I Know I'm Healthier - Why The Continuing Funk?

I sincerely hope the best for you as you work your way through the problems, Box. I'm not much of a fan of AD in most cases but since I've never taken them, my opinion is pretty much worthless (great, huh?).  I can tell you that I went through a bout of depression about six months post-WLS which was mostly driven by : "Job still sucks.  Marriage still... well... let's just say there's no improvement, like I'd hoped.  And dammit, the BRONCOS got knocked out of the playoffs, too!  " (sound familar?)  Things eventually cleared up with the passage of time but I still struggle with the same-o, same-o crap on a daily basis just like we all do. Hang in there BoxMan and sorry for the lame message as I wish I could be more help. Boner 

On January 30, 2008 at 10:47 AM Pacific Time, Boxman wrote:

They say that advice is what you ask for when you already know what to do.  But what do "they" know, anyway?   I'm just wondering how many of your docs put you on ADs after surgery, and how long did you feel the need to stay on them? My surgeon started me on Lexapro, and said I should stay on them for at least 2 months.  If I wanted to continue after that, she said I should go through my primary care doc.  I know it was a benefit in the first month - going through all that head-hunger / feeling sorry for myself crap. Well, I got my regular doc to write a script, and I continued taking it for another couple months.  A month ago, I weaned myself off it.  I didn't want to screw with my brain anymore if I didn't need to, right?  And besides, my physical health was improving by leaps, everything else should follow, right?  Who needs ADs anymore? Ooops.  Everything else DOESN'T follow.  Job still sucks.  Marriage still... well... let's just say there's no improvement, like I'd hoped.  And dammit, the Colts got knocked out of the playoffs, too!  So, maybe I should go back on the Lexapro for awhile longer, even though I don't think I should HAVE to.   It's kinda like my pre-surgery thinking about how I shouldn't NEED surgery, I guess.  Just wondering if this is a common feeling, and hoping that it is.  

Be careful of weight gain with the Lexapro, I gained 35 pounds in 2 months while on it. Weight gain is in the fine print, needless to say I sent several strong letters to the manufactuer. I am now on 300 mg Wellbutrin XL and its been working for me the last 3 years. I'm a month from surgery and my therapist says to stay on it, my depression will always be there and the Wellbutrin helps. Good Luck, Rich

I told my doc I was thinking about weaning myself off it, by cutting my last week of pills into 14 half-doses.  He seemed to think that would be OK, if I felt I wanted to get off them.  So I did.

He ALSO said, if I get returning symptoms, there was no problem in starting back up again.  He never mentioned an alternative med. though.  But I didn't ask, either.

And I WOULD like to hear your recomendation on a psych. or therapist up here aroung Kokomo.  I've thought about it from time to time, but just picking a name at random out of the yellow pages doesn't seem like the best way to choose, yanno? Send me a PM, would ya?  Don't know if I'll go, but it might be nice to explore the possibility. Thx, Boxman Colts fan year 'round, Giants fan this weekend! 

Wow Box,
You sound like a guy who just had Weight loss Surgery about 6 months ago! (sorry to cough-up and "re-chew" some of my old cud, but it beats typing all of this again...re-posting of some old response....so at least you're not alone.  Others have asked for the same penny advice in the past, and this is what I passed on......)

There are several factors at work all at once…
Your "blue mood" could be a result of any of them, or all at once.
One ‘culprit?’—
Testosterone levels…….
We often hear of the INCREASE of free testosterone levels
associated with the rapid weight loss following WLS.
Stored Testosterone in the Adipose Fatty Tissues is released into the body.
And significant increases of Free Testosterone can result.

BUT, for many, the radical change in diet actually will produce the opposite effect.

Studies linking reduced fat intake with lowered testosterone levels in humans were published as early as 1980.
Subjects cutting their fat intake in half experienced a 13% drop in free testosterone. When they resumed their normal diet, Testosterone levels returned to normal.

So, with a drop happening as a result of the cut back in food, and an increase from stored testosterone being released, it should "just balance out?"
Nope. More like shifting Testosterone Levels higher than usual in the morning, then dropping sharply, then back up, then down, etc…throughout the day…
Moody Man-PMSing-Biotch of a Roller-Coaster Ride!!!

