WLS & Mental Illness.

[Eumoirous 3]

I was wondering if anyone here had any sort of mental illness and how that affected their surgery's process. Like did having mental illness make it difficult to find a surgeon willing to operate? Did you have to do anything extra like more visits with a psychiatrist before surgery? Did they want to you stay "stable" for an allotted time before surgery? Or anything else that may be affected with having mental illness.

I have schizoaffective disorder that is controlled with medication/therapy/the like and am considering weight loss surgery, but I was wondering if it could get in the way of having the surgery.

If anyone has any experiences related to this please share as I'm pretty apprehensive about approaching the process. I've gone to an information session so far and that went well, but am unsure of what my mental illness will make the process like....if that makes any sense.

Thank you!

[sunnkistme 76]

What a great question. I would think there would be much better chance to find a surgeon if your therapist and psychiatrist are on board. Would they give their OK before you start your surgeon search?

[jtickle 295]

I have bipolar type 1 and I am well controlled with medication. My psychiatrist wrote a letter to my surgeon stating that I could make decisions about having surgery on my own. The surgeon accepted my letter as my psych evaluation, so I saved some money there. Good luck with your journey. Keep us posted.

[Inner Surfer Girl 12,015]

Definitely keep your surgeon in the loop, especially if you rely on meds.

[MindyLynn5 21]

I have bipolar and did not have an issue of being cleared medically. I was upfront with them. I rely on meds too. Surgery nov 24.

[Eumoirous 3]

What a great question. I would think there would be much better chance to find a surgeon if your therapist and psychiatrist are on board. Would they give their OK before you start your surgeon search?

I went to the information centre at Johns Hopkins and they have their surgeons there. The Nurse Practitioner for the Briatric Centre there actually recommended a surgeon to me that may understand my situation better. I am still just worried a little lol. I will definitely be trying to get my therapist and psychiatrist on board. The Nurse told me the more effort I put into trying to get the surgery, (support groups, changing diet in advance, exercising, etc.) the better and I definitely am! Thank you for replying!

I have bipolar type 1 and I am well controlled with medication. My psychiatrist wrote a letter to my surgeon stating that I could make decisions about having surgery on my own. The surgeon accepted my letter as my psych evaluation, so I saved some money there. Good luck with your journey. Keep us posted.

I see my psychiatrist at the end of October and will be speaking with him about it then. Thank you for helping me feel a bit more hopeful with the process!

Definitely keep your surgeon in the loop, especially if you rely on meds.

Definitely will! Thank you.

I have bipolar and did not have an issue of being cleared medically. I was upfront with them. I rely on meds too. Surgery nov 24.

This makes me hopeful. I will definitely be upfront with them and already was at the information session I went to. Congrats on getting cleared and receiving a surgery date! Thank you for your insight.

[Puppypaws57 137]

I have bipolar and am stable with the correct meds. The only thing that my psychiatrist brought up was that if I went with the gastric bypass he would have to change the amount of medication I am on to doses that hadn't been approved of by the FDA - hope that makes sense.

Because of that I chose the lap band instead.

Also, I didn't have to stop my meds at all!

Other than that, there will be no problems and I'm sure you will fine.

[Eumoirous 3]

I have bipolar and am stable with the correct meds. The only thing that my psychiatrist brought up was that if I went with the gastric bypass he would have to change the amount of medication I am on to doses that hadn't been approved of by the FDA - hope that makes sense.

Because of that I chose the lap band instead.

Also, I didn't have to stop my meds at all!

Other than that, there will be no problems and I'm sure you will fine.

I am stable on meds as well. I was doing more research and found that the most important medication I take (risperdal) is also available as an injection which would be perfect. My antidepressant (effexor) isn't, but there are some other ones available as a liquid which would probably absorb better than the pill form. Thank you so much for replying and being so reassuring.

Anyhow woop! Everyone who replied has made me much more hopeful. I'm looking forward to getting through the process and changing my life. Thank you everyone!

[nairobi78 58]

I went to a seminar and to be honest with you the psychiatrist that came out to speak to us said they didnt care about the mental status bcos they dont discriminate also he stated that some of the patients with bipolar or any other mental illness do better than those that don't have anything wrong with them

[Dr-Patient 830]

i didn't read all posts, but might I suggest that you simply:

1. Make/Keep an appointment with your psychiatric caregivers--psychiatrist, psychologist, etc.

2.Inform them of your plans for WLS.

