From the LapSF newsletter.

********

Many people can't imagine becoming depressed AFTER losing weight. However, depression can occur after weight loss surgery or when undergoing any time of major lifestyle change. Possible causes of depression after WLS may include:

- Mourning the loss of food for comfort. If food has always been your "friend" or something you depended on when feeling sad, stressed or lonely, saying "goodbye" can be difficult.

- Mourning the loss of pre-operative lifestyle. For example, feeling left out while socializing, participating in holiday rituals, or when dining in restaurants.

- Reactions from others. Relationships with loved ones can change or become strained. Reactions to weight loss may be negative or jealous, or otherwise unsupportive friends/family may resort to "sabotage." Positive reactions or increased attention from others can lead to feelings of discomfort, vulnerability, or resentment.

- Having unrealistic expectations. For example, thinking that everything will get better after surgery or that your emotional eating or other disordered eating habits will simply disappear.

- Hormonal changes. For some women, estrogen is released while fat is burned to make energy. This release of estrogen may cause mood swings.

- Body image discrepancies. After rapid weight loss, you do not recognize yourself or lose a sense of self. You may experience a loss of identity between the inner and outer you.

The postoperative blues typically occur during the first few weeks or months after surgery and subside over time. However, if you find that your symptoms are worsening or are beginning to interfere with your relationships, work, or daily functioning, it is time to seek help from a medical professional.

I wouldn't be too concerned at only 2 weeks out. I was exhausted for the first 4 weeks. I took a lot of naps and just tried to let my body get all the rest it needed to heal and adjust to the drastic calorie reduction. When I was able to start eating mushies at 4 weeks, my energy returned pretty quickly. Now I am constantly on the go. I have more energy than I have had in years.

I wouldn't be too concerned at only 2 weeks out. I was exhausted for the first 4 weeks. I took a lot of naps and just tried to let my body get all the rest it needed to heal and adjust to the drastic calorie reduction. When I was able to start eating mushies at 4 weeks, my energy returned pretty quickly. Now I am constantly on the go. I have more energy than I have had in years.

Oh, thank goodness I'm not the only one feeling exhausted. I'm 16 days post-surgery, and I was feeling so good that I joined a gym on Monday, and on Tuesday, Wednesday, and Thursday, I worked out. Or at least walked and swam. I walked one mile the first day, 1.5 miles the second, swam vigorously for a half-hour yesterday, and today...well, I am absolutely exhausted. Couldn't drag myself out of the house. I'm not sure if I'm going to be able to do it tomorrow, either. I slept in until noon today, then had a three-hour nap late this afternoon, and now I'm ready to go to bed. I feel like a wimp! I think in retrospect, I probably pushed myself 'way too hard. What I WANT to do versus what I CAN do are still poles apart.

On the good side, at least, I can handle more than tiny sips of fluids now. It still takes me a half-hour or longer to finish a 16-ounce bottle of Water if I'm not doing anything but focusing on drinking it, but that's 'way down from taking a couple of hours (or longer). I don't feel on the bare edge of excruciating thirst now. And water, just plain water, has never tasted so good in my life!

I think I'm having some kind of hormone/brain chemistry thing going on. I'm just not motivated to do the million things I need to do. I just feel like sitting in front of the TV, and I'm not usually like that. How long does this last? I'm 2 weeks post op.

Donna, you and I had our surgery on the same day. :001_smile: I'm having trouble with fatigue as well, and I just saw my primary care physician on Wednesday for unrelated stuff. He's familiar with the various kinds of weight-loss surgery, and he told me that it can take 4-6 weeks before you feel back up to your pre-surgery energy levels. I've found that aspect of this really frustrating, especially after three days in a row of going to the gym and then going *splat* today.

But, I think we just have to remember to be nice to ourselves. I've started reminding myself frequently that I went through major, serious surgery, even if it was done laparoscopically like mine was, and that most of a major organ was removed. It's more than the incisions that have to heal (I do have to keep reminding myself of this). And fatigue is a big part of the healing process, because the body uses up huge resources to do it. Combine it with being on a liquid, low-calorie diet, and it starts to make at least a glimmer of logical sense. I hope I don't come across as lecturing--unless I'm lecturing myself at the same time!

Anyway, keep your chin up. I'm trying to do that too.:thumbup:

Thanks Katt good info. -Can you tell me the brand name of the Fish Oil you take and how many per day (do you take them all at once)? Thanks again.

I take Lovaza fish oil pills, myself. They're a prescription-strength, super-concentrated form of the fish oil. I take one gram (1000 milligrams) twice a day. And it actually ends up being cheaper to get it via prescription, especially if you're taking high doses of fish oil pills. Plus, with the Lovaza, I've found that I don't have issues with burping fishy flavor all day long (they get it out in the concentration and purification process). And it's a lot fewer pills: one, twice per day.

