoid therapists who:

• Minimize chronic illness (“Just don’t think about it”)
• Think celiac is a “lifestyle choice”
• Suggest you might be “too focused” on diet
• Don’t take physical health seriously

The First Session

What to Explain

Give your therapist basic celiac education:

“Celiac disease is an autoimmune condition. When I eat gluten, found in wheat, barley, and rye, my immune system attacks my intestines. It causes damage and many symptoms. The only treatment is a completely gluten-free diet, forever. Cross-contamination can make me sick.”

Key Points to Convey

• It’s medical, not a preference
• The diet is strict and permanent
• It affects every aspect of life
• There are real mental health implications

What You’re Working On

Be specific about what you need help with:

• Anxiety about food/eating out
• Depression since diagnosis
• Grief about dietary loss
• Social isolation
• Relationship strain
• Identity issues
• General coping with chronic illness

What to Address in Therapy

Food-Related Anxiety

• When vigilance becomes hypervigilance
• Distinguishing necessary caution from excess anxiety
• Managing eating situations
• Coping with uncertainty

Grief and Loss

• Specific foods you miss
• The life you had before
• Social ease you’ve lost
• Identity changes

Social Challenges

• Navigating social eating
• Feeling like a burden
• Explaining celiac to others
• Isolation and withdrawal

Depression

• Related to chronic illness stress
• Related to nutritional factors
• Related to identity disruption
• General mood struggles

Relationship Issues

• With partners who don’t understand
• With family
• Social relationships affected by food

Anxiety Beyond Food

• Health anxiety
• Perfectionism activated by celiac
• Control issues

Helping Your Therapist Understand

Provide Context

Help them understand the scope:

“Eating isn’t just a thing I do three times a day. It’s something I have to think about constantly, every meal, every snack, every social situation. It takes energy and attention all the time.”

Explain Cross-Contamination

Many people don’t understand this:

“It’s not just avoiding bread. I have to think about how food is prepared, what surfaces it touched, whether utensils were shared. A crumb can make me sick.”

Describe Glutening

Help them understand the consequences:

“When I accidentally get gluten, I get [your specific symptoms]. It can last for days. And even when I don’t feel symptoms, my intestines are being damaged.”

Share Resources

If they want to learn more:

• Point them to celiac disease foundation websites
• Share articles that explain the mental health connection
• Offer to bring educational materials

What Good Therapy Looks Like

Validation

A good therapist will:

• Acknowledge that this is hard
• Not minimize your experience
• Understand the chronic illness stress

Practical Strategies

Therapy can help with:

• Coping skills for anxiety
• Communication scripts for social situations
• Grief processing techniques
• Stress management

Perspective

A good therapist helps you:

• Find balance between vigilance and anxiety
• Not let celiac take over your identity
• Build a meaningful life that includes celiac
• Process difficult emotions

Connection

The therapeutic relationship itself:

• Someone who understands
• A place to process
• Support that doesn’t tire of your issues

Special Considerations

If You Have Eating Disorder History

Celiac and eating disorder history is complex:

• Necessary restriction can trigger old patterns
• Find a therapist who understands both
• Be honest about your history
• Watch for warning signs

If Depression Is Severe

Celiac-related depression can be serious:

• Don’t minimize it
• Consider medication evaluation
• Address both the celiac context and the depression itself

If Therapy Isn’t Helping

If your therapist isn’t getting it:

• Advocate for yourself
• Provide more education
• Consider a different therapist if needed

Not every therapist is right for every person. It’s okay to switch.

A Prayer for Healing

Lord, I’m seeking healing for my mind as well as my body.

Guide me to the help I need. Give my therapist wisdom to understand. Give me courage to be honest.

Let this work bring peace. Let me learn to carry this illness without being defined by it.

Heal me, body, mind, and spirit.

Amen.

Making the Investment

Therapy takes time and money. For chronic illness:

• It’s a worthwhile investment
• Mental health affects physical health
• Support makes the difference

You don’t have to figure this out alone. Get the help that helps.