3. They'll likely discuss with you the yeahs/nays, i.e., how they feel you're processing the upcoming surgery, etc. Review any medications you're on (or might additionally need, or need cut back); discuss your coping skills with anxiety, trauma, fear, etc. Review/Assure support systems around you--folks who recognize when you're having a moment; then,

4. Your psych professionals should talk with your surgeon and his/her team--including the psychology team at the surgeon's. Then your psych do should write a letter to "clear" you for surgery, from a psychiatric standpoint.

5. Everyone--all your docs [mental and physical] should keep in touch re: your condition, post-op.

6. Also touch base with your spiritual advisor or prayer partner, if you have one.

All of that will ease everyone's mind--yours [hopefully], and your surgeon's. Good luck. Do well.

Edited October 13, 2014 by Dr-Patient

[Eumoirous 3]

I went to a seminar and to be honest with you the psychiatrist that came out to speak to us said they didnt care about the mental status bcos they dont discriminate also he stated that some of the patients with bipolar or any other mental illness do better than those that don't have anything wrong with them

Thank you for you insight into it. I really appreciate it!

i didn't read all posts, but might I suggest that you simply:

1. Make/Keep an appointment with your psychiatric caregivers--psychiatrist, psychologist, etc.

2.Inform them of your plans for WLS.

3. They'll likely discuss with you the yeahs/nays, i.e., how they feel you're processing the upcoming surgery, etc. Review any medications you're on (or might additionally need, or need cut back); discuss your coping skills with anxiety, trauma, fear, etc. Review/Assure support systems around you--folks who recognize when you're having a moment; then,

4. Your psych professionals should talk with your surgeon and his/her team--including the psychology team at the surgeon's. Then your psych do should write a letter to "clear" you for surgery, from a psychiatric standpoint.

5. Everyone--all your docs [mental and physical] should keep in touch re: your condition, post-op.

6. Also touch base with your spiritual advisor or prayer partner, if you have one.

All of that will ease everyone's mind--yours [hopefully], and your surgeon's. Good luck. Do well.

Thank you for all of that advice! I will definitely keep all of this in mind. (by making a list of questions, things to do, people to call, etc.)

[4LgrLife_53 82]

I just wanted to add to this posting and wish everyone huge successes with their weight loss goals and surgeries. Mine is scheduled for November 4th. I have post-traumatic stress disorder (PTSD).

One thing imperative---whether you have mental illness or not, is to work with your psychologist (therapist) either at the clinic or whoever you see regularly and coordinate any medication changes with your psychiatrist or MD. They say as the weight comes off you will encounter issues with your self esteem, self doubts, anger, etc. as well as dealing with any friends/family who want to try to push you back to old habits.

I found out from my psychiatrist and my MD that all the medications I take are crushable (to powder form), and I can mix the powdered medication in my food or drink. Remember that a lot of the medications you can't stop cold-turkey (have to wean off them). So make sure to consult your Doctor!

Right now I'm struggling with a long-term friend who is trying to get me to cheat on my pre-op diet (later this month), saying I should go out to dinner and one day won't hurt. I think she's jealous, of all things.

This decision came hard, and I still struggle with it at times, but it is a move toward a longer and healthier life for me. Staying strong and stable!

[Puppypaws57 137]

Good point especially about the meds. The Dr. switched two of mine - Paxil & Trileptal - to liquids. Works just as well!

[HilaryInRC 116]

I have Bipolar I. I had no problem being approved for the lap band or my revision to gastric bypass. I did have to see my surgeons psychologist one time, but he requires it of all patients. However, I am 4 months out with the gastric bypass and am struggling with depression/anxiety/moodiness. My psychiatrist gradually ups my meds due to the malabsorption. If that doesn't work we will go to liquids, but he warns me it will be a battle to get my insurance company to approve the abilify and celexa in liquid form. I highly recommend gastric bypass to all, it has been amazing for me. However, I am currently not well controlled and a bit frustrated that I feel so different than pre-surgery. I had a meltdown at work and got really angry with my boss and then cried for about 15 minutes. Now they are "adjusting" my caseload/work responsibilities. All of this because I need more time to get my meds right. And of course I can't tell them at work that I have Bipolar and I'm struggling because, well, because their is so much stigma. I think if I told them, it could seriously mess up my job. Anyway, my point is that you need to really coordinate with your psychiatrist pre-surgery and make sure s/he understands the malabsorption issues. Have a plan for that in advance. I didn't tell my psych until 2 months post-op and now I'm paying the price!

[Puppypaws57 137]

Hillary - so sorry to hear of your struggles.