From the LapSF newsletter.

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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 think it is interesting, that the decreased Ghrelin secretion after surgery, can induce depression. What will make the appetite go away, can also give us a depression?

Thanks for all this useful information, seriously the first week after my surgery I wanted to die. I couldn't stop crying and my husband was starting to get worried because of the things I was telling him. The emotions are on a roller coaster which I can deal with, I guess. My major hang up is sleep, I soooooo miss that. I'm a 8-10hr of sleep type of person and now Im lucky to get 4 hrs.

when was you surgery? Mine was one week ago and I cant sleep either. I too am use to sleeping 8 hours each night. What the heck is going on and will I ever be able to sleep 8 hr again!

Thanks for all this useful information, seriously the first week after my surgery I wanted to die. I couldn't stop crying and my husband was starting to get worried because of the things I was telling him. The emotions are on a roller coaster which I can deal with, I guess. My major hang up is sleep, I soooooo miss that. I'm a 8-10hr of sleep type of person and now Im lucky to get 4 hrs.

when was you surgery? Mine was one week ago and I cant sleep either. I too am use to sleeping 8 hours each night. What the heck is going on and will I ever be able to sleep 8 hr again!

I had my surgery Nov 9th, I wonder the same thing will I ever have my sleep back. Some people have stated it takes almost 3 months to get your body back into routine, I really hope not. I've called my Dr several times and the only thing he states is ya this is normal for some people and just try over the counter sleeping aids. Well I've tried benedryl, nothing just worked the opposite and tylenol pm the same thing.

Try not to worry re: the lack of sleep. We were put under general sedation and that put's a huge strain on our entire body!!! I've always been an easy sleeper and my insomnia was unbelievable in the first 2 weeks!! I've also been the type of gal to always have my cycle every 28 days but, after the surgery, I went 42 days!! (yes, i was a bit scared and took 3 pregnancy tests!!). Again, don't worry....it's the darn general sedation that messes us up!!

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?

have you checked your vitamen d levels I know if my levels are low it takes a toll on my body and creates a mild depression for myself. also If you use natural sunlight or bulbs that produce natural sunlight it will help with depression. I have a lot of seasonal depression when fall and winter is here my levels of vitamen d falls and it creates a depression for me. I take extra vitamen D and use natural sunlight it really does help

I figured I'd add this in for anyone following the thread.

Since I posted, I've made dramatic improvements in mood. I no longer really suffer any blues or anxiety; it really seemed to be more of a post-surgery thing, or due to poor nutrition/sleep.

I am careful to take plenty of Omega 3's and Vitamin D -- my last blood test showed that all of my levels are good. More importantly, I take great pains to make sure I get enough exercise and sleep. What I've discovered is that if I eat right, drink enough Water, exercise enough, and sleep regularly, I don't get depressed or anxious. Period.

I got the Wellbutrin prescription, but never used it -- it's sitting in the cupboard. My experience is unique to me, of course -- for anyone else, talk to your doctor and make your own choices. But for me, I'm glad to be able to keep a level, positive mood the "old-fashioned way."

In short: eat well, exercise, and mind your sleep. If your depression STILL hangs around after that, and you're more than -- say -- six months out from surgery, talk to your doctor.

I am almost 2 weeks out of surgery and I can relate to you about the missing food. I never realized how often fast food and unhealthy food is thrown into our faces. While watching television, every other commercial is about food... billboards on the side of the road are about food.. it's everywhere! I was discussing this with my mom and like she said.. "That's what wrong with us!" Food IS everywhere. It's def. an addiction that we have to cope with ending...

Thank you so much for this I am 3 weeks post op and dealing with depression regarding this surgery I start a support group this week hopefully it will help Food as always been my friend, lover,my everything so I am dealing with this hard.

