Depression After Gastric Sleeve Surgery

[carolyn24seven 11]

Here is a thought. Think of the sleeve as getting a tool to assist you in loosing weight. Instead of negative thinking. Just because I need help in losing weight for good, does not mean I am weak or what ever you want to lable it. I lost weight lots of times the "normal" way. I cannot keep it off. Weight loss and re-gain is diastarious for my heart. I just refuse to beat myself up for needing help to solve a long term health problem. Just my take on the whole WLS process.

Very intersting the carb~depression link. I did not realize that carbs could effect mental health. Mine is good, so dam happy to be loosing weight I guess. I truly wish the best for anyone suffering with depression. Miserable deal. Do what ever you need to do to get yourself well.

[LAN2k 18]

Here is a thought. Think of the sleeve as getting a tool to assist you in loosing weight. Instead of negative thinking. Just because I need help in losing weight for good, does not mean I am weak or what ever you want to lable it. I lost weight lots of times the "normal" way. I cannot keep it off. Weight loss and re-gain is diastarious for my heart. I just refuse to beat myself up for needing help to solve a long term health problem. Just my take on the whole WLS process.

Very intersting the carb~depression link. I did not realize that carbs could effect mental health. Mine is good, so dam happy to be loosing weight I guess. I truly wish the best for anyone suffering with depression. Miserable deal. Do what ever you need to do to get yourself well.

I WANT sooooooooo badly to shake off every trace of depression and anxiety! In fact pre surgery I felt certain that I was psychologically able to handle a major change in my anatomy and my capacity to eat...so sure I would be like so many others who have had the sleeve and felt almost immediate gratification and freedom from past food cravings and eating behaviors. I am working on the spiritual and emotional parts of my life that apparently need healing. I think it's great that you are not encumbered by depression. Who would have thought that I would become depressed while being released from all of that poundage! I am quite better now but still not where I want to be emotionally/spiritually. I went from a size 22 to a size 10 and it's a good thing I saved some of my yesteryear size 9-10 clothing because I've zero motivation to buy anything new and that's a good indication of where my spirit is at this time. :001_unsure:

[carolyn24seven 11]

I WANT sooooooooo badly to shake off every trace of depression and anxiety! In fact pre surgery I felt certain that I was psychologically able to handle a major change in my anatomy and my capacity to eat...so sure I would be like so many others who have had the sleeve and felt almost immediate gratification and freedom from past food cravings and eating behaviors. I am working on the spiritual and emotional parts of my life that apparently need healing. I think it's great that you are not encumbered by depression. Who would have thought that I would become depressed while being released from all of that poundage! I am quite better now but still not where I want to be emotionally/spiritually. I went from a size 22 to a size 10 and it's a good thing I saved some of my yesteryear size 9-10 clothing because I've zero motivation to buy anything new and that's a good indication of where my spirit is at this time. :thumbup:

Liz,

OMG you have done such marvelous work in getting yourself "right". Your situation was so miserable. I am so happy for your progress. That you have the strength and willingness of spirit to continue is so inspiring for me. My little foibles and set backs are put in proper perspective because of your courage to continue posting honestly. Thank you, you may still be on a difficult journey, if you look back from where you were, doesn't the journey to where you want to be seem shorter? and worth it? and "doo-able?

That is how I am dealing with the back slides and "failures" I experience. I am a bit disappointed that I can eat so much now. ( 6 months out) I am longing for the uncomfortable feeling that made me stop eating earlier. Carbs fill me up so I tend to want to go there first. Bad habit I am working on. I just wish I could be satisfied with one egg like before. See? there I go beating myself up for my thoughts. Working on that too! LOL

gonna get back to exercizing, I felt the very best then. Thanks again Liz, you are my hero. HUGS !!!

