WORRIED about psych eval...
I have a 16 year history of mental illness including depression and anxiety. I am very worried that this will disqualify me, so I am wondering if anyone else has such a history but passed the psych eval???
ALSO, I am looking for local support and friendships, so if you live in the western new york area (Buffalo and surrounding areas esp.) PLEASE check out my profile and consider adding me!!! Thank you!
Michelle
Michelle 
Michelle, I also have a history with mental illness. It took a little while for me to get my psych eval through, but I did. It took two months for her approval. My hold up was the Dr. I saw. She wanted to talk to my pcp and they had trouble connecting. When I had my appt, my Dr. I told her about my history. She told me she felt that people who have dealt with their issues are better candidates. I only had to have the one appt.
Good Luck, Betsy
P.S. I also live in WNY. I live in Genesee County, just east of Akron.
I do not have a history but i do work in the mental health field. I do not see how this would stop you from having this surgery. As long as your doctor believes that you can take the lifestyle changes and demands post op this surgery takes you should be fine. It helps if you have a history of mental illness or not to seek therapy following surgery anyway for our own benefits. Best of luck to you ..Keep us posted.
LisaMarie
Michelle:
HI! 
WELCOME!
Although I can comment on generalities, know no-one here can give you a absolute answer. I have been doing pre-operative weight loss surgery (WLS) {both lap band and gastric bypass} psychological evaluations for over 3 years now ofr various WLS surgeons in my area, with that experience and what the leterature shows is a history of psychoogical issues is not a automatic contraindication/disqualification. It is common in obesity to be depression, if depression was a disqualification, there wouldn't be many WLS!!! An individual practitioners criteria may differ but soe general themes emerge for criteria in the literature and what I use based on that and experience personally/professionally.
What I use as guidelines...no hard and fast rules. I do most evals in ONE 1 hr session (I also have a few forms on emotional eating, diet history and a history form I have people fill out and bring in)...BUT there have been times I require more than one session depending on patients issues and knowledge of the surgery. I think in several hundred evals I have declined 2 people! One due to no knowledge at all of tool and no interest in learning and compliance issues/unrealistic expectations & the other had current alcohol abuse issues not in treatment....I have seen many with depression, anxiety, bipolar disorder etc, all if stable w/ minimal symtoms and in treatment and plan on continuing it was never an issue!
Exclusion Criteria:
1. Current drug & alcohol dependence/abuse (needs to be in remission 1 year).
2. Untreated and/or unstable mental illnesses: Depression, Bipolar disorder, Anxiety disorder, severe personality disorders or Thought disorders, need to be in treatment with minimal symptoms.
3. A history of near lethal or repetitive suicide attempts may require further evaluation.
4. Eating disorders: anorexia, bulimia, severe compulsive/binge eating with no ability to control intake.
5. Noncompliance issues & concerns (unwillingness to diet, exercise, or follow treatment recommendations).
6. Inability to give informed consent for treatment.
7. Inability to make lifestyle changes (ex. financially, psychosocially).
8. Unwillingness to follow post-surgical care.
9. Unrealistic surgical expectations, ambivalence about surgery or impulsiveness in decision-making regarding surgery.
10. Inadequate family supports or family hostility toward surgery.
11. Presence of unresolved severe situational stress that may interfere with patient's success/compliance: current divorce, job stress, financial issues or family issues.
Plese consider that the psychological evaluation is an important piece in the multi-disciplinary pre-operative evaluation of the bariatric patient, and a piece that can assit your success! Be as honest as possible and that is all you can do!
Now for me I'd recommend educatng yourself to typical issues you may have after wls, issues such as more depression and anxiety due to loss of food, it can be a huge challenge the grief reaction and mourning that many go through. the anxiety and no food to pu**** down, the return of emotional eating after 6 months, especialy when the honeymoon slows/emds and the pouch can accomodate a larger quantity and variety of food (Expected), hen defeating the tool can happen, drining calories, discovery that sugar doesn't cause dumping in many, grazing etc.
Depression due to the hormonal shifts inestrogen etc that are released into bloodstream from fat cells, it can be like a bad case of PMS! Really! It is not a time to stop antide[ressants at all for at least the first year I recommend. The change in your self image, body image, some feel threatened by the attention, so many feelings can come up. Some turn to other addictions such as alcohol, drugs, sex, shopping.....so watch for that. Some becoe bulemic, others anorexic, sounds strange but happens! the deprivation for many is hard, so all I say is edicucate self, have a PLAN, hav follow up, keep on meds...
Meds are another thing, if you are on sustained release consider they may not be as effective or work at all after WLS if u r having bypass surgery. Many have immediate release forms so switching ahead or after is a personal choice. Make sure your psych prescriber is aware. Many nutritional deficiencies such as the anemias, B vitdeficiencies can add to depression as well so regular labs ad follow up and compliance w aftercare and suppliments is imperative!
