Question:
Mental illness
Hi. I'm having surgery in June and I have a mental illness. Very bad depression. My question is this. Will I still be able to take the medications that I'm taking now? I take the following: Effexor, Tegretol, Zoloft, and Ambian for sleep. Will I experence post-op depresstion? Will the doses of my meds need to be rearaanged? Any help on this would be GREAT!!!!! Thanks!!!!!!!!!! — [Anonymous] (posted on May 12, 2000)
May 12, 2000
Hi there. I had clinical depression, too, prior to my surgery. You didn;t
mention what type of surgery you are seeking. If there is any intestinal
bypass included, you may need a revision in your dosages, etc. My advice
to you is to ask your psychiatrist for his answer to this. All of the
helpful folks on this site have been extremely informitive, I've found...
but you need to do what YOUR doctor(s) think is the best course in this.
You may wish your psych person to contact your surgeon to conference on
this, if he or she is not sure how medications will be absorbed post-op, in
order to decide the best dosages of your meds, for when you come home
post-op. I wish you the very best of luck, and a cessation of your
symptoms!
— lisadiehl
May 12, 2000
Hi, I also have clinical depression and am 11 weeks postop. I met with my
psychiatrist prior to surgery and she said I should have no trouble taking
my meds. I can take pills now no problem, even capsules. I'm on prozac,
welbutrin and depakote. Beware of liquid anti-depressants though, I hear
they taste awful and can cause you to not want to take them. Some people
have postop depression because of the trauma of having surgery and the
effects of the anesthesia. Just make sure you keep in touch with your
therapist if you're feeling down.
— Elizabeth M.
May 12, 2000
I just yesterday asked my doctor's nurse this question. I take zoloft and
she said I could just crush it up or get it in liquid form if it comes that
way. She said this would only be necessary at the beginning when on
liquids.
— Denise K.
May 12, 2000
I take Remeron and Ambien and have took them crushed for the first 10 days
after surgery through my tube, crushed for the next 2 weeks orally, and now
don't have to do anything to take them orally. Ask if you can split the
dosage if malabsorbtion is going to be a problem, just to make sure you
stay at a therapeutic level.
— Alicia B.
May 12, 2000
No you meds should not be adjusted or changed. I have bipolar
and also on several medications. I was able to take all of
them after the surgery. The only time they have been adjusted
is when I went through a depression, not from the surgery
or its affects. Because of my meds I did not have post op
depression. Iam not saying you wont, but chances are you may
not because of your meds. Tegretol is one of my meds as well,
Your meds should not change. Good luck to you.
— chris M.
May 12, 2000
First of all, good luck with your surgery. One question I have for you is:
Is your depression caused in part by your obesity? I work in mental health
and have for nearly 13 years. With nearly every person I have worked with
who has depression, we have been able to identify often concrete thinking
processes that cause the depression. I think medications can be helpful
for a time, but they are NOT curative and very often have disasterous
side-effects. I, personally, do not buy into the theory that depression is
caused by a chemical imbalance. I think a chemical imbalance may just as
well be the result of depression as opposed to the cause of it. People
covit. We covit what we cannot have. We covit what we see every day.
Most problems of depression IMHO stem from things in our lives that prevent
us from being the person we want to be. With obesity, there seems to be a
certain comfort it eating which fulfills a basic need. The pathology also
seems to include control issues with respect to one's own body. Perhaps
the weight itself gives us a mass to hide behind. I would encourage you to
do some real soul searching with a therapist. I know many of you are
probably going to site research that supports chemical imbalances. Please
check the funding sources - often such research is funded by pharmaceutical
companies who have done a massive sell job on this nation. Psychiatrists
are often reduced to being agents for pharmaceutical companies practicing
medication management only and completely leaving out the social context or
environmental influences that lead to feelings of worthlessness,
hopelessness, helplessness, etc. Most problems of living can be directly
related to our relationships with other people. WE NEED PEOPLE! We need
to belong. We need to love and be loved. We need to love ourselves. In
obesity we seem to gain comfort from food which carries a major side-effect
- weight gain. In American society the more weight gained, the less
acceptance we experience. With little acceptance, we sometimes (maybe
often) feel we don't belong. This message is reinforced in a society that
builds theater seats and resturaunt seats too small for folks of our
stature. We glamorize being anorexically thin. I remind you all
discrimination is not seen nearly as much as it is felt and I dare say
everyone on this list has felt that or we would not even be considering
such a major surgery to rectify the problem. I hope I have not confused
the issue even more. Please, please, please follow up with your therapist
and/or psychiatrist. Best of luck to you and all who read this.
Depression is not a hopeless thing. We have to get really honest with
ourselves I think to actually overcome it. Again, I think medication can
be helpful, but psychotrophic meds are NOT curative and often have very bad
side-effects.
— [Anonymous]
May 12, 2000
Jeff - I have to agree with you. I was diagnosed with major clinical
depression and on everything (SSRIs, MAO's (its been a couple years so I
don't recall the lingo - prozac, effexor, paxil, wellbutrim, zoloft etc).
The only thing I knew after 2 years was that I was exactly the same as when
I started the meds and knew that it wasn't me. Against medical advice, I
stopped all meds cold turkey and had a few psychotherapy sessions-and I do
mean few. There was an enormous dissatisfaction and dissapointment with my
life, and mostly with my body. Keeping myself focused on changing my body
and my life keeps me sane. I have short 'relapses' - a day or two of
feeling sorry for myself - usually premenstral. I've seen too many people
given antidepressants instead of directed to the real problem - their
unhappiness with their current life situation. I think people that believe
they have a problem and that their depression is valid should continue
whatever they believe it is that helps them. You create your own reality.