[LAN2k 18]

Yup regrets or not, after having this surgery we can only move forward and adapt in the best way we can. This is one of the reasons I stay connected to this message board. I need to know that their are others out there who may be experiencing similar issues and/or have information that I need. Another thing that has emerged in me since the surgery is this odd fear of the elements!! I feel so vulnerable to what substances I eat, drink and breath. As if I am now so much more fragile. While a heavy weight I went out into the LI Sound and swam with the fish nearly every day with little to no fear or reservation. Now I am wondering if I will have the courage since I now worry about pollutants and bacteria in the water!! I used to ride my bicycle for miles on skinny roads with lots of traffic...(not too bright but no helmet). Now I look for roads with bicycle paths and sidewalks scared s**t that I might get hit!! I mean I keep asking myself WHAT HAPPENED? WHY AM I NOW SO FEARFUL? But like I said already, I'm working on these issues now that I can no longer bury my emotions with food. With regard to eating with the sleeve, I too have noticed that refined carbs go down easier. For me dense meats including cold cuts and tuna are more difficult and I can eat about 4oz sometimes 6 but then I'm uncomfortably full and need to unsnap my bra, and walk about to help ease that discomfort. Thanks so much for the vote of confidence Carolyn. You are very self aware and I think you are going to do very well in reaching and maintaining your WL and fitness goals. I'm really glad your here.

[Jane_J 117]

Lis, I understand what you mean about being more fearful. I think I wore my fat a protective suit of armour and now I am stripped down and more vulnerable in some way. It's a weird thing isn't it, totally illogical, but for me it it getting better and I am now seeing my present state as more normal.

[LAN2k 18]

I'm glad that your growing Jane. It's also a comfort to know that someone else identifies with what I am feeling. Thanks.

[ouroborous 519]

So, I think I'm hovering riiiight at the edge of this post-sleeve depression.

It's weird. Most days, especially days where I take care of my body and mind, I feel pretty good! I'm positive and upbeat about things like exercise and losing weight. I feel like I'm on the right track and things are mostly going well.

But I also feel like I have no... reserves? I don't know how to explain it better than that. I feel like I used to be able to weather a day or three of not taking care of myself before I got down in the dumps. But now, it feels like ONE day of not eating properly or not getting enough sleep, and I'm miserable.

It's not clinical depression (I know what that is, I've had it before). It's just a low feeling, feeling negative, slightly hopeless/pessimistic about the future. For instance, my girlfriend took some "six weeks post-op pictures" of me yesterday, and instead of seeing the good things -- my face looks much, much thinner, and my belly is sticking out WAY less -- all I saw were the negatives -- I'm STILL a fat, middle-aged man.

That plus my mild, ongoing anxiety leads me to believe that I'm suffering from very mild depression. Again, I'm not willing to be medicated for something so mild; self-talk does wonders (for instance with the weight loss, I've lost 40 lbs, but I also had to remind myself that I technically have nearly 100 lbs to go, and it took me nearly 30 years to build up this blubber, I'm not going to lose it all in a day). Also, taking care of my needs (enough sleep, Water, exercise, etc.) really helps, as does simply not allowing myself to dwell on stuff. As I said, I've fought with the grey demon of depression before, and this is NOTHING compared to what I went through in my 20's.

That being said, I was wondering if anyone knows of any nutritional (not herbal; I don't want to take St. John's Wort, which is just a poor man's MAOI) ways to improve the body's serotonin/dopamine output? What I figure is happening in my case is that my reserves really ARE low. Instead of my body being able to draw upon copious precursors to these neurotransmitters circulating in my blood from all the food I eat, it's having to work harder. Anyone know of what I can do to help it out?

I think I read somewhere that L-tryptophan is a precursor to serotonin. Anyone know if tryptophan helps with mild depression?

[youknowit 11]

Well, I don't know anything about Tryptophan (other than the whole being in foods thing, making you tired, etc), I am glad I was brought back to this thread again, because I am at a cracking point with this issue now (again), and it's really come to a head in the last week.