Anyways hope this frames it for you, be as ready as you can, start developing some skills to cope now, learn to eat smaller portions, sip water all day, skip caffeine carbonation, sugar now, start an exercise routine however u r able now, for the day after wls isnt the tie to have al these tasks to do, having them ahead puts you ahead in the longterm succes column! WLS is a great tool but only as effective as the operator that knows how to use it and ecides to use it! Be well! HUG
Take Care,
Jamie
Lap RNY 10/9/02
Dr. Singh
320/163 5'9'' (lost 45 before Surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King
"Being happy doesn't mean everything's perfect, it just means you've
decided to see beyond the imperfections!"
WELCOME!
Although I can comment on generalities, know no-one here can give you a absolute answer. I have been doing pre-operative weight loss surgery (WLS) {both lap band and gastric bypass} psychological evaluations for over 3 years now ofr various WLS surgeons in my area, with that experience and what the leterature shows is a history of psychoogical issues is not a automatic contraindication/disqualification. It is common in obesity to be depression, if depression was a disqualification, there wouldn't be many WLS!!! An individual practitioners criteria may differ but soe general themes emerge for criteria in the literature and what I use based on that and experience personally/professionally.
What I use as guidelines...no hard and fast rules. I do most evals in ONE 1 hr session (I also have a few forms on emotional eating, diet history and a history form I have people fill out and bring in)...BUT there have been times I require more than one session depending on patients issues and knowledge of the surgery. I think in several hundred evals I have declined 2 people! One due to no knowledge at all of tool and no interest in learning and compliance issues/unrealistic expectations & the other had current alcohol abuse issues not in treatment....I have seen many with depression, anxiety, bipolar disorder etc, all if stable w/ minimal symtoms and in treatment and plan on continuing it was never an issue!
Exclusion Criteria:
1. Current drug & alcohol dependence/abuse (needs to be in remission 1 year).
2. Untreated and/or unstable mental illnesses: Depression, Bipolar disorder, Anxiety disorder, severe personality disorders or Thought disorders, need to be in treatment with minimal symptoms.
3. A history of near lethal or repetitive suicide attempts may require further evaluation.
4. Eating disorders: anorexia, bulimia, severe compulsive/binge eating with no ability to control intake.
5. Noncompliance issues & concerns (unwillingness to diet, exercise, or follow treatment recommendations).
6. Inability to give informed consent for treatment.
7. Inability to make lifestyle changes (ex. financially, psychosocially).
8. Unwillingness to follow post-surgical care.
9. Unrealistic surgical expectations, ambivalence about surgery or impulsiveness in decision-making regarding surgery.
10. Inadequate family supports or family hostility toward surgery.
11. Presence of unresolved severe situational stress that may interfere with patient's success/compliance: current divorce, job stress, financial issues or family issues.
Plese consider that the psychological evaluation is an important piece in the multi-disciplinary pre-operative evaluation of the bariatric patient, and a piece that can assit your success! Be as honest as possible and that is all you can do!
Now for me I'd recommend educatng yourself to typical issues you may have after wls, issues such as more depression and anxiety due to loss of food, it can be a huge challenge the grief reaction and mourning that many go through. the anxiety and no food to pu**** down, the return of emotional eating after 6 months, especialy when the honeymoon slows/emds and the pouch can accomodate a larger quantity and variety of food (Expected), hen defeating the tool can happen, drining calories, discovery that sugar doesn't cause dumping in many, grazing etc.
Depression due to the hormonal shifts inestrogen etc that are released into bloodstream from fat cells, it can be like a bad case of PMS! Really! It is not a time to stop antide[ressants at all for at least the first year I recommend. The change in your self image, body image, some feel threatened by the attention, so many feelings can come up. Some turn to other addictions such as alcohol, drugs, sex, shopping.....so watch for that. Some becoe bulemic, others anorexic, sounds strange but happens! the deprivation for many is hard, so all I say is edicucate self, have a PLAN, hav follow up, keep on meds...
Meds are another thing, if you are on sustained release consider they may not be as effective or work at all after WLS if u r having bypass surgery. Many have immediate release forms so switching ahead or after is a personal choice. Make sure your psych prescriber is aware. Many nutritional deficiencies such as the anemias, B vitdeficiencies can add to depression as well so regular labs ad follow up and compliance w aftercare and suppliments is imperative!
Anyways hope this frames it for you, be as ready as you can, start developing some skills to cope now, learn to eat smaller portions, sip water all day, skip caffeine carbonation, sugar now, start an exercise routine however u r able now, for the day after wls isnt the tie to have al these tasks to do, having them ahead puts you ahead in the longterm succes column! WLS is a great tool but only as effective as the operator that knows how to use it and ecides to use it! Be well! HUG
Take Care,
Jamie
Lap RNY 10/9/02
Dr. Singh
320/163 5'9'' (lost 45 before Surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King
"Being happy doesn't mean everything's perfect, it just means you've
decided to see beyond the imperfections!" 
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