According to a recent study published in the journal Chronic Illness, women with celiac disease are more likely to report stress, depression and disordered eating, even if they are following a gluten-free diet.

The researchers found that women adhering to a gluten-free diet did experience greater vitality, lower stress, decreased depressive symptoms, and greater overall emotional health than those women not following the diet, but even so, they still experienced more stress, depression, and body dissatisfaction when compared to the general population.

I can see how people with celiac disease not following a gluten-free diet could have these issues. Gluten is a digestive tract’s nightmare in people with celiac disease (and most people, really), which would be enough to depress anyone. But I can also see how people adhering to the diet can struggle with stress, depression, and body image issues.

Eating gluten-free, even in today’s world of readily available gluten-free fare, is a big adjustment, even when you have been eating gluten-free for years. Food becomes a central focus, rather than an afterthought. Everyday meal planning is required to be sure you have access to the right foods. Shopping at multiple grocery stores becomes the norm. Eating gluten-free creates a whole new way of life. This has the possibility of becoming stressful—and even alienating, depending on the company you keep.

But eating gluten-free—especially in those with celiac, but even in those who are gluten sensitive—is also a ticket to freedom for many people. Freedom from constant digestive issues with seemingly no solution, freedom from wondering, “What the heck is wrong with me?” and freedom from a downward health spiral that itself can cause more stress, dis-ease, and depression.

If you have celiac and you tend to get down about it, take a moment to think about what a gluten-free diet has given you, rather than what it has taken away. Sometimes a shift in perspective is all you need.