They've made a huge difference in my cholesterol and triglyceride levels, even before surgery. I'm excited to see what my levels are when I get the labwork done again in another couple of weeks. :001_smile:

I agree that 4 to 6 weeks is a reasonable length of time to give yourself to be more sedentary than usual. Listen to your body. Don't push yourself. You have plenty of time to tone up and work out when your body is ready. Plus you really have to get to the point where you can ingest 60+ grams of protein a day to support your heart and other muscles if you're going to work out. You want to get strong, not tear yourself down further after major surgery. The surgery is not that difficult and I think we expect too much of ourselves because we don't feel worse, like we would have if we had a mid-line abdominal incision. Hang in there, it'll happen and before you know it you're going to feel better than you have in years!

I think I'm having some kind of hormone/brain chemistry thing going on. I'm just not motivated to do the million things I need to do. I just feel like sitting in front of the TV, and I'm not usually like that. How long does this last? I'm 2 weeks post op.

It will pass, you are going through a lot of physical changes and also you will still have residual general anaesthetic in your system. It made me feel very low after the op from time to time. Just be kind to yourself and if you are tired, sleep if you can. Then get up and have a nice walk. It will all get better over time.

Jane x

Jane J is absolutely right. I had a couple of down days (a "what have I done" moment or two!), and got very tired, but now, I think I am getting my mojo back!

When you buy food, buy the best. Treat yourself to some gorgeous body lotion. Or have a manicure and pedicure done. Buy a glossy magazine... You deserve it, and it does make you feel better :001_smile:

Judy is giving good advice. Treat yourself as, in the words of a some famous cosmetic brand, "Because you're worth it"!!!

Jane x

Well said Jane and Judy!

It's so odd how different things occur in people. I could not watch TV at all for many months after the surgery. TV literally freaked me out. I felt as if I were watching the dead, or as if it were some sort of evil carnival. Antidepressants and anti anxiety medications helped. Eventually I stopped the antidepressant medication but I still take Klonopin as needed for anxiety. Hope that helps.

endorphins are the only things that have ever successfully controlled my anxiety. when i don't exercise, i'm just emotionally down enough to make life more difficult. but when i exercise, i get everything out of my mind and body, the catharsis is deep, and my brain chemistry is more balanced. i'm talking about daily exercise.

my favorite exercise is hiking and walking. this sounds psycho -- and i'm not saying i'm NOT psycho -- but i power walk and hike with my bluetooth earpiece on and talk to myself. it looks and sounds like i'm on the phone, but really i'm just getting it all OUT. i have to work out all my stuff, and doing this gets my stuff worked out of me physically and mentally. this is when i'm in shape, mind you. i know the hardest part of this journey for me will be when i'm thin -- thinness is where the rubber hits the road for me. i have no armor, no excuses, i can't blame anybody else for any number of things, and life is vivid and REAL and mine to mess up.

i have a fear of being thin. i know this now. so, this time i'm armed with a clear understanding of how i tick, and i know i have to treat my food and weight issues the same way an alcoholic treats their recovery. i know life isn't going to be ideal just because i'm thin again. life will be awesome, i'm ready for that, but it will still be challenging and i'll have to work through it. my plan is to be in individual and group therapy in perpetuity, and i've already lined up steady exercise activities to keep me balanced (i've already joined an ocean swimming group, stuff like that). i'm ready to LIVE.

all a long-winded way of saying TRY EXERCISE once you're recovered enough and have lost enough weight to move around without feeling like you're going to die. the link between endorphins and serotonin levels is well documented. drugs don't always help, so endorphins can be your friends.

Edited July 31, 201016 yr by kristykreem

It's so odd how different things occur in people. I could not watch TV at all for many months after the surgery. TV literally freaked me out. I felt as if I were watching the dead, or as if it were some sort of evil carnival. Antidepressants and anti anxiety medications helped. Eventually I stopped the antidepressant medication but I still take Klonopin as needed for anxiety. Hope that helps.

It is odd how meds and anesthesia affect people differently. When my dad had major surgery, he kept thinking that he was actually in the shows on the television in his hospital room. I think they did wind up giving him something like Klonopin.

Okay, is this weird or normal? I have a birth control implant (Implanon--fairly new). I've had it since March. Prior to that I was on Depo Provera (shot) for six months. Up until surgery, I was not having my period, which was fine with me because it was what I was after with the birth control. Now, suddenly I'm going from spotting to having agonizing cramps and fluid retention (the reason I wanted to stop my cycle in the first place). I don't even have any sanitary supplies in the house. That one's really easy to remedy, but what gives on the sudden resumption of my cycle? Help!!!!

Do as I did and trade your menstural cycle in on a Honda.

Sorry. That's sick post menopausal humor. I have no answers on this one but I do hope you figure it out and feel better soon!

It is odd how meds and anesthesia affect people differently. When my dad had major surgery, he kept thinking that he was actually in the shows on the television in his hospital room. I think they did wind up giving him something like Klonopin.

Wow BJean, I just read that and your the 2nd person who mentioned anesthesia and how it effects some people. One of my mother's friends told us about someone who, having heart surgery, thought he was in prison. His thinking and reacting to his thoughts persisted for a few days. In my case it took a few months and medications to shake off those feelings.