Nervous about Psych

So a little over a month ago I had my first meeting with my surgeon and my social worker. The surgeon kept saying that I would be an excellent candidate and that he was very excited to work with me. However, right off the bat the social worker said I was too young and needed to wait till I finished college. She then pointed to the fact that I self harmed (over 4 years ago) and struggle with depression. I told her that I deeply regret that I self harmed and that it hasn't even been a temptation for me in years and My depression is being managed very well. She told me that she wouldn't pass me because I was too big of a risk because after surgery I will become depressed and gain weight. Anywho, I changed surgeons and hospitals. I now have another psych eval coming up and I'm very nervous. Should I disclose my past struggle with self harm and suicidal tendencies? Will they disqualify me? Again these are long gone, however I'm fearful that my age (21) automatically decreases my chances of approval. Thoughts?

If you are not currently taking medications and receiving treatment for this and it is in the past, I would leave it there and not mention it. Just my opinion. There is a stigma against mental health problems. That being said there is nothing wrong with seeing a therapist to help you through this journey and support is key. Get support here, at support groups where ever you can. Very important!

In our society, just being seventeen is a form of mental illness. You are pressured with making decisions about the rest of your life and being jerked out from the security of being a child.

There may not be outward signs to others, but it is a rare teen who does not suffer from anxiety and uncertainty as they make the plunge from childhood to adulthood. I would also advise you to leave those problems in the past and talk about your plans for the present and the future.

I will also add that having weight loss surgery while so young involves a big responsibility to eat correctly and live a different life than other twenty-two year olds. For most of us, early adulthood means drinking parties, weddings, pizza stops, birthday parties and other occasions where following your food plan is not going to fit in.

Surgery is not a magic carpet ride where you lose the weight and then go back to eating and drinking whatever you please. If that happens, then you will quickly find your lost weight. Surgery can be a wonderful life altering event for you. Weight loss can give you new confidence as you finish college and start your career.

I don't think you should be punished for what happened four years ago and I would not bring it up during your next exam. Just be aware that surgery requires a life-time commitment to the new life.

Be honest. Lay everything out. The more information that medical professionals have, the more they can help you.

These evaluations are for your safety and health. If you had heart problems, would you hide that from the cardiologist?

Be honest. The worst thing that can happen is you have to wait a little while longer for surgery. If there is an issue to be addressed, you will only be helping your cause by addressing them now.

Good luck. Please keep us updated.

Wow.  That first social worker sounds horrible!  

So on the one hand I want to say "yes, you should disclose because you should be honest."  I did mention my mental health issues from my past (suicidal ideation, depression, and PTSD) in my psych eval, but I was 37 and those things were all over 10 years behind me.. as much as these things are ever totally behind you.  

On the other hand... I totally get why you wouldn't want to and I would NOT judge a person who didn't disclose based on your experience.  

Regardless of what you choose, I highly recommend that you find a therapist for your pre-op and post-op life.  Even though, right now, you feel that these things are in the past and under control, massive weight loss can really **** with your mind.  So if you're not seeing a therapist regularly already, I think that you'd benefit by finding one that you click with now so you can maintain that throughout your weight loss.  I want to emphasize that I think these things shouldn't prevent you from getting surgery and won't prevent you from being able to be successful, just that you've got to be aware that the process might dredge stuff up that you weren't expecting, and having a therapist might be extremely beneficial.  

I have a history as well, but like Gwen they were a long time ago.  It didn't stop me from failing my psych eval, and honestly, I burst into tears in the middle of it.  

I know it may not work out great for you, because you've already been denied once, but I would tell the truth.  I think that if you're willing to do the work and you're being honest with yourself, then it will all work out.  

Good luck to you.  

I saw adolescents with eating disorders during my clinical internship and helped some with getting bariatric surgery.  I saw a 15 year old who weighed more than I did at the time (350 pounds) who were getting surgery, so they'd certainly approve you.  Being 21 is of legal age in the medical and mental health systems.  You can make your own determinations about care.  Also, you absolutely can get surgery even if you have a mental illness.  And regarding self harm, that's sort of a ridiculous social worker.  She was probably worried about personal liability and a future lawsuit - an unfortunate reality of the American healthcare system.

As psychological professionals when we do any sort of assessment for surgery, what we are trying to determine is if pathology will exclude a patient due to compliance.  If someone has extant mental illness or psychopathology, an evaluation is important because it determines how well your illness is controlled.  If you are stable and not suicidal, I might approve you with recommendations.  I would only suggest someone was excluded based on current instability and the inability to follow the post-surgical regimen.  They actually do psych evaluations for transplant patients, too, not just WLS!

I'll use myself as an example.  I have major depressive and binge eating disorder (yes, we counselors can have health issues too!) and I have a history of suicidal ideation.  However, I had spent seven years in counseling coming to terms with my trauma.  I went from being completely disabled at 750+ pounds to going back to school and getting a masters' degree while working 50 hours a week.  So, they looked at that and my current state; I was in graduate school at the time about to start my clinical hours.  They determined I might need extra support post-op, and that I should be open to extra services if I had difficulty.  The first two months post-op I did go to counseling whenever I needed it, and it made a huge difference.

Lying will immediately decrease your chance of approval.  I'm a novice therapist and I can tell when someone lies during even small assessments.  Certainly someone with their full clinical license will also notice.  Be completely honest.  Emphasize you have worked on yourself and you continue to work on yourself; talk about your progress.  Talk about where you are now compared to then.  Emphasize if you are doing better.

Even if you do not pass a psych evaluation I would argue it is still useful.  It is still an opportunity for weight loss and self-improvement.  It also does not mean you can never get surgery - it means they want to do what is best for your health.  I have witnessed what happens when people who shouldn't get surgery get it, and the consequences range from unfortunate to fatal.

.

I disclosed everything during my psych visit.  I even stopped several times to go back and add things I forgot earlier in the conversation.  I would not recommend trying to hide anything.  It seems like owning my 'issues' and being able to speak about them openly gave my psychologist the information she needed to hear.

Excellent reply.

This is a really wonderful reply.