Gastric Bypass Surgery & Mania
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Q:  Gastric Bypass Surgery & Mania

My wife was significantly overweight and had gastric bypass surgery.  Before surgery and the ensuing 100# weight loss, she was treated for depression.  After surgery her behavior became manic /hypomanic.  She is now diagnosed bipolar and generally manic.

I'm curious if her "short gut" makes her more susceptible to deficiencies in fatty acids, or other nutritional deficiencies that are bipolar related. 

Do you know of any studies specific to bipolar patients post gastric bypass?

Our marriage is day to day right now and I'm really desperate.


Dear Mr. M' -- 
This would be an interesting question if it weren't for the "day to day" desperation; sorry to hear you both are at that point. (A very nice book on holding marriages together and more importantly, making them stronger, is The
Seven Principles of Making Your Marriage Work, which you could read while you're waiting to see if your wife's treatment might get her symptoms addressed. Of course that presumes that the problem in the marriage is her symptoms. If that was only part of the issue(s), this book would be even more appropriate to have a look at right now. 

As for the stomach change, make sure she's had a B12 level checked, as that's a standard stomach-mental health connection we wouldn't want to miss. Not likely the basis of this. Since gastric bypass is usually just stapling the stomach to make it smaller, I wouldn't have thought (nor have I seen reports of) it would have any impact at all on absorption of anything essential -- unless she had some sort of "dumping syndrome", where things are going through her GI tract too fast. But I've not researched this area. But there are other gastric bypass techniques (e.g. vertical Roux-en-Y) that might have more significant impact on absorption of nutrients. I'm sure there's a huge literature on that, but I've never seen anything from it in the Psych' literature (could have missed it, though). 

Just to make sure, I searched gastric bypass mania in PUB MED (the link shows you how to do this yourself), and surprisingly, found two reports of using vaproate (Depakote) for mania after bypass surgery. These might be just reports on how to deal with mania when one cannot use pills, right after surgery; I'd suspect that was the case. But I was surprised to find two such reports. They're not online so we can't easily read the reports themselves. Searching gastric bypass mood did not turn up anything more useful. 

Sorry, I guess my answer is "hmm, interesting question; not sure, can't say "no connection"; and didn't find anything but a puzzle with a quick literature search. I wonder if you could ask a the doc's office where that surgery was done for a nutritional specialist, perhaps connected with their program, and ask this question again there.  Sorry not to be of more use here. 

Dr. Phelps

Published June, 2006


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