I haven't had my surgery yet but have thought about all these things. Thanks because while I am in my pre-op I am really praying about these topics, while also praying about who I can trust to really support me and not judge me for this life changing decision. If you have any suggestions on how to deal with these feelings that would be great but right now I am just really trusting God for comfort and solutions. I have even practiced going to eat out with my best friend and my husband eating only what is required of me and although I had to ask my husband not to order one particular dish, I did very well with socialization and eating only what I could on my pre-op. I praise God for that! I know there will be many more adventures such as vacations, holidays etc... But with change requires change, so I have to do it! I pray everyone else does the same.

Wow i was reading some of the posts on this thread and i came across mind from November 2009. . . i can't believe how much i have changed since then. . .i was there carrying on about how i don't miss food and so on blah blah blah. . . well that was written before i was sleeved. . . now at 1 + year later having been sleeved, i must say i battle with head hunger a lot. . . it's the most irratating thing ever. . . i still don't really miss food, but the head hunger is crazy. . . i am one of the unfortunate people who never got rid of the hunger pangs and have had them since day 1 . . tough but i'm losing and that is what matters. . . i find myself slipping into old habits ever now and then but i quickly correct them. . . good luck to all who are struggling. . i guess we will struggle for the rest of our lives skinny or not. . .

I've recently had experience in a Cognitive program and it is fabulous. They teach you how to 'alter' your core beliefs and how to change your thinking. The Cog Model is a circle - SITUATION>THOUGHTS>BEHAVIORS>SITUATION and around and around. If you can recognize automatic thoughts and work to change them - the negative emotion will change. They have all sorts of ways of working something out. It's very interesting and I'm glad that I now have that knowledge and I hope I will use it! I'm currently looking for a Cog therapist.

I so appreciate your posting this. I am having a very difficult post surgery adjustment time and although I am hesitant to speak about it as I do not want to discourage anybody, I most definitely need one on one therapy and a support group as well. Can anybody here give me some suggestions of what to look for in a therapist?

I had my surgery Nov 9th, I wonder the same thing will I ever have my sleep back. Some people have stated it takes almost 3 months to get your body back into routine, I really hope not. I've called my Dr several times and the only thing he states is ya this is normal for some people and just try over the counter sleeping aids. Well I've tried benedryl, nothing just worked the opposite and tylenol pm the same thing.

I've found a FANTABULOUS supplement for sleep and you can find it in some health food stores (I know Henry's carries it). It's called POWER TO SLEEP PM and it's made my Irwin Naturals. Henry's charges about $20 for it but I get it online at vitacost or luckyvitamin for $10-$15. I don't take it every night - only when I need it and it really does work and I wake up without any weird groggy feelings!

I've shared this with many people in the past year or so and *most* are so happy! My friend is on Ambien and started having terrible nightmares and found herself eating whole cakes in the middle of the night and all sorts of craziness. I gave her six of them to try for a few days (2 caps, 30 min before bedtime) and she was really amazed. She said that she felt so good the next day and was laughing and full of energy and her daughter thought she was drunk! lol

Just a little different take on things, maybe it's the increase in artificial (chemical) sweeteners. My personal experience is Splenda(sucralose) gave me a melancholy depression when I first started using it and it escalated from there, got pretty dark and scary with no apparent reason. It took a good friend and research to figure it out; it was easy to stop though I just stopped eating/drinking/ingesting anything with Splenda and voila I was cured. Please no haters; I've tried to share this with family members and even they can't have someone coming between them and their beloved fake sweetness but they've tried five different antidepressants and none of them work. I know it doesn't affect everyone like this, some of us are just more sensitive to it than others but this could help someone who needs to hear it because depression is terrible. It's an easy test: quit using it for a couple days if you start feeling better Great; if you're like me you'll start taking it again and start falling into that terrible funk again. Best wishes to everyone, hope y'all feel better soon.

Since appetite supressants cause significand depression in most people, I am wondering if the supression of ghrelin will also cause the same? I agree with the post about the many reasons we may feel depressed after wsl but has anyone heard of the role of ghrelin on this?

Thanks