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Forums / Depression / Bariatric surgery and depression

Topic: Bariatric surgery and depression

12 posts, 0 answered
  1. FrancescaS
    FrancescaS avatar
    5 posts
    7 August 2017

    In May this year I had bariatric surgery as I was morbidly obese (sleeve gastrectomy), and since this time my depression has worsened and I'm currently in the midst of a major depressive episode. I'm wondering if there are any other BB forum participants who have similarly had bariatric surgery and also find themselves in a similar situation?

    I’ve been doing a lot of reading about depression following sleeve gastrectomy surgery, in the hopes that I will discern why it has happened to me.

    Most scientific/academic articles say that depression and other psychological conditions are more prevalent in bariatric surgery patients than they are in the general population. This is ascribed to the physical and psychological impact that obesity has on patients’ lives. The articles claim that bariatric surgery has a positive affect on patients’ lives given the health benefits of surgery and the boost to self-esteem that comes with being thinner. However, some studies have shown that a small number of bariatric patients have a psychological downturn following surgery, and one study has found that the likelihood of attempted suicide is 4-5 times higher in bariatric patients than it is in the general population. These articles make the case that this psychological downturn is the result of patients not being able to eat as much as they are used to, and/or patients turning to alcohol and substance abuse to manage their emotions following surgery, and/or patients having unrealistic expectations of the benefits of bariatric surgery. What seems to be absent though, to my mind, is analysis of the physical impact of bariatric surgery on brain chemistry.

    Now, I am not a chemist, am not a scientist, so I cannot wait until further research is conducted into this issue. My pressing need is to dig myself out of the hole that I’m in. Or grab a ladder and start climbing.

    Is there anyone else here in a similar situation?

    FrancescaS

    3 people found this helpful
  2. Blue Jane
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    Blue Jane avatar
    195 posts
    8 August 2017 in reply to FrancescaS

    Hi Francesca

    First of all thanks for taking the time to share what is going on with you.

    It sounds like the surgery was a great step forward, even if you are not feeling the psychological benefits of it yet. To answer your question I have not been in your situation but I am wondering if your GP can recommend a therapist or psychologist, someone who might specialise in clients like you who have had this surgery? Or maybe your surgeon/specialist might know someone?

    Your intelligence is clear from your post, sharing what you have found with a doctor will be interesting.

    Hopefully someone else on these forums has some experience they can share.

    Blue Jane

  3. White Rose
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    White Rose avatar
    6325 posts
    8 August 2017 in reply to FrancescaS

    Dear Francesca

    Hello and welcome to Beyond Blue. This is a huge topic with all sorts of issues hanging off it. Let me say up front I have no personal experience of bariatric surgery, but a friend had this surgery and lost a huge amount of weight. It's a topic I was interested in and I asked her how she was managing, was it easy? She battled through the change of lifestyle with the help of her adoring husband and I imagine her adult children.

    I think you would have been to one or more psychology sessions before the surgery. Can you return to this psychologist for further discussion or perhaps a referral to another psychologist well versed in bariatric surgery and it's outcomes.

    I love the way these so called expects make pronouncements on how people feel and decide that the impact of of a particular type of surgery. After surgery and probably for the next six months at least but more likely 12 months, there is a huge impact on the way you eat, what you eat and how you eat. This is where you need so much support and for the same reason you put on weight. There needs to be someone to help you eat only the amount of food your body will allow at any one time and provide reassurance, comfort and support.

    I am certain anyone who had this surgery will feel so much better simply by being thinner and of course all the illnesses that hang off obesity become less likely. One reason I can think of for someone becoming depressed after surgery is the flat feeling once the surgery has been done. It's almost an anti-climax. You feel different but the weight is still there and will be for a while, though slowly going. I think we build up life changing events and get very disappointed when nothing much changes immediately. So maybe that's a reason.

    What I know of depression, and remember most of what I know is from my personal experience, is that it hits without warning and often those people who are considered less likely to be impacted. It may be you have less resilience to counter depression, and remember you have had major surgery and recovery takes time.

    It is interesting reading your comment about the increased likelihood of suicide in bariatric patients. The expectations from this surgery are high but require the patient to be very aware of the food they eat. I believe you can never tell another what this will feel like. The other thought I have is about the realisation that this surgery is irreversible so no matter what the patient wishes they are stuck with it.

    Mary

    1 person found this helpful
  4. FrancescaS
    FrancescaS avatar
    5 posts
    9 August 2017 in reply to Blue Jane

    Dear BlueJane

    Thank you so much for responding so kindly to my post. Yesterday I had my first session with a psychologist who actually specialises in brain chemistry and nutrition (what a God-send!). She has diagnosed "burn out" (I work in a senior role full-time and am also undertaking a PhD). While I was with her she rang a chemist to discuss what I'm eating and my nutritional needs. In addition to pregnancy Elevit I am now taking Bioceuticals Mega B & Q10 as well was Ostelin Vitamin D. She strongly recommends that I have leave from work until September. I have now applied for a 6-month intermission for the PhD. She reassured me that she has seen many bariatric surgery patients and they too have been suffering from depression. She says she is confident that I will recover and regain my health. I feel like a lifeline has been thrown to me - I still feel shaky, but now have hope.

