Coping with Chronic Illness

Deborah Garnett, RN, Ph.D., Clinical Therapist, Center Point, Inc., Kansas City, MO
Lifeline, Winter 1993, Vol XI, No 1, pp 1


Dr. Garnett opened her talk by asking the audience to list their feelings related to celiac sprue; fear, guilt, sadness, anger, loneliness and resentment were among those named. In our society, many families discourage the expression of emotion. When a child's cries or outbursts of anger are punished or labeled as "bad" by the parents, the offspring tends to grow up denying the negative feelings and behaving in a rigid pattern which proved acceptable. Dr. Garnett stressed their feelings in order to deal with emotions and resolve day-to-day problems.

She emphasized the importance of sharing feelings in our support groups. The insecurities, frustrations and adjustments related to the gluten-free diet and the illness should be aired with those who understand our situation. Such meetings can contribute greatly to easing denial, isolation and potential anger.

Depression is a manifestation of anger turned inward. The symptoms include unpredictable tears, sadness that lingers longer than the situation warrants, too much or too little sleep, listlessness, trouble concentrating, extreme guilt, suicidal thoughts, too little or too much appetite, and a sense of worthlessness. Expressing the anger either verbally or in writing can be the start toward resolution of the problem, but the long-suppressed emotions tend to resurface again and again.

Tools for coping listed by Dr. Garnett include exercise, good nutrition, adequate rest, personal time for relaxation, leisure and play, keeping a journal, facing feelings and accepting them, and expressing thoughts and feelings with others.

Depression can be a symptom of celiac disease and is caused by abnormally low levels of three major monoamines in the cerebrospinal fluid as a result of malnourishment. In many cases, the gluten-free diet alone may not ease the depression, but adding 80 mg of Pyridoxin (Vitamin B6) daily has been found to correct the imbalance for most patients. This protection factor is best discussed with a monitoring physician and is suggested to be done by prescription.

Apathy (indifference, disinterest or lack of feeling) is also included as a common feature of CS. However, this too is of physical origin rather than psychological and usually clears promptly with the gluten-free diet. In children, apathy has been noted to be the first symptom to disappear according to reports by physicians at the time gluten-free diets were initiated as treatment of CD back in research studies of the 1950s



CSA Library Series
CSA Library Series is a collection of articles that pertain to celiac disease and dermatitis herpetiformis. Most of these articles have appeared in CSA’s quarterly newsletter, Lifeline, which all CSA members receive. Historic articles included in these resources may or may not include updated notes. Updated information indicated in red type. Articles represent the work of the author.