DEPRESSION IS NOT A CHARACTER DEFECT
Depression is a frequent disorder in the population and is characterized by continuous or long-lasting feelings of sadness, lack of interest, tension that can interfere with everyday life. Any person can experience depression at any age.
Depression is twice as common in women than in men.
Common signs and symptoms of depression include sadness, anxiety, irritability, decreased energy, difficulty concentrating, abnormal sleep habits, changes in appetite and more.. This requirement is often successfully treated with a combination of medication and psychotherapy, however many individuals with depression do not seek treatment due to stigma, shame or prejudice.
Depression is not a character defect or a sign of weakness, it is a disorder that if left untreated can become a real disease.
CONNECTION BETWEEN CELIACIA AND DEPRESSION
From an organic point of view
According to several studies, there is a possible link between brain function and malabsorption which is the inability to absorb nutrients from food properly.
When the intestine is “damaged”, the essential substances for the body pass through the intestine without passing into the blood and are then distributed throughout the body.
The risk of developing depression for people with celiac disease is 1.8 times more likely than for the general population
Adopting the gluten-free diet can help relieve symptoms of depression for people with celiac disease as essential nutrients also to keep the mood good, they are absorbed again.
From a psychological point of view
Depression can occur before diagnosis because the disorders caused by gluten in subjects genetically predisposed to the disease are very strong.
Living with gastric (stomach) and abdominal pain, skin reactions, anemia, make the life of celiacs difficult and very tiring.
After the diagnosis, especially if it occurs after weaning or even older, there is a great repercussion in the change of eating habits; get used to new flavors, mourn the old foods that you have loved and that have characterized a part of your life.
This detachment is also made difficult by the difficulty, especially as children, of being able to connect physical ailments to foods , especially the best ones: fresh bread from the oven, pizza, pasta with a sauce prepared with love by family members, “party” foods , sweets, birthday cakes.
All foods are invested with great emotional value , means and means of profound relational exchanges with one’s parents, family members, friends.
After the diagnosis, the celiac person discovers that he will have a “curvy” life, in which attention to food and contamination engages a lot of will and from an emotional point of view.
People with celiac disease are endowed with a great spirit of sacrifice that has a great impact and emotional charge in their life.
The impact is also significant in daily life in which attention to nutrition is a continuous challenge, both for the stresses that can come from both the gluten-free diet, not easy to implement outside the home, and from the management of a chronic condition , not susceptible to change.
PSYCHOLOGICAL CONSEQUENCES IN THE VARIOUS AGES OF LIFE
CHILDHOOD
If the diagnosis is made at weaning, the child does not know other eating habits and therefore the diet is more easily integrated into the lifestyle.
It seems that celiac disease is perceived by the child differently depending on whether the diagnosis occurs before or after language development (1.5 / 2 years): first the child simply grows up in a gluten-free world and does not know another way of live, while afterwards he feels that something in life has been taken away from him and must give it up.
If the diagnosis occurs with the start of schooling,even if the physical ailments generally disappear in a short time with the gluten-free diet, some emotional and behavioral alterations may persist for longer: anger, irritability, listlessness at school, apparently unmotivated aggression with friends and companions, psychomotor agitation as an expression of a depressive disorder and manifestation of an inner discomfort, due to the “injustice” of having a disease that forces you to lead a different life than others and that makes you feel “different” even if you do not “see” and perhaps for this reason even more painful for fear of not being believed and not understood.
ADOLESCENCE
In adolescence there can be opposing reactions, they can be observedstrictly dieting or “transgressive” adolescents.
Celiac adolescents are generally “toy soldiers” with very marked anxious and sometimes “phobic” traits, really terrified by the possibility of ingesting foods “contaminated by limiting their social relationships or influencing them a lot.” It can become a strong identity element that can be experienced as a “characteristic” or as a “problem”. If diversity is a problem, it can manifest itself with friends, where in order to align with others, strains from the diet can also be frequent, hidden from the family, since at home, where you feel calm and not judged, the diet is followed scrupulously.
Since in adolescence it is natural to modify the image of oneself and the image that others have of him,the celiac adolescent can reject his condition, “fight it”, rebel against it and break the diet in an attempt to support his “self-esteem” and not feel “sick” or not accepted.
While children stick to what parents and pediatricians say , they want to be guided, learn and make parents happy, they respond well to reassurance and gratification, they want to no longer have “stomach ache” and finally be and feel good.
On the other hand, adolescents with respect to diet are influenced by some variables: –
The age of diagnosis
– The anxiety and concern of the parents
– The addictive link that the disease induces between parents and children
-The absence of acute symptoms after the “strains to the diet”
-The experience and experience of “diversity” compared to peers and family members if not celiac
ADULT AGE
Accept the idea that for the whole life we ​​must strictly respect the diet is not simple but more acceptable and in the end a habit if you come from an experience of significant physical suffering.
This is simpler in private life, in the family, while it is more complex in work and social life , also due to the lack of knowledge of the problem in general and the scarcity of adequately equipped facilities for celiacs.
Celiacs want to live a life as normal as possible, they don’t like to isolate themselves and don’t feel “special” , but the obstacles of daily life, first of all the fear of running out of food, and a thought that constantly accompanies them, even if it is not declared.
Even the continuous “renunciations” have a weight on the emotional balance, the constant and periodic checks, the prevention protocols within which they are inserted.
Holmes (1996) conducted a study on adult celiacs on a diet for 10 years and found a percentage of depression, even severe, in 10% of celiacs.
In fact, while the state of anxiety following the diagnosis decreases with the passage of time, the same does not happen with the depressive state, which seems to be frequently associated with celiac disease, together with a perceived quality of life significantly worse than the general population, in terms of vitality and general well-being. It can be hypothesized that the presence of psychological disorders can reduce the perception of the quality of life and compliance with the diet, this confirms that it is not always said that adherence to the diet guarantees the perception of health (global, physical + psychological) in the patient. (IG Cimma).
PSYCHOLOGICAL SUPPORT
Children such as celiac adolescents and their families need support from the medical team as well asof reference, also of psychological support, of an analytical psychotherapy or of an analysis be it individual, of the parental couple or of the family.
Living with a chronic disease, even if asymptomatic thanks to the diet, is not easy.
Many patients report that periods are “exhausting”, a sort of “irritating thorn” that accompanies them.
Psychotherapy and analysis are important as they allow you to work on the daily micro-traumatic aspects of the diet; they make it more resistant than the temptation to “yield”; they help to “integrate” one’s celiac condition ia harmonious way within the personality which is a complex entity and goes far beyond disturbance; they help to “organize” one’s life not according to celiac disease but by understanding it and thus adapting to the variables that social, work and family life entail; they allow you to face difficulties with greater strength, confidence and determination; they cure or prevent depressive slips .
PHARMACOLOGICAL THERAPY
When necessary, psychopharmacological therapy, prescribed by the specialist , can also be indicated.
CELIAC AND SCHOOL
Parents of celiac children and adolescents, upon specialist certification certifying their necessity, can request the activation of a BES (law 170/2010) in the school environment which may be temporary or prolonged according to subjective needs.
