Question:
Anyone with Bipolar Disorder been approved by a Psych Eval?
Ok, I was diagnosed with BPD in 2001 a few months after my RNY procedure. I'm now seeking a revision due to the weight gain, most commonly from the meds taken for the disorder. This is a very important question for me because I'm so afraid of gaining a lot of weight, my pharmaceutical (meds) choices are limited. Do I automatically fail the P*doc eval? WHat about insurance? they paid for it once, will they pay for it again with this condition. (WHich by the way is intensely managed. PLEASE ANSWER. P.S. Bipolar Disorder doesn't allow you to eat, it's the meds that keep you starved! — corpdiva2005 (posted on February 26, 2009)
February 25, 2009
I have BPD and I was able to have Lap/RNY. They changed my medications so
that I could successfully lose the weight and keep it off.
— angelalynn1968
February 25, 2009
Hi there, Adrienne,
I was diagnosed with Bi-Polar Type 2 about 6 years ago, although I'm STILL
not convinced that's true. I honestly believe that I suffer from bouts of
clinical depression that are situational in nature. However, the P-doc has
had me on all kinds of different meds to see which one works and is the
least expensive and has the least number of side effects (many of which are
directly contributory to weight gain)... Zyprexa was very good, but is
indicated in Type 2 diabetes, Geo-Don zombied me out, Lithium made my hands
shake, now am on Depakote ER (1000 mg at night - they recommend 1500, but I
do well on the lower dose). However, they are "horse pills" and
no way can I take them after surgery. So, my P-Doc prescribed Depakene,
which is a liquid version of Depakote. I am transitioning now, because my
surgery is Monday morning. I seem to be doing fine. I have not had a
major depressive episode for over 5 years, and I am not aware of any
"manic" behavior ever. I began researching this surgery about a
year ago, and taking steps to begin the insurance approval process last
September. One of the things I had to do was work with my surgeon's
registered dietician on a weight loss program, and she gave me a general
guide that involved eating 75% protein and 25% carbs at 6 small meals per
day... with the first meal within an hour of rising, and the last meal
within an hour of bed. And no caffinated drinks, and LOTS and LOTS of
water/liquids. She told me no white carbs (rice, potatoes, popcorn, pasta,
etc), and to keep my fat intake at less than 8 grams per meal. Well, I
started that eating plan in October and have lost nearly 30 pounds, despite
the Bi-Polar medication, so I know it can be done. And also, my surgeon
has a list of therapists he works with to get the psych evals done... and
they are all very sympathetic to morbidly obese people who need bariatric
surgery. They just want to make sure that you know that the surgery itself
is not a "magic bullet" that will cure you of being fat.... that
you understand that YOU must make a life-change to lose the weight and keep
it off. Because if you don't go into this with your eyes wide open and
understanding that... depression is almost inevitable.
And, I must ask.... I don't understand your "PS"... your meds
keep you starved??? BiPolar doesn't allow you to eat?? I must be missing
something... can you elaborate?
— Erica Alikchihoo
February 26, 2009
I take BP meds. My psych approved my eval. Also made sure all my meds
were either crushable or in liquid form. I take Lexapro which works best
for me. It comes in liquid form. I also take klonopin which comes in
sublingual form. I wasn't able to continue taking geodon because it was in
a capsule form and it bothered my stomach. I also use to be on adderall
which I can't take anymore either due to stomach issues. Best Wishes
— Corina C
February 26, 2009
Yes! I have bi-polar disorder and just had my lap RNY on January 22nd.
My only suggestion is to be totally honest during the psych eval. We all
worry about whether or not we will "pass", but if you are not
honest, you will not get an honest reaction from the evaluator.
Best of luck to you!
— anitak
February 27, 2009
i haven't had a revision but i had the rny and was approved with my psych.
eval. i've been bipolar many years though. i am 37years old now i had the
gastric bypass almost 2 years ago and still losing very slow. talk to your
insurance co. first and see if they cover the revision. as long as you are
seeing your psychiatrist for meds. and therapist regularly it souldn't be
an issue but be warned, as you may know, being bipolar makes everything
harder.
— velvet M.
February 27, 2009
I am one of the few diagnosed with BPD II in 2001 that does not take any
meds for it. When I had my psych eval, I did disclose this, and I passed
without any problems - they just wanted to make sure I was under a lisenced
mental health providor's care in case after the surgery I needed to go back
on the meds. I used to take Depakote, but with counselling and modifying
my lifestyle, I was able to SLOWLY ween myself off with my doc's help.
I am waiting on an approval from my insurance, and I am hoping that I do ok
without my Depakote. It's more impotant to be honest, even if it delays
your surgery a little bit. They (Bariatric centers) want to make sure that
if you are having issues that you have adequate support to help you, and
you shoudl also want that for yourself.
I also do not understand the last sentene of your post, "P.S. Bipolar
Disorder doesn't allow you to eat...."
Good luck to you!
— stellarsan
February 27, 2009
Sure Erica, thanks for the great advice. I'm BPD, rapid cycler, very much
different than you in that you've never had a manic episode (that you truly
know of), when manic, you're extremely hyper and food is the LAST thing you
think of, but the meds, especially Zyprexa and Seraquel and depending on
the person, Lithium, tend to not only zombie you out but there main side
effect is weight gain. Now for us, we can't eat a lot at one setting, but
we can certainly graze more than the typical 6 small meals a day. The
research I've done is that many of he BPD 'cocktails' slow down your
metabolism as well. Many people present differently when depressed, some
sleep all day (like me) some eat all day. I can tell you that while I was
on Topamax, it acted as an appetite suppressant and for a while I was
starting to look like crack addict, (The FDA has now approved it for weight
lost, migraine headaches and alcohol addiction supression).
Hopefully, my long paragraph gave some clarity on my P.S. statement, as you
know not all BPD suffers are the same. Thanks again for your great input,
Erica.
— corpdiva2005
February 27, 2009
Thank you everyone for being sensitive to my question, even behind a
keyboard it was a hard question to ask because there are so many
ill-meaning people who don't understand the disorder. I was diagnosed 4
months post-op in 2001 before a psych evaluation was required. I'm still
so greatful that I had it done, otherwise due to familial history I was
destined for diabetes, morbid obesity, heart disease and osteoartritis, but
you are so limited on what meds you can take without gaining weight (Its a
good thing here are a lot to choose from.) Just as people who are on
lifelong doses of Prednisone (a steroid) battle with the same issue, weight
gain.
— corpdiva2005
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