Short fuse

Very few therapists specialize in bariatrics... there's not really a bariatric specialty or credential we can get like nurses. I was told to specialize in eating disorders, because that's...sort of...the closest? Except it's not, because not all WLS patients have an eating disorder by far. And, treating WLS patients involves integrated care, which few of us are trained in. Programs haven't caught up yet. My counselor actually works in my PCPs office - she is an integrative health care clinician. She actually works and coordinates with my bariatrician, my bariatric surgeon, and my PCP. Once every so many months they talk about my case. It has made my care tremendously better, let me tell you. This is what I want to be when I'm a grown up therapist, so I am biased. ;)

It's frustrating for me on both sides, because there is no specialized training or assessment for us as patients (or therapists), and so all of us sort of piecemeal together stuff depending on what bariatric programs we work with.

That aside, it depends what you need from the therapist. If the mood swings are due to hormones, it's hormones that will fix them. As Gwen said, not every therapist will jive with you. I am absolutely not the best counselor for everyone, never mind every WLS patient. I fit the needs of some and not others. That's just how it is. It may take a few attempts to find who works for you.

It also depends what you want out of therapy. I encourage my clients to be direct with me, to tell me what doesn't work, and to chart where we are going to go from there. I am more of a pragmatic problem-solver. I brainstorm and do clinical work, don't get me wrong, but if someone has depression because they are hypothyroid, all the counseling in the world won't help. They need to get their thyroid looked at. I also am direct, and I do not waste time or mince words. My style isn't for everyone by far, though, and that's okay. If it's not, I always do my best to find referrals, and to get my clients what they need, because that is my #1 job. My first session is 50 minutes, and I have those 50 minutes to prove to someone that I am worth their time and money.

At any rate, what I am getting at, is don't hesitate to tell a therapist you feel its not working, and say why. Say what your needs are. I think journaling is great for this, because we can have a voice without a lot of the anxiety that may come with it. No one will judge your journal if it is private, and if it is in a support community, that can be very helpful, too.

My mood swings were so awful I had to supplement with progesterone to counterbalance the mood swings. That helped more than anything, really. The psychiatrist didn't want to touch it, and my bariatric surgeon, actually suggested I see the gynecologist. It was amazing.

I have never had mood swings despite coming from New Jersey. I had the most awful and hideous mood swings. I dropped a washcloth I was trying to fold at the laundromat and burst into tears. I became furiously angry because someone held the door for me when my hands were full. I sobbed hysterically when I dropped a spoon on the floor.

The progesterone was like a switch. One day later I was fine. I was annoyed I had to take it, but it was sure great to have my mind back.

Hormones can make us crazy- when I first started going thru peri menopause I called my de and told her she had to give me something before I killed someone- my mood swings were awful! I took progesterone for awhile - it worked well-but then ended up on an anti depressant that had bad interactions so she took me off of the hormones- the anti depressant helped with the symptoms of the perimenopause. It was life changing . So thankful we have options to help with these ups and downs.

Some of that may be hormonal. But what I felt was that I could no longer stuff down my emotions with food. I had to just take a pause and not just spout off the first thought that entered my head. It didn't seem to last very long. I just realized one day that I had calmed down.

Well I seem to remember something about fat cells containing a lot of estrogen and losing weight fast can result in a big hormone dump. So therapy and/or medication may help. Don't hesitate to seek help. Mind and body are one and changes to one part affects all others. GL Diane S.