She's shared the tough times raising kids, now popular parenting blogger Maria Foy has gone public on living with coeliac disease, particularly the unexpected effect the condition can have on mental health.
Foy started the Happy Mum Happy Child blog five years ago and now has 300,000 Facebook and 65,000 Instagram followers around the world.
She shared her stories of both joy and struggle following the births of her children, aged 5 and 7, because she wanted to show others going through the same experiences they were not alone.
It was no different when it came to living with coeliac disease, the Mangere mum told the Herald on Sunday as part of Coeliac Awareness Week.
"My motto for Happy Mum Happy Child is helping parents feel less alone, and this is the same. When you talk about a topic if doesn't matter what it is, it automatically helps.
"People feel less alone."
A story in Coeliac NZ's Coeliac Link magazine last year cited a Danish study which showed having coeliac disease increased the risk of developing a mood disorder by 91 per cent, and a 1998 study which found about a third of those with coeliac disease suffered depression.
Other studies suggested gluten-related intestinal damage could lead to nutritional deficiencies, causing depression and anxiety.
Auckland-based clinical psychologist Dr Liesje Donkin told the magazine in terms of scientific evidence it was not yet known if coeliac disease caused depression, anxiety, schizophrenia or bipolar, because there were inconsistencies around how research had been done.
But anecdotally sufferers, especially when undiagnosed, appeared to have mood issues, Donkin said.
The symptoms that point to coeliac disease
Reasons included uncertainty around their symptoms, the discomfort of those symptoms, their symptoms being doubted by others and less social contact because of fears related to eating out.
Foy was diagnosed with coeliac disease in 2015 when she was 32, after suffering stomach aches. A blood test and a biopsy confirmed the disease.
In hindsight, Foy thought she had probably had the condition much longer, and she had "absolutely" noticed its effect on her mental health.
"I just connected the dots myself. But [when I heard there was a connection], I thought 'I knew it!'"
That knowledge gave her extra motivation to take care with her diet, as her physical reaction to eating gluten wasn't immediate and she sometimes found it hard to stay away from foods containing gluten.
She believed the impact on her mental health was the main effect on her body when she ate gluten.
Foy, who suffered post-natal depression — identified before her coeliac disease diagnosis, but which she believed her undiagnosed condition had contributed to — and who has been on medication for depression for seven years, said she hoped sharing her story would help other coeliac sufferers recognise the condition could also be affecting their mental health.
"I like talking about my experience because everybody takes something from it, even if they don't believe it. And the more we talk about stuff . . . it makes people think a little bit more about how they're feeling, whether they're coeliacs or not."
COELIAC DISEASE - WHAT YOU NEED TO KNOW
• Coeliac disease is a permanent autoimmune disorder where the body's natural defences mistake gluten for a threat and release antibodies to fight it, leading to inflammation of the bowel and a host of related symptoms and medical problems
• An estimated 60,000 to 70,000 Kiwis have coeliac disease, but up to 80 per cent are unaware
• If undiagnosed the disease can cause long-term poor health, osteoporosis, depression and increased risk of throat and intestinal cancer
• The average time between symptoms and diagnosis is 11 years, and undiagnosed sufferers often have anaemia because of associated problems absorbing nutrients
• Symptoms can include digestive problems, such as diarrhoea, cramping, nausea, vomiting, bloating and constipation, bone and joint pain, neurological issues, skin rashes, ulcerations, weight loss, fatigue and brain fog. Some people have no symptoms
• Coeliac disease tends to occur in family groups — 10 per cent of each sufferer's direct relatives usually have the condition too
• The only treatment for the condition is to avoid gluten, which can be found in wheat-based bread, pasta, cereals and many food starches, preservatives, soy sauce and stabilisers made with wheat. Gluten can also be found in some medicines, vitamins and lip balms
• A self-assessment test for the disease is available on the Coeliac NZ website at www.coeliac.org.nz
WHERE TO GET HELP:
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call 111.
If you need to talk to someone, the following free helplines operate 24/7:
DEPRESSION HELPLINE: 0800 111 757
LIFELINE: 0800 543 354
NEED TO TALK? Call or text 1737
SAMARITANS: 0800 726 666
YOUTHLINE: 0800 376 633 or text 234
There are lots of places to get support.
For others, visit: https://www.mentalhealth.org.nz/get-help/in-crisis/helplines/