Before surgery, and for many years, I have been struggling with depression, have been to counseling, which kind of helps I guess, and have been off and on anti-depressants as well (Zoloft at some points, Wellbutrin more recently). Although before surgery I had to be weaned off the Wellbutrin, and was ok for the first two months. But, since then, I have had to go back on it, which helped for a while. Now, I'm at meltdown point again. In fact, meltdown to the point of crying every day over some of the dumbest stuff, general malaise, insomnia, with incessant tiredness, not feeling like I can get out of bed, etc. In fact, as I type this, I'm welling up with tears... I'm a huge mess. I've been trying to get out there and date, but my return (increase) in depression is definitely having an affect on that as well. It's probably the demise of my current relationship, which is just making me feel even worse.

So... for me, I was really (really) hoping that I'd be ok after surgery, and that maybe these problems would not resurface, or that I'd magically get "better" in this regard. Unfortunately, at least as of the last few weeks, I am truly going down hill rather quickly, and I cannot pin point any good reason other than the return of major depression. Anyone else in this boat? I'm calling my therapist and psychiatrist tomorrow. I have to get this in order... I can't walk around life all weepy and crazy.

Thanks for listening, all! :thumbup:

[deletedsally 8]

"That being said, I was wondering if anyone knows of any nutritional (not herbal; I don't want to take St. John's Wort, which is just a poor man's MAOI) ways to improve the body's serotonin/dopamine output? What I figure is happening in my case is that my reserves really ARE low. Instead of my body being able to draw upon copious precursors to these neurotransmitters circulating in my blood from all the food I eat, it's having to work harder. Anyone know of what I can do to help it out? "

I have two suggestions:

1) Your weight loss has been excellent. You are doing well enough that you could consider slightly increasing your intake of complex carbohydrates. Carbohydrates play an important role in the regulation of serotonin. I'm probably eating more carbohydrates than most people post VSG because I know from past experience that if my carbohydrate intake drops too low, then I have problems with depression, anxiety, anger, and sleeplessness. I'm attaching some info on this.

2) I have never tried L-tryptophan, but my experience is that a good quality fish oil can work wonders with mild depression and anxiety. A high percentage of the brain is composed of fatty acids, and most Americans are deficient in Omega 3's. If you decide to try it, I would recommend a molecularly distilled fish oil, such as Nordic Naturals, Ultimate Omega. This eliminates impurities, and never causes me any GI problems. Don't use a 3-6-9 combination. It's the DHA in the Omega 3's that will help with brain health and the production of neurotransmitters. Don't waste your money on cheap/poor quality fish oil--studies show that most of it is rancid. Also attaching some info on this.

"The Low Mood Connection

Low-carb dieters are susceptible to mood swings, according to MIT researchers. The issue involves serotonin, the "feel good" brain chemical that elevates mood, suppresses appetite and acts as a natural tranquilizer.

In news released earlier this year, the Massachusetts Institute of Technology Clinical Research Center reported that a lack of dietary carbohydrates causes the brain to stop regulating serotonin. Researchers discovered that serotonin is naturally produced only after consumption of carbohydrates in the form of sweets and starches.

In the 1970's, MIT professor Richard Wurtman and colleagues first showed that eating carbohydrates raises brain serotonin levels. Since then, additional studies at MIT, including those by Dr. Judith J. Wurtman, have explored the relationship between carbohydrates in the brain and their connection to mood and weight loss. Dr. Wurtman states in a February MIT press release that "When serotonin is made and becomes active in your brain, its effect on your appetite is to make you feel full before your stomach is stuffed and stretched." The researchers explain that people may still feel hungry after eating a large steak-their stomachs may be full but their brains may not be producing enough serotonin to shut off their appetites.

It's not unusual for people who are changing their eating patterns or embarking on any kind of diet to experience episodes of irritability. However, according to Psychology Today, many who are trying testing low-carbohydrate regimens are reporting unusually high feelings of anger, tension and depression. Dr. Wurtman claims that that it's a very well documented response-she calls it the "Atkins attitude". Dieters who have eliminated or reduced dietary carbohydrates may find that their low mood is combined with irritability if the diet is heavy on Protein, and/or combined with a lack of energy if the diet is heavy on saturated fats.

