Question:
Anyone with Bipolar Disorder been approved by a Psych Eval?

Ok, I was diagnosed with BPD in 2001 a few months after my RNY procedure. I'm now seeking a revision due to the weight gain, most commonly from the meds taken for the disorder. This is a very important question for me because I'm so afraid of gaining a lot of weight, my pharmaceutical (meds) choices are limited. Do I automatically fail the P*doc eval? WHat about insurance? they paid for it once, will they pay for it again with this condition. (WHich by the way is intensely managed. PLEASE ANSWER. P.S. Bipolar Disorder doesn't allow you to eat, it's the meds that keep you starved!    — corpdiva2005 (posted on February 26, 2009)

February 25, 2009
I have BPD and I was able to have Lap/RNY. They changed my medications so that I could successfully lose the weight and keep it off.
   — angelalynn1968

February 25, 2009
Hi there, Adrienne, I was diagnosed with Bi-Polar Type 2 about 6 years ago, although I'm STILL not convinced that's true. I honestly believe that I suffer from bouts of clinical depression that are situational in nature. However, the P-doc has had me on all kinds of different meds to see which one works and is the least expensive and has the least number of side effects (many of which are directly contributory to weight gain)... Zyprexa was very good, but is indicated in Type 2 diabetes, Geo-Don zombied me out, Lithium made my hands shake, now am on Depakote ER (1000 mg at night - they recommend 1500, but I do well on the lower dose). However, they are "horse pills" and no way can I take them after surgery. So, my P-Doc prescribed Depakene, which is a liquid version of Depakote. I am transitioning now, because my surgery is Monday morning. I seem to be doing fine. I have not had a major depressive episode for over 5 years, and I am not aware of any "manic" behavior ever. I began researching this surgery about a year ago, and taking steps to begin the insurance approval process last September. One of the things I had to do was work with my surgeon's registered dietician on a weight loss program, and she gave me a general guide that involved eating 75% protein and 25% carbs at 6 small meals per day... with the first meal within an hour of rising, and the last meal within an hour of bed. And no caffinated drinks, and LOTS and LOTS of water/liquids. She told me no white carbs (rice, potatoes, popcorn, pasta, etc), and to keep my fat intake at less than 8 grams per meal. Well, I started that eating plan in October and have lost nearly 30 pounds, despite the Bi-Polar medication, so I know it can be done. And also, my surgeon has a list of therapists he works with to get the psych evals done... and they are all very sympathetic to morbidly obese people who need bariatric surgery. They just want to make sure that you know that the surgery itself is not a "magic bullet" that will cure you of being fat.... that you understand that YOU must make a life-change to lose the weight and keep it off. Because if you don't go into this with your eyes wide open and understanding that... depression is almost inevitable. And, I must ask.... I don't understand your "PS"... your meds keep you starved??? BiPolar doesn't allow you to eat?? I must be missing something... can you elaborate?
   — Erica Alikchihoo

February 26, 2009
I take BP meds. My psych approved my eval. Also made sure all my meds were either crushable or in liquid form. I take Lexapro which works best for me. It comes in liquid form. I also take klonopin which comes in sublingual form. I wasn't able to continue taking geodon because it was in a capsule form and it bothered my stomach. I also use to be on adderall which I can't take anymore either due to stomach issues. Best Wishes
   — Corina C

February 26, 2009
Yes! I have bi-polar disorder and just had my lap RNY on January 22nd. My only suggestion is to be totally honest during the psych eval. We all worry about whether or not we will "pass", but if you are not honest, you will not get an honest reaction from the evaluator. Best of luck to you!
   — anitak

February 27, 2009
i haven't had a revision but i had the rny and was approved with my psych. eval. i've been bipolar many years though. i am 37years old now i had the gastric bypass almost 2 years ago and still losing very slow. talk to your insurance co. first and see if they cover the revision. as long as you are seeing your psychiatrist for meds. and therapist regularly it souldn't be an issue but be warned, as you may know, being bipolar makes everything harder.
   — velvet M.

February 27, 2009
I am one of the few diagnosed with BPD II in 2001 that does not take any meds for it. When I had my psych eval, I did disclose this, and I passed without any problems - they just wanted to make sure I was under a lisenced mental health providor's care in case after the surgery I needed to go back on the meds. I used to take Depakote, but with counselling and modifying my lifestyle, I was able to SLOWLY ween myself off with my doc's help. I am waiting on an approval from my insurance, and I am hoping that I do ok without my Depakote. It's more impotant to be honest, even if it delays your surgery a little bit. They (Bariatric centers) want to make sure that if you are having issues that you have adequate support to help you, and you shoudl also want that for yourself. I also do not understand the last sentene of your post, "P.S. Bipolar Disorder doesn't allow you to eat...." Good luck to you!
   — stellarsan

February 27, 2009
Sure Erica, thanks for the great advice. I'm BPD, rapid cycler, very much different than you in that you've never had a manic episode (that you truly know of), when manic, you're extremely hyper and food is the LAST thing you think of, but the meds, especially Zyprexa and Seraquel and depending on the person, Lithium, tend to not only zombie you out but there main side effect is weight gain. Now for us, we can't eat a lot at one setting, but we can certainly graze more than the typical 6 small meals a day. The research I've done is that many of he BPD 'cocktails' slow down your metabolism as well. Many people present differently when depressed, some sleep all day (like me) some eat all day. I can tell you that while I was on Topamax, it acted as an appetite suppressant and for a while I was starting to look like crack addict, (The FDA has now approved it for weight lost, migraine headaches and alcohol addiction supression). Hopefully, my long paragraph gave some clarity on my P.S. statement, as you know not all BPD suffers are the same. Thanks again for your great input, Erica.
   — corpdiva2005

February 27, 2009
Thank you everyone for being sensitive to my question, even behind a keyboard it was a hard question to ask because there are so many ill-meaning people who don't understand the disorder. I was diagnosed 4 months post-op in 2001 before a psych evaluation was required. I'm still so greatful that I had it done, otherwise due to familial history I was destined for diabetes, morbid obesity, heart disease and osteoartritis, but you are so limited on what meds you can take without gaining weight (Its a good thing here are a lot to choose from.) Just as people who are on lifelong doses of Prednisone (a steroid) battle with the same issue, weight gain.
   — corpdiva2005