Abibliophobe

Psych evalution

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I'm not close to getting  the psych evaluation but I'm a little worried about it.  I do have bipolar disorder as well as anxiety.  My issues have been regulated and in January 2016 I was put on a medication that made my depression go away pretty much entirely.  

 

The main thing I'm struggling with is anxiety.  

I worry these issues will weigh against me.  

 

I plan on working closely with a therapist while I go through this process. I'd like to go once a month and then after I get the surgery go more if necessary.  I'm at a place where I probably don't need therapy any longer but I want to go to deal with my food related issues. 

I'm working on finding a therapist.  I was seeing someone but he made some insensitive comments about my weight and I didn't feel comfortable talking to him about my desires for surgery.  

I want through this process once before and I'm pretty sure I passed so I think I'll be okay as long  as I'm honest.  

 

Just needed to vent.  I've been bugging my boyfriend about this for a while and I don't want to keep doing  that even though he's being extremely supportive.  

Edited by Abibliophobe

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Venting is fine. Sounds like you have a good plan in place and nothing going on that would be a hurdle. Your bariatric practice may be able to give you the names of a few therapists.

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One more point to consider is that the surgery almost certainly will have a major effect on your medications.  Some of your medications may not be as effective or may be totally inappropriate after your surgery (e.g., almost any medicine ending in XR).  Also, when you have a new gastric system after the surgery the dosages of all of your medicines will need to be checked (and adjusted) frequently, especially as you lose weight.  

At the pre-surgery psych evaluation the psych will want to make sure that you have a therapist and psychiatrist in place to support you, and that you understand that major weight loss can and almost certainly will result in unexpected pressures and stress.  The psych will also explore at the evaluation if you have an alcohol or other addiction problem, whether you understand that you will need to radically change your food habits in order to succeed in long term weight loss, and whether you have a good support system (family and friends) in place to help you get through the stressful times that will come after weight loss surgery (such as the all too common 3-weeks after surgery weight loss stall).

Finally, be sure that you are totally off of any alcohol a few weeks before you have your surgery.  Alcohol consumption after weight loss surgery is risky, as it is bad for our new gastric system, will result in rapid intoxication, and (sadly) is far more likely to result in an addiction to alcohol.

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59 minutes ago, Res Ipsa said:

One more point to consider is that the surgery almost certainly will have a major effect on your medications.  Some of your medications may not be as effective or may be totally inappropriate after your surgery (e.g., almost any medicine ending in XR).  Also, when you have a new gastric system after the surgery the dosages of all of your medicines will need to be checked (and adjusted) frequently, especially as you lose weight.  

At the pre-surgery psych evaluation the psych will want to make sure that you have a therapist and psychiatrist in place to support you, and that you understand that major weight loss can and almost certainly will result in unexpected pressures and stress.  The psych will also explore at the evaluation if you have an alcohol or other addiction problem, whether you understand that you will need to radically change your food habits in order to succeed in long term weight loss, and whether you have a good support system (family and friends) in place to help you get through the stressful times that will come after weight loss surgery (such as the all too common 3-weeks after surgery weight loss stall).

Finally, be sure that you are totally off of any alcohol a few weeks before you have your surgery.  Alcohol consumption after weight loss surgery is risky, as it is bad for our new gastric system, will result in rapid intoxication, and (sadly) is far more likely to result in an addiction to alcohol.

Thank you for the response. I don't have any drug or alcohol problems. I don't even drink all that often in general. I drank the fourth of june because I was having a graduation party but before that I hadn't had anything to drink in months.

I was aware that medications might change. I didn't know that some of them might not be effective but I was aware that I might have to change dosages. I go to my psychiatrist in July and I'll talk to him about my desire to get surgery. We talked about it the last time I went through this process and he seemed really supportive. I plan on getting in with a therapist soon. It can be a process to find one but I have a few female therapists on my list so I'll give them a call. I know my psychiatrist suggested one for me so I'll probably call her first.

I am fully aware of the stress. I mean, I might not know of everything but I remember my mom talking about how depressed she got after getting the surgery because she couldn't eat food like she wanted. I also think some of the new things I'll have to do in regards to eating could cause stress as well but I am fully ready to deal with that.

My impression is that the person who does the psych evaluation just wants to determine that you are equipped to deal with the many changes that will come my way.

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Hi Abibliophobe,

I'm bipolar as well and had RNY surgery on June 7. I'll visit my doctor on the 21st to see if any med adjustments need to happen for me yet. So far the only annoying thing is having to crush 2 of my meds every night for a while... they taste pretty bad. My gastric bypass psych evaluation was pretty straightforward compared with my years of therapy and medication trial-and-error. :)

Please feel free to PM me any time. I may or may not have any insight about what you're going through, but I do my best to be a good listener.

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