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Depression risk after Sleeve Surgery?



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Hi my name is Dan.

Apologies if I'm breaking any etiquette here but my wife is considering Gastric Sleeve surgery and I have some concerns / questions on her behalf.

My wife has struggled with depression and her weight for 10 years + and there have been a number of tradegys in her family including the death of her mother last year from cancer who she was extremely close to.

She is currently on the maximum dose of Sertraline (200mg) plus thyroxine and 50mg Amitriptyline for sinus pain. Recently her depression worsened again but the thought of having the surgery done finally is giving her a boost.

One of her close friends who suffers from depression and self harming, had a sleeve procedure in March and so far and it's been a huge success. She is like a different person mentally and physically. We also know of another lady who had a sleeve and it's also been a great success.

So we're both very keen to go ahead with the surgery but I have heard there is a risk of depression worsening in the short to mid term and there can be issues with malabsorption of medications and estrogen release when losing weight quickly.

I'd be very interested to hear of your experiences, particularly if you suffered from depression before the sleeve surgery and were taking antidepressant/s (especially Sertraline) and / or thyroid medication before and afterwards.

We'll also be trying to book an appointment with a psychiatrist before she makes a final decision.

Many thanks in advance for your help. I'll also share your responses with my wife.

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malabsorption can happen with bypass, but I don't think it's an issue with sleeve.

and yes - the estrogen release is pretty common and can affect people's moods and menstrual cycles for a few weeks or months following surgery (it eventually stabilizes)

there are a lot of people who've had surgery who've had depression issues prior to surgery. Her depression may or may not get worse, but if it does, her doctor can always adjust her dosage or try a different med

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I have bipolar disorder (the depressive type) and I am on an antidepressant and a mood stabilizer. I am 4.5 months post op and I have noticed a few days of mild depression and several days of decreased energy immediately post op but those have stabilized now and I feel about the same.

I am not familiar with sertraline but as long as it is not extended release it will most likely work the same after the sleeve. If it doesn’t though, there are hundreds of other medications her doctor can try (probably a handful that work the same way sertraline works). I had to change my mood stabilizer because there was a minimum calorie requirement with my old one and I went ahead and asked my doctor to change it a few months before surgery (while I was on the supervised diet) just so I would know that I started off on a medication that worked post surgery (one less thing to worry about).

It sounds like she has a great support system in you at home. As long as she is honest with you about how she is feeling and stays in close contact with a doctor who is willing to adjust medications if needed she should be fine.

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Hi Dan, I think it’s great you are asking these questions. She is luckily to have someone like you watching out for her well-being and helping her along with this process. I suffer from anxiety, major depression and lupus and take meds daily. I can tell you that I did have a about 4-5 days after surgery where I did fall into a depressive state. I truly believe it was my hormones. Most of what I was suffering in my depressive state were questions like “why did I do this?” and the “what-if’s this it or that go wrong” and “will I ever be able to eat or drink normally?” type questions. From my research, it seems a lot of sleeve patients experience some depression after surgery, but for most of us it resolves quickly. Helping her through this period is so important. My husband was helpful and constantly told me how proud of me he was and how strong I was to have gone through this. That helped me get through those bad days. Hope this helps you and your wife! :)

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Fat causes inflammation, which is linked to depression. While not 100%, I feel SO much better mentally now compared to before surgery, in so many ways.

However, when I couldn't get enough Water in, had to think carefully about what I was eating, was so tired all the time in the first 3 months after surgery, I didn't feel great.

For me, those weeks of feeling low were totally worth it.

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Hi Dan. You're a great husband being so supportive of your wife. She's definitely blessed to have you.

I am currently 11 days post-op from my gastric sleeve. I have been living with bipolar II for many years, and I have continued to take my meds as scheduled. I talked with my psychiatrist prior to surgery to ask her if any changes would need to be made, and she gave me tips on my different medications. One she switched to a dissolves-in-the-mouth form, which helps a lot since it is a difficult pill to get down after surgery. As someone stated above, the malabsorption issues tend to happen with bypass more than sleeve. One of the reasons I leaned toward the sleeve instead of bypass is for that very reason. I've been stable on my meds for some time now, and I didn't want to risk throwing myself off. Something to remember too, is that as weight loss occurs, sometimes doses need to change (often go lower) to work with our new weight. So, as long as your wife and yourself keep that in mind too, it will help to know if maybe something needs adjusting in time.

As for the immediate depression that people sometimes feel, I had that. The first week following my surgery I sat there feeling low and asking myself, "Why did I do this to myself?" I was in pain and had very little energy, so I just felt like I had made a huge mistake. However, prior to surgery, I had read that type of depression can occur. Therefore, I just tried my best to keep telling myself it is only temporary. Sure enough, now as the pain has significantly subsided and my energy is going back up, I feel much better. I would say, being prepared for those ups and downs are one of the biggest aides in our recovery. It helped me to know it was something common that many people experience, and also that it was only temporary.

Well wishes to your wife on her new journey!

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Thanks so much for your responses and kind words. It is really helpful to hear your first hand experiences!

It's reassuring to hear malabsorption issues are not so common with the sleeve and that whilst post operation depression is common it usually passes fairly quickly.

We also spoke in depth tonight with our friend who had the sleeve operation in March, and this has helped a lot too.

My wife has a consultation with a surgeon from Healthier Weight tomorrow. I think we are very close to deciding the Sleeve is the right thing to do but we'll also see a psychiatrist and make sure my wife and I are prepared as best we can be for this major change.

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Posted (edited)

On 7/18/2021 at 3:20 AM, 3bee said:

Hi my name is Dan.

Apologies if I'm breaking any etiquette here but my wife is considering Gastric Sleeve surgery and I have some concerns / questions on her behalf.

My wife has struggled with depression and her weight for 10 years + and there have been a number of tradegys in her family including the death of her mother last year from cancer who she was extremely close to.

She is currently on the maximum dose of Sertraline (200mg) plus thyroxine and 50mg Amitriptyline for sinus pain. Recently her depression worsened again but the thought of having the surgery done finally is giving her a boost.

One of her close friends who suffers from depression and self harming, had a sleeve procedure in March and so far and it's been a huge success. She is like a different person mentally and physically. We also know of another lady who had a sleeve and it's also been a great success.

So we're both very keen to go ahead with the surgery but I have heard there is a risk of depression worsening in the short to mid term and there can be issues with malabsorption of medications and estrogen release when losing weight quickly.

I'd be very interested to hear of your experiences, particularly if you suffered from depression before the sleeve surgery and were taking antidepressant/s (especially Sertraline) and / or thyroid medication before and afterwards.

We'll also be trying to book an appointment with a psychiatrist before she makes a final decision.

Many thanks in advance for your help. I'll also share your responses with my wife.

Have you discussed this with her Drs or even the pharmacist? It's a very important conversation to have but I think you need professional advice. UPDATE: I saw on the last line she is going to see a Dr. but I'm leaving my response for others.

Edited by LisaMarrie

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