WLS and Mental Illness

i have lived with mental illness for over 25 years. i have to admit, the risk of malabsorbing my psych meds is a little scary to me. i look forward to reading more of your experiences.

Hi J.t.~

Some don't have many problems at all, some have a few, and some, like me, have a significant increase in symptoms. The best advice I can give is to talk frankly with your doctors, including your surgeon and your mental health professional, and discuss any changes they recommend both prior to and after surgery. Knowledge and preparation are among your best tools for seeing you through any mental health problems that may arise.

Best of luck to you!

Rebecca

I had the sleeve - I had some very miserable problems after surgery (Hyper thyroid, AFib) but with the doctors help, they got fixed and yes, even had a period 10 years after menopause.

With all that said and done - ask yourself - would you rather have the different (ie new) problems WITHOUT the extra weight, or the regular (ie old) problems with the old WEIGHT???

As one other reader responded and I agree - you're not going to know exactly how your body will react after surgery - there's no crystal ball to cover everything - but remember how miserable you are/were with the fat and move forward (pun intended because with the weight loss- you get to "MOVE" much more easily!!!

I began researching weight loss surgery in March 2011 and went to my first informational meeting April 1, 2011. I decided that I wanted to go forward and have Roux-en-Y gastric bypass and went through my local hospital to meet all their prerequisites for surgery.

I have Vermont Medicaid, and they have a requirement which was 6 months with a dietician before surgery. I met with a nutritionist, did my classes, and was set for the final steps of "Attend evaluation meetings with a nurse practitioner, dietitian, representative from Patient Financial Services, and the bariatric surgeon."

However, at this point, in October 2011, I was told that because of my history of hospitalizations for depression, the team was removing me from the program and refusing surgery. They said if I could remain hospital-free for a minimum of 2 years, they would reconsider me for the program. I was extremely discouraged.

Last year, I called a different hospital and was told that nobody would do surgery on me until I made that requirement. According to them, any hospital would say the same thing.

I can't seem to stay out of the hospital for longer than a year. I have been hovering between 275 and 292 pounds for the past couple of years. I can lose some, with my low being 275, but then I gain it back. I am 5'7" and 39 years old. Am I doomed to be morbidly obese for the rest of my life?

I have been in therapy for most of the last 32 years. I have been on many different medications, and even done ECT (Electro-Convulsive Therapy) more than once. I do not expect WLS to make me happy, just healthier. I have mild sleep apnea, mild stress urinary incontinence, Poly-Cystic Ovarian Syndrome, fatty liver disease, and high cholesterol. I have resigned myself to the fact that I may have to go into the hospital once a year or so to get my meds adjusted and get stabilized. My therapist and psychiatrist of the last 5 years support me getting weight loss surgery. They think I can handle it. The hospitals don't care. They seem to only be concerned with statistics, not with who I really am.

Is my issue of depression going to end up killing me? I go to the hospital when my depression overwhelms me and I start considering suicide, but it seems as if I may end up dying anyway from all this weight and the health issues that I can't get on top of.

Rebecca, I am bipolar, too and my psychiatrist insisted that I have the band because my medication would not be properly absorbed after bypass surgery.  I would have been at risk for a manic episode.  I am 3 plus years out from surgery.  My BMI is 24.  Some of the meds I take are Geodon and liquid Depakote.  I also had a kidney transplant this past August and the Transplant team has been careful about the amount of Prednisone I am taking because that can cause mood swings.

I hope that your bariatric team warns you against the bypass.

Sincerely, Elizabeth

Hi.  I'm Bipolar also.  Had lap-band in 2009, got very sick from not being able to eat properly and did not lose weight.  I had the band removed in 2011 and had the sleeve surgery 8 (Feb 2012) weeks later.  I had a very frank talk with the surgeon and my psychiatrist at the time who both said that I'd be fine with either bypass or the sleeve and I would just need to monitor my moods.  (i used to use a mood chart to see how everything was going)....  I'm happy to say that although it has not been easy per se.... I have not had any truly bad experiences with my bipolar being out of control.  I have to say though... I am still looking and thinking about a revision due to being stalled for a little over 8 months now.  Losing weight and being on a higher dose of meds can bring on a manic episode (or so I have been advised). 

As far as doing this again.... Planning a revision if I can't jump start the weight loss again.

As far as being "dropped" from a program, look for another one out there.  My first psychologist did not want to allow me to have surgery due to being out patient 7 months prior to surgery.  Had my meds been correct, I wouldn't have ended up out patient. 

I'm also bipolar, have anxiety disorder, and PTSD.  I was not on any meds prior to surgery, and hadn't been for years.  I was receiving counseling for a solid two years prior to starting the process.  My counselor actually encouraged me to do it, and I am so glad I did!  I am a completely different person than I was 2 years ago.  As far as my mental illness is concerned, it was a really rough ride after the surgery, but I would venture to guess that what I went through, most people go through mental illness or not.  Like it's been said already, you deal with extreme mood swings (worse for those of us with mood disorders) due to the hormone balance changing with the weight loss.  You also have to deal with the feelings you'll have to process regarding food.  I went through a period right in the beginning where I cried because I DIDNT"T want to eat but HAD to.  Then I remember lying on the couch balling because I couldn't have chinese food (this was in the first three months).  You have to break away from emotional eating (if that's a problem for you), and/or your addiction to food, and this is not easy.  You have to have an excellent support system in place.  Cross addiction is a big thing to look out for.  Some people end up latching onto another substance after surgery, such as alcohol.  I have a friend, whom I met in the hospital - we had surgery the same day, hours apart - who has gone from one end of the eating disorder spectrum to the other.  She's now bulemic.  :(  I think the most important thing is to work on your head issues first.  If we don't address what got us here to begin with, we cannot be successful.  My husband (who had the surgery as well) and I plan on starting a support service agency that will include, counseling, nutrition, exercise, group therapy, peer services, etc.  There is nothing like that out there.  Bits and pieces here and there, but we're going to start a an agency dedicated to helping the whole person in all stages of WLS - contemplative, going through, and post-op.  As far as psych meds go, like I mentioned, I had not taken any for years and managed fine - worked full time, balanced my family (5 kids and a husband) and a household, all just fine.  Before I was a full year out, I knew I finally had to get back on something for depression.  At first I felt like a failure.  Now I realize it was self-awareness which is a good thing.  I ended up getting on a mood leveler not too long after that, and my thoughts started to slow down and clear, and I came out of that dark place.  I'm still on meds and doing well.  As far as the effect the surgery has on your meds, the biggest thing I found was to avoid time released meds, but my surgeon said that it didn't really matter if they were or not.  That didn't make sense to me so I insisted my psychiatrist give me ones that weren't time released.  Mood swings and a rough time right after surgery are inevitable.  That first three months are the hardest.  Have help lined up, reach out to people when it's really bad, and know that you're almost through the worst of it. 

Thank you everyone for all the feedback. Yes, there's so much we need to know to make an informed choice. I just wish I had heard all these stories before I had my surgery. I would still have had the surgery but at least I would have had a better idea of what to expect afterward. It is my most heart-felt wish that I am able to address the special needs of those of us who must deal with mental illness so that those who follow will be better prepared for what follows.

Rebecca

I also am bi polar and was luckily stable on my meds before surgery and they just kept right on working after.  So luckily I had no problems.  This was also a requirement of my psych eval that I had a note from my psychiatrist stating that I was stable on my meds.