Are certain people more susceptible to low mood? According to Wurtman, some people are "carbohydrate cravers" -- they tend to experience a change in their mood, usually in the late afternoon or early evening -- and they need to eat a certain amount of carbohydrates to keep their moods steady. And although both men and women can experience low mood when cutting carbs, women are more likely to feel the effects because they are known to have typically lower levels of serotonin in their brains than men.

Because of her research, Wurtman believes that low-carb diets may be dangerous for individuals who are already struggling with depression or bipolar disorder. In an Oxford study involving women, researchers did find that those who had a predisposition to mood disorders exhibited a measurable drop in mood when following a low-carb regimen, but reported that other subjects on the diet did not seem to be impacted.

Of course, the pharmaceutical solution to depression and mood disorders is the use of antidepressant drugs. These are designed to help regulate mood by keeping serotonin production active in the brain for extended periods, accomplished via an unnatural mechanism that prevents the cellular reuptake of the brain chemical (which is why most of these medications are known as "SSRIs", for "selective serotonin reuptake inhibitors"). St. Johns Wort is a popular herbal solution that also mimics the unnatural mechanism of SSRIs because the herb's active ingredient, hypericin, increases circulating levels of serotonin by also selectively preventing its cellular reuptake.

There are natural alternatives that can assist in regulating mood by playing a similar role as carbohydrates in serotonin production. Low-carb dieters who are experiencing low mood might consider taking specific Vitamins that are known to help boost serotonin naturally. Important nutrients like selenium, several B Vitamins (thiamine, riboflavin, pyridoxine, folic acid, Biotin, etc.), and Vitamin D have been shown to help increase the enzyme supply that converts certain amino acids into serotonin."

"It's no secret that long-term diet and nutrition choices have an effect on the way we look and feel; but new studies show that nutrition can also affect the way we think. As it turns out, there really is such a thing as ?food for thought.?

It may seem strange that what we put in our stomachs can have such a powerful effect on what goes on in our minds, but research is increasingly showing that emotional, mental and psychiatric disorders like depression, bipolar disorder and schizophrenia may more likely be the result of dietary deficiencies than genetic predispositions. The same is true of people who struggle with

memory loss

, have trouble learning new tasks, have

Alzheimer?s

disease or simply suffer from a lot of blue moods. The dietary deficiency that tends to frequently show up in these patients is a lack of

omega-3 oils

-- abundant fatty acids found in cold-Water fish like

salmon

, herring and cod.

Omega-3s and

brain health

The omega-3 fatty acid known as

docosahexaenoic acid

(DHA) is an important ingredient for optimal

brain function

. Earl Mindell, RPh PhD, writes in Earl Mindell's Supplement Bible, ?There's a reason why fish is known as

brain

food. It is a rich source of docosahexaenoic acid (

DHA

), a fatty acid that is found in high concentration in the gray matter of

the brain

. DHA is instrumental in the function of brain cell membranes, which are important for the transmission of brain signals.? By making cell membranes more Fluid,

omega-3 fatty acids

, especially DHA, improve communication between the

brain cells

, according to Mind Boosters author Dr. Ray Sahelia. As a result, lack of

omega-3

in the body can cause a communication breakdown in the brain, which is probably the last place you'd want such a breakdown to happen.

Omega-3

fatty acids

are so important to the development and proper maintenance of the brain that ?some scientists even postulate that it was the ingestion of omega-3 EFAs that allowed the brain to evolve to the next stage in human development,? according to Superfoods Rx authors Steven G. Pratt and Kathy Matthews. While

omega-3s

were abundant in our

diets

before the 20th century, they are now seriously lacking. The Editors of FC&A Medical Publishing write in The Folk Remedy Encyclopedia, ?Just like a machine, your brain needs oil -- in the form of omega-3 and

omega-6 fatty acids

-- to run smoothly. Unfortunately, the average diet doesn't usually contain the right balance of these fatty acids. If you eat a typical modern diet, you probably get plenty of omega-6 through

corn

, soybean, and other oils in

processed food

. But omega-3 oils, which are just as important, are often missing.?