    2 people found this helpful
  5. FrancescaS
    FrancescaS avatar
    5 posts
    9 August 2017 in reply to White Rose

    Dear Mary,

    Thank you for your thoughtful comments. The surgeon that I went through does not include any psychological assessment prior to or after surgery - nothing. His focus is purely on weight loss. I naively thought that as my obesity was causing me physical and mental distress, bariatric surgery would take this away - I was very wrong! It turns out that there is a strong connection between the gut and mental health.

    My advice for anyone contemplating bariatric surgery with an existing mental health condition is to work through a psychiatrist or psychologist with a strong interest in brain chemistry and nutrition before scheduling surgery.

    I am lucky to be writing this on the 9th August 2017. Exactly one week ago I was planning my suicide. I was 12 weeks post surgery. I have had some trauma in my life, but I have never felt as bad as I have since bariatric surgery.

    FrancescaS

    3 people found this helpful
  6. White Rose
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    White Rose avatar
    6325 posts
    9 August 2017 in reply to FrancescaS

    Dear Francesca

    I am so pleased you are still here to talk to us. Suicide is a topic that usually has everyone in the room trying to think of something else to talk about. It would be funny if it were not so serious and damning.

    I am surprised your surgeon did not send you to a psychologist for at least one session. It's not as though the surgeon went through this stuff. While it's true, I'm guessing, that some patients may have a change of heart after meeting with a psychologist, surely the surgeon must have some consideration of the psychological effects. Doesn't part of the Hippocratic Oath say, And do no harm. I am really surprised. My GP sent me to a surgeon to discuss gastric banding. In turn he sent me to a psychologist and another doctor.

    It was the doctor who put me off. She pooh-poohed my fears about eating after surgery, told me I would breeze through it because her husband had been OK after his surgery, made no attempt to discuss my weight and if there was an alternative. I didn't go back. Mind you I was not entirely convinced in the first place.

    It's sad that you came so close to ending your life and I am thankful you are here. I have gone down that road and I know how hard it was for me to come back. Suicidal thoughts are a measure of your distress and that of anyone else in that position. The thoughts you had about yourself before the surgery will not simply disappear. While you may understand what has happened to your body and what steps you need to take after surgery, it's all tucked up in your brain. Your body has not had a chance to process it.

    I have been fortunate to have a very skilled GP who is quite fussy who she refers me to. My doctor often reminds me about the time lag between learning something new and understanding that new information, and the time it takes to filter through the rest of the body. Your body remembers itself and in your case it remembers how you used to eat, what you ate etc. It takes time for your stomach and the connections to the brain to accept this.

    I often call it head and heart understanding. Your head understands that you had surgery and why. You processed all this information before having surgery. Your body didn't realise how much it would affect you physically or realise how hard it would be to reduce your food portions until it started to happen. Big shock. Now you are having the old thoughts about eating and depression and your brain is saying you cannot eat much. Out of words.

    Mary

    2 people found this helpful
  7. Blue Jane
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    Blue Jane avatar
    195 posts
    12 August 2017 in reply to FrancescaS

    Hi Francesca

    Gosh that psychologist sounds great. What an interesting specialisation. Are you going to see her again? I know it is expensive but sounds like a positive investment.

    Burn out makes sense with everything going on! I guess it is too early to feel any difference as a result of the supplements and diet? Because of my mental illness I am mindful of my diet and supplements too, I eat a lot of strawberries and blueberries as they are apparently great for our minds.

    I am sorry to read that you were contemplating suicide. Thank goodness you are still here with us making constructive steps forward.

    How do you feel about going back to work next month?

    Blue Jane

  8. dare2diva
    dare2diva avatar
    14 posts
    29 November 2018

    Hi. I had sleeve 11 weeks ago and I have had a rough recovery. 3 additions for dehydration due to vomiting and not being able to eat or drink. I have schizoaffective disorder and anxiety has now come forward every time I go to eat because I’m terrified I will be sick. I can eat half a cracker and half a teaspoon of tuna a day. Anymore and I’m sick and other foods i loved like dairy tea coffee fruit chicken veggies I just can tolerate. Surgeon and dietician have said it will get better and to keep trying but I want a damn date. It’s been 11 weeks of feeling like hell. Not having energy constant head and muscle aches and nausea from hell. I can’t walk into the kitchen because I get so anxious and I can’t watch people eating or cooking even on tv. Now I’m wondering if I’ve got anxiety which is causing me to vomit. Psychiatrist and psychologist don’t seem concerned. Nobody seems concerned but I have no energy. I have trouble showering everyday because I am so exhausted. I have to work from home but they are getting annoyed with me asking when I’ll be back. I’ve tried to go back 3 times twice I fainted and once my body just collapsed. Where do I turn for help? I am so incredibly hungry it is causing severe stomach pain. Of course I can’t keep my regular medication down every day because they are big uncoated and hard to swallow. I am so incredibly angry I feel anger beating in my head all the way down to my toes. My heart is pounding. It’s all doing my head in and I don’t know what to do. I’m hoping somebody has had a similar situation and come out the other side.