As if that alone wasn’t enough….
Brain Chemistry Imbalances- 

The first couple of months following General Anesthesia of surgery,
The brain is still working to restore balance of 
Serotonin, Norephinephrine, and Dopamine levels. Thus your Doc putting you on ADs for the first months. Sounds like he know's his sh*t
That anesthesia is quite the "Brain-Bath"
and accounts for a very high incidence of innitial "Post-operative Depression"
that shows up after all surgeries, not just WLS.
Many, many docs just put their patients on an anti-depressant as a regular preventive course.
But "I’m not Depressed! just feeling 'unfullfilled!  Right?" Could be........... 
The symptoms of Depression include-
Restlessness, inability to concentrate, anxiety, trouble getting to sleep, being sleepy all the time, feeling "anxious," feeling list-less, etc…
Give it a quick check at-
http://www.med.nyu.edu/psych/screens/depres.html

Then add to these-
"Head Hunger," and having to adapt without the usual coping mechanism of "Comfort-Food."
Most of us who are or were Obese, were good at using food like a drug.
"Hard Day?" Calm down with too much food and get that "Full as a Puppy" stupor that calms the day. Or- Snack away the evening sitting on the couch, numb from the raised blood sugar levels of constant carb intake.
Suddenly there’s all of these "Feelings" that used to be ‘numbed’ by a life of denial and Comfort Food---------------

                                       

Looking at this list, do the words in the "Glad Box" seem like "Good Feelings" and the rest are "Bad?"
They probably do for most Men, but shouldn’t.
According to Psychologists, It’s the "Naming" that seems to give us the most trouble.
Anger is normal, healthy and necessary for our protection and our safety.
Sadness, too, is normal, healthy and allows us to fully experience life and appreciate the joyous moments.
Shame teaches us humility and gives us perspective while reminding us that we are human, and not perfect.
Feelings are neither good nor bad.
They are how we respond to the world, and in combinations,
they make each of us, uniquely, Who We Are.
The past mindless snacking and typical routine of most "over-eaters" numbs and dulls emotions and self-awareness; it favors inertia and ignores situational demands.

Denial, avoidance, and ‘putting things off’ may have taken precedence over engaging the task at hand or world in general.  (example- didn't have to talk through a problem with the missus to a resolution, could just let it slide and numb out any feeling with a bag or two of Dorritoes.  Now?  Damn, have to finish that discussion!) When you are suddenly very self-conscious of your daily activities and choices, and not in the comfortably numb state of denial, all sorts of feelings you had been missing will surface for you to deal with.  Expecting this to be the case, is half the battle.

A sense of loss, loneliness, emptiness and depression or separation and performance anxiety can all arise. Letting go of a long held routine can be especially troublesome. At minimum, a state of psychological withdrawal is a distinct possibility. What many Post-Ops refer to as "Grieving Food," may well just be experiencing feelings that have been numbed by the disengaged lifestyle of thoughtless habit.

One last one…..
Energy Levels:
Many people while their metabolism is in a state of Ketosis, claim to have extreme energy. Euphoria in fact. Mant take advantage of it while it lasts, then feel really bummed out as energy levels drop back to normal, or worse, drop below normal due to a lack of B-Vitamins, etc... Staying way on top of vitamins can help fight off fatigue that is experienced as "The Blues." Some extra exercise and sunshine will help with that too.
All of this to say-
You sound Very Normal for a 1/2 year Post-Op.
"Will it always be like this?!?!"
Nope. Particularly if you are aware of it and set about doing something about it. Could be Anti-Depressants will help you over the hump, and don't write off plain ole "talk therapy" with a doc who specializes in just such problems.
Each week gets easier, and more second nature and if you’ve used the first year to establish new lifestyle habits, it gets down-right Easy!

Sorry to throw so much in one reply,
But hey, if you read this, at least you passed this time…
Tomorrow can be better, and the day after that better still.....

Hollar if you you need an ear.... We're here.....
Best Wishes-
Dx