one month post op and struggling with anxiety and depression

Ever since surgery I have felt very anxious all the time. It's worse in the morning and sometimes gets better as the day goes on. It feels like butterflies in my gut or - worse -tightening in my chest and a feeling like I'm about to jump out of my skin. I thought that when I got home after surgery that I would feel better once I was home with my husband and my kids in familiar surroundings, but, no. I felt strange, weird, broken somehow and disconnected, if that makes any sense.  

I'm feeling more at home now but I have no motivation to do anything and I'm not happy - no matter how hard I try to get out and do something fun. I don't feel normal. I don't feel like myself anymore. This past Saturday night I went to a party and had fun with friends and relaxed a bit, was able to nibble on a little food and felt like myself again, but only for that night. The next day I was a bundle of nerves again. 

My PCP put me on wellbutrin but it hasn't been four weeks yet and I haven't noticed much difference in my mood - just side effects like diarrhea and insomnia. 

On 7/19 in the early morning,  I took my bp and it was sky high and I felt super anxious - like I was about to jump out of my skin.  So I took myself to the ER and since I was fine physically and my bp had gone down, the doc just talked to me and gave me an Rx for xanax. The xanax works great - completely calms my anxiety and I feel more like myself. He only gave me 9 pills and I've taken 6 of them at different times since then...but the next day I feel even more anxious than before. So I don't use them anymore. Plus, I read up on xanax and it's very addictive and the withdrawals are horrible. 

I see my PCP tomorrow and I will ask her for something else for anxiety and tell her about my family history. My father had anxiety disorder and I don't think that is in my medical record, and she's a new doc for me, since my last PCP just retired. Maybe I was "feeding" my anxiety, or it's the sudden loss of ghrelin. Even if she does give me something it will take about a month to start working. 

I just know that I feel awful and I have to go back to work next week to my teaching job - which is very stressful. I just hope I don't have a panic attack while at work. 

If I would have known this would happen, I would have never had the surgery. I want to be happy again. 

This is an effect of surgery I had no idea would happen. I've had a band before and never gone through this. I didn't feel like this at all after the band. 

Has anyone else gone through this? and hopefully found a way to be happy again?  

-Anne

Anecdotally, Wellbutrin can make anxiety/panic worse. I have bipolar, and when I tried increasing my dose of Wellbutrin I very nearly crawled out of my own skin. There are other meds that may be better for a depression/anxiety combination.

Are you stuck with your PCP for med management, or can you get to a psychiatrist? Or at least a psych NP? They'll be far more familiar with medication and can help you find something that will work better for you.

When you take a Xanax, how much is the dose? And how often? The "rebound" can be greater if you take more of the medication in a 24-hour period. I do half of a .5mg tab when I'm edging towards panic and it's often enough.

You may also be up against the infamous "hormone dump." Estrogen is stored in fat cells, and when we lose a ton of weight quickly it all goes flooding out into your system. Like PMS, but worse, and often with anxiety.

I read that Wellbutrin can cause anxiety before it starts to "settle in". That might be the problem. 

And, thanks for the tip about the xanax. My pills are .5mg. I didn't think about halfing them. 

This is all new for me, so I have dealt only with my PCP for meds. I did see a psychologist and she encouraged me to contact their office if I felt like I needed to see a psychiatrist. I'll talk to my PCP tomorrow and then probably set up an appt with a psych from there. 

Certainly worth waiting a bit longer to see how you feel. But in my experience (~15 years on psych meds), any side effects that are sticking around by the 6-week mark are there to stay.

I think heading to a psych is a good choice. I started with my PCP, but it really does help to work with an expert. There are LOTS of options out there to try!

If you ever want to compare notes on meds, drop me a line. I've been on plenty over the years and sometimes it's nice to be able to ***** about antidepressants :)

I'm sorry your going through this. I second what Julie said about seeing a psychiatrist. They are much more knowledgeable than a PCP. Sometimes it takes a little trial and error before you find the right medication combo. I think you may have been using food as a coping mechanism before surgery and you can't do that now, so the anxiety feels worse. 

It;s difficult to get the right meds and right dose with depression and anxiety.   Keep working with someome until you get it right.  I'm sorry you are going through this, I have too.   It's hard to go through.   But mine started way before my surgery, so I know it's not my sleeve.

Annie,  you and I are going through similar things. I don't know if it is because we were converted from the band to the sleeve but I never felt like this before. Just sadness all the time, I go back to work on Wednesday and don't yet have any idea how that is going to work out. Everyone at the doctors office pretty much has the attitude of its done now and that doesn't help me at all. I hope it gets better for both of us. 

I was reading - after the surgery - wish I'd seen this before - but, scientists are creating new anti-depressive drugs that mimic ghrelin.

http://www.utsouthwestern.edu/newsroom/news-releases/year-2014/april/anti-depressant-mechanisms.html

"A team of physician-scientists at UT Southwestern has identified a major mechanism by which ghrelin (a hormone with natural antidepressant properties) works inside the brain."

I would be willing to bet that this depression may be related to the sudden loss of ghrelin. 

I am sorry you are going through the same thing. I am relieved, though, to know that I'm not alone. Everyone else seems to be excited about the sleeve and thrilled to see the weight come off. I don't even care if I never lose another pound; I just want to be myself again. 

-Anne

And here I am at 2:26 and I can't sleep. I slept for two hours and woke up and then slept for one hour and woke up. I'm so tired but I can't sleep.  I am going in to work for three hours today and I don't know how I am going to make it today, much less how I am going to get through next week. 

I'm afraid I may lose my job if this anxiety doesn't get better. 

-Anne 

What do you teach? I just want to caution you about revealing too much at work about struggling with anxiety/depression. I am truly not trying to cause any undue stress, but our profession can be horrible about  mental health or simply health issues. I have dealt with a ridiculous amount of fall out due to my cancer status- even though I have been cancer free for a couple of years now it is still dogging me. During the worst periods of it I have no doubt that had I complained even a tiny amount it would have been far worse too. Lean on good friends outside of the profession and just fake it at wor****il you are able to sort things out.