— Toni B.
May 12, 2000
My prior message sounds too brief and flippant - I am talking about my own
experience. I think mental illness is a very real disease. I question
whether it is as 'common' as the docs & pharmeceuticals would like us
to think it is. I never had major depression. 3 psychiatrists liked this
diagnosis, and as long as I kept believing them, I was depressed and
compliant with the meds.
— Toni B.
May 12, 2000
the thing that always bothers me is - specifically, what chemical is
unbalanced? What is my current level? what should it be? If these
questions can't be answered, how can I buy into this chemical imbalance
argument. I mean, when my thyroid is disfunctional, they can tell me
exactly what my tsh factor is and what the normal range is. Chemical
imbalance - they need better info to convince me that I have one.
— Toni B.
May 12, 2000
I am on Welbutrin, Neurontin and Klonopin for Bipolar Illness (moods go
from high to low, etc).
I ckd w/ my surgeon and my shrink. I found out that I need to crush the
pills for a short time after
surgery. The pills that can not be crushed have to be changed to kind that
can be crushed. Fortunately,
all my meds come in dosages that can be crushed. I was told that I have to
be off all medication for the
entire week after surgery. In order to do this, I have to decrease my meds
slowly one wk prior to surgery.
My shrink does not think that being off the meds for one wk will be harmful
to me. As others have stated,
the effects of emotional stress due to surgery, etc can activate some
problems. My shrink is working w/ me
prior to surgery to make sure I am "well adjusted" at the time of
surgery. Af far as bipolar being caused by
elements in our environment, I do not buy that concept. It is a chemical
imbalance in the brains function.
Anyone telling you differently, beware of..depression can sometimes be
caused by things "outside of ourselves"
other times it is caused by chemical imbalances in the brain, too. Do not
let any non physician tell you that
you do not need meds. Leave that to the professional psychologists and
psychiatrists to determine. I have seen
people have disasterous consequences after following the lead of people not
qualified to access their real needs.
I, too worked in the field of mental health yet do not in anyway consider
myself qualified to act as a professional
doctor and tell anyone if they really have a chemical imbalance that
requires meds or not. It is too dangerous to
do! I leave this to qualified physicians and psychologists. I know that the
reasons that I ate a lot of the time was due
to the feelings that I experienced a lot of the time. When I was angry,
sad, lonely, frustrated..I found that food helped me
to cope w/ the feelings...at least for the moment. It was a QUICK FIX. I
have to learn to use other more positive things to put
in the place of food to help me to cope or I will gain the wt back again
slowly. I do not want that to happen.
— [Anonymous]
May 13, 2000
Ava - thanks for the explanation, but I have heard all the chemical
imbalance theories. Its not my intention to invalidate people's beliefs,
particularly when they are working for them - for me, unless they can
specifically measure whats imbalanced - seratonin, dopamine, etc. like they
can with cholesterol, calcium, etc. - they can keep their theories out of
my brain matter and medicine cabinet.
— Toni B.
May 14, 2000
You have received a variety of answers....let me add to them... I as well
suffer from clinical depression. My WLS was in Sept. of 1998. I had been
taking zoloft prior to surgery and discontinued it 3 weeks prior to
surgery. All went fine, as it usually does for me, until my depression
crept back into my daily life. I started on Wellbutrin and now take 200mg
BID... the highest dose allowed. But I also talked with many different
doctors with different beliefs which lead me to adding specific supplements
to my regimen. This doctor advised that I add (1). a soy supplement (2).
the supplement DHA and (3). high potency Bcomplex vitamin. So I did....
and I can't tell you that I felt noticably different but I do not get
depressed as often and when I do, I am able to catch it right away and talk
to my Dr. or Psychologist as needed. I also take vitamin C and of course
the Multi Vitamin w/minerals. My bloodwork is great.... I have been taking
this combination, including the Wellbutrin for a year + now and I am
feeling good. My cholesteral when last checked was 148!!!! my BP is
100/55, which I thought was low but my Doc says I am very healthy!!!!! I am
human, I still get down, believe me it is not always easy.....but it's
better ; I just had my abdominoplasty surgery on May 2, and have the post
op blues...but I know this to shall pass. When it does I will be on top of
my game - living my life for me. Won't you join me? and enjoy your life as
well, the good with the bad, the happy with the sad, and everything else
that goes with LIVING!!
— Edith B.
May 14, 2000
Ava - I think you missed my point - I never was depressed - I was
misdiagnosed with depression -- as I believe many people who are
dissatisfied with their current life situation (and their obesity, as was
I) are. Docs love to attach a label (that stays forever) and prescribe
meds.
— Toni B.
May 14, 2000
Hi. I am diagnosed Bipolar. However, I took many of the same meds that
you list, Tegretol, Zoloft, i took Klonopin instead of ambien, same
principle. I had trouble getting my meds down following surgery. I had
to crush them and inject them into the g tube with a syringe. This went
on about 2 1/2 months to 3 months. But I took a lot of other meds too.
I had surgery 10/4/2000. I started at 419.5 pounds. Today I weigh 253.
I did have a lot of trouble when the psychiatrist did not take into account
how much weight I lost and adjust the meds. Instead of decreasing, she
kept increasing. I had to do a psych hospital stay to get it straightened
out. However, now I am maintained with good control on 300 mg. seroquel
and 150 mg. Wellbutrin Sr. This is amazing for me. LOL Beth
— Elizabeth H.
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