[deletedsally 8]

This article is from the WebMD Feature Archive

Fish Oil to Treat Depression?

Omega-3's may have an affect on serotonin levels.

WebMD Feature

Dave thinks a lot about fish these days. Study after study has suggested benefits for omega-3 fatty acids, which are plentiful in certain fish oils. But what intrigues Dave isn't that omega-3's might reduce his risk of heart attack, or ease the pain of arthritis. He's hoping to lubricate his mind.

A handful of small studies have suggested that omega-3 fatty acids can help smooth out the mood swings of bipolar disorder. There are few effective treatments against the disease, so the news is a hot topic now at support groups for manic-depressives, like the Berkeley, CA, group in which Dave participates.

The first news to attract attention was a 1998 report in the Journal of Affective Disorders. Researchers noted significantly lower levels of omega-3's in the red blood cell membranes of patients with depression.

Then in the May 1999 Archives of General Psychiatry, Andrew Stoll, M.D., and colleagues reported a study of fish oil in 30 manic-depressive patients. Sixty-four percent of those who took 10 grams of fish oil per day for four months reported a marked improvement in their symptoms. By contrast, only 19 percent of those receiving the placebo benefited.

A Visual Guide to Understanding Bipolar Disorder

Cell Softeners?

These studies aren't the only research that points to the benefits of fish oil for mood problems. "There are a lot of reasons to believe it works," says Stoll. "In countries where the average fish consumption is high we see lower rates of depression."

On the biochemical front, researchers point out that cell membranes are made up partly of omega-3's. It is possible that increasing the omega-3 levels makes it easier for serotonin -- a chemical that carries messages from one brain cell to another -- to pass through cell membranes. "Research still needs to be done on the exact mechanisms involved," Stoll notes, "but we do know that omega-3 does affect the membranes and changes functioning." And increasing omega-3 "has direct effects on serotonin levels."

Diet and Depression

Joseph Hibbeln, M.D., a psychiatrist at the National Institute of Health, thinks omega-3's might explain why the rate of depression is rising in the United States.

In a health-conscious push to rid our diets of saturated fats and cholesterol, Americans have been eating less red meat and eggs -- two good sources of omega-3's. Furthermore, we have been switching to the polyunsaturated fats, such as corn, soybean, and sunflower oils, which are relatively low in omega-3's.

Supplement or Go Fish

But just how to mend that situation remains controversial. Omega-3's might worsen some chronic illnesses. (Check with a doctor if you have such a condition before starting to take supplements.) The food and Drug Administration is now considering what quantity of omega-3's to recommend; currently it has no recommendation but classifies three grams per day as "safe."

Fish Oil to Treat Depression?

Omega-3's may have an affect on serotonin levels. (continued)

Supplement or Go Fish continued...

Though Stoll gave patients 10 grams of fish oil a day for his study, he advises starting with lower doses. He believes that packaged fish oil supplements are the easiest -- and possibly safest -- way to increase omega-3 levels.

"Unfortunately in our country eating too much fresh fish is potentially dangerous because of possible mercury and pesticide levels," he explains. "Farm-raised fish is perhaps safer, but depending on what they are fed, the fish may not have the needed quantity of omega-3's."

But concerns have also been raised about the levels of contamination in fish oil supplements. Regulators do not currently test the purity of supplements.

Hibbeln cautions that people should not take cod liver oil in the quantity necessary to get three grams per day of omega-3's because that much cod liver oil would contain dangerous levels of Vitamin A.

On the other hand, flaxseed oil is a good source of omega-3's. It can be taken as a supplement or used in salad dressings. Unlike fish oils, which contain a different combination of omega-3's, flaxseed oil should not be cooked because heat can destroy the omega-3's.