    2 people found this helpful
  9. White Rose
    Champion Alumni
    • Community champion volunteers who are not currently active on the forums.
    • Life membership is awarded by beyondblue for providing outstanding peer support to the online community over a period of 3+ years.
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    White Rose avatar
    6325 posts
    30 November 2018 in reply to dare2diva

    Hello dare2diva

    Sounds like you are having a horrible time and I am sorry this has happened.

    On a practical level can you ask your GP to prescribe different medication that is coated and smaller. I know that usually there are several brands making the same meds and one of them may be more comfortable to swallow. There may even be a pill you can chew before swallowing.

    I can understand how frustrating it is when no one appears interested in in how you feel. I think it is more likely they do not understand your feelings and reactions and find it hard to relate, though a psychiatrist and psychologist should understand how to relate to you.

    I had a similar operation at the end of July, a gastric by-pass. I am also struggling with eating. I have a severe reflux of bile from my stomach which makes everything I eat taste disgusting. I too can only tolerate a few foods. My surgeon gave me medication to line the stomach and stop the reflux. It does work so long as I remember to take it before eating. Sorry I cannot give you the name as this is against forum rules. Previously the reflux gave me very bad chest pains and I have ended up in hospital a couple of times because of the pain. They are always concerned with chest pain and want to make sure all is well there.

    It sounds like your vomiting is due to anxiety although I have done this a couple of times due to eating the wrong food, eating too quickly or too much. I am working on this. My weight has been dramatically reduced and I try to remind myself of this when I struggle. It is getting better but it's a slow process. Do you live alone? I think it is a hindrance as there is no one support to you when you get anxious.

    I love fish but found it one of the foods I cannot eat. Fried or oily food is also a no-no. I have gone back on the diet drink I had to start with before the surgery on occasions. Cannot drink a full amount but my dietician said to use less water to make it and make it a thick-shake. No need to worry so much about nutrition and it will help line the oesophagus which may well be still inflamed from the surgery. In any event it is easier to swallow. Try it for one meal a day or try the various other diet foods made by this company.

    Once your body can start accepting this food you may be able to start eating 'real' food. Have a chat to your dietician about this option. It may be OK for a couple of weeks and help with the anxiety.

    Hope this has been helpful. Feel free to write in again.

    Mary

    1 person found this helpful
  10. future_
    future_ avatar
    40 posts
    30 November 2018
    you have to push thru your thoughts my friend. each day take another extra spoonful of tuna. I am the opposite I emotionally eat and have to really concentrate on not picking up anything available. Please try and eat a couple of grapes and two crackers and just a fraction more each day, you have to go to work so you can pay the bills. keep going someone needs you today xox
  11. burden
    burden avatar
    1 posts
    11 October 2021 in reply to FrancescaS

    Hi Franchesca, I'd love to hear how you're doing now 4 years on?

    I Just saw a surgeon today regarding a bariatric procedure and I haven't been able to stop crying since I left. I know I need more than a procedure to deal with my eating disorder, but this surgeon was quite disinterested in me as a person. I felt like a number on a BMI scale and a $ in his pocket.

    It was pretty awful but I am stuck needing a new knee and the surgeon not wanting to do that procedure until I loose weight.. In the meantime Im a full time carer for my severely disabled child with 100 % care requirements 24/7

    Its a pretty serious situation and I'm not sure who I can turn to to help me.. Right now its all simply too hard and Im wondering how I can keep going.

    Not sure if this thread is still active but just incase anyone has any ideas..

    Thanks in advance..

  12. Sophie_M
    Community Moderator
    • Works for beyondblue moderating these forums
    Sophie_M avatar
    5940 posts
    11 October 2021 in reply to burden
    Hi Burden,   Thank you for reaching out here on the forums and sharing what is going on for you. We're sure that a lot of our community members will relate to these feelings and hopefully some of them will pop by to offer you words of wisdom and kindness.   It sounds like things are incredibly hard right now, you must be feeling so overwhelmed and exhausted by everything. Being a full time carer for your son while also trying to navigate through the health system with your own physical and mental health issues would be really tough.     It’s so disheartening to learn that you’ve had such a negative experience with your surgeon. You deserve to be seen and treated as a person, not a body or a number. You mentioned that you are needing ore help with your eating disorder.   There is an organisation called the Butterfly Foundation which offers support for eating disorders  We'd recommend you check out their website - https://butterfly.org.au/ They also have a helpline that you may like to call to see if they can give you some guidance as to where to get some help. 1800 33 4673. They are open 8am – midnight AEST, seven days a week.   If you would like to talk through some of these feelings we would recommend that you get in contact with the Beyond Blue Support Service. They are available 24/7 by phone on 1300 22 4636 or on Webchat 1pm-12am AEST on our website: www.beyondblue.org.au/getsupport  One of our friendly counsellors will be able to talk through these feelings with you and can offer support, advice and referrals. 
    1 person found this helpful

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