More answers are expected soon. The National Institute of Mental Health's Center for Complementary and Alternate Medicine is sponsoring Stoll in a large new study, one of three now under way. All three are expected to be complete by the end of next year.

But Dave probably won't wait for the results. "Looks like I need to go out and get myself some fish oil," he says.

[youknowit 11]

This article is from the WebMD Feature Archive

Fish Oil to Treat Depression?

Omega-3's may have an affect on serotonin levels.

Thank you, Katt, for putting up this information. It may help me as well... I am taking the Omega's every day, but perhaps it's the carbs I need to get in check? Nonetheless, with my previous history of chronic depression, I'm going to attack this head-on, and get this thing straightened out!

And, once again, thank you to ALL of you here that are so amazing, and helpful, and just AMAZING! :thumbup:

[ryansgirl 1]

sadly i had to go back on a antidepression pill. it was getting a bit much. i think i have narrow it down to made cause i'm not eating all the time anymore i have to deal with every feeling i have nothing to mask it anymore:confused: just my guessing. i feel more vulnerable as well all the attention is overwhelming and it seems as if all of the sudden pressure is more on you or something. it a lot of crazy thoughts

Edited June 13, 2010 by ryansgirl

[redroses47 1]

I posted last night about excessive tiredness and a poster suggested fish oil, too. I will give that a try again because as a fish-oil consumer for 20+ years, I stopped a couple of months ago prior to surgery. Seems like it's time to get back on that wagon again. Great info, thanks for posting.

As far as I know, I have never had any sort of depression in my life but I am feeling quite 'different' post-op. I can't exactly pin-point it but I just feel blue at times and it's hard to climb out of it. My energy (what little I have) plummets and all I want to do is sleep. At the same time, this is a new feeling for me so I am working through why I am feeling that way. Is it related to my surgery? I highly suspect this is the case but I have faith that things will eventually work themselves out as my weight loss continues.

So my plan is to continue to eat well (including healthy carbs), take my Vitamins and get lots of sleep. Exercise/walk when I can and come back in these forums and read that I am dealing with things that others are experiencing, too. I appreciate the support in here :thumbup:

[LAN2k 18]

I wish I had the ANSWER. Now I'm thinking that once this throat/sinus/reflux? problem is resolved then so will my hovering depression and relentless anxiety. I must say that since loosing a hefty amount of weight (was able to get into an old/new (never worn), pair of jeans yesterday, I am feeling more vulnerable physically and mentally. I don't know but my mind is reeling with information overload because I just keep looking for solutions. When I awake usually too early 5, 6, 7 AM...I am literally burning with anxiety in the "pit of my stomach"...I choose to pray.

I often dream and awake with an eeire, or disturbed feeling. I fall asleep again and when I again awake I'm ready to rise but the anxiety lingers as well as that hovering depression, (a general feeling of gloom, and sadness). I've lost my spark and motivation--I don't even care to buy new clothing. I'm trying very hard to shake off these oppressive feelings. The more I read these boards the more I am seeing that I am not alone.....Yet I know there are many here who feel elated since their surgery and have inspiring stories to tell and that's what I want to feel. It's summer and I had hoped with winters passing I would have been lifted...I'm not..so those of you out there who need to express the blues and those who can offer possible solutions...keep them coming. Thanks Ouro...youknowit, katt,ryansgirl, eloquentblue ...

[SouthernSleever 228]

I have not dealt with depression since my 20s but I have found what when I get the blue/doom feeling like I had after my first baby/c-section that reconnecting with nature really helped. I think not only the sunshine for my B12 but also the enviroment helped a lot. My husband works at a rehab for teens with drug/behavior problems and they often deal with depression. The company which owns them recently required the kids be outside for a certain amount of time and bringing live plants inside. He said they gave a list of a number of studies that show an increase in mood directly relating to an increase in the time spent around nature.