Post-Surgery Depression: Symptoms, Causes, Coping Techniques

The recovery process from a surgery can take time and also involves varying levels of discomfort. While most people feel encouraged to take better care of themselves to speed up the recovery process, but in cases of a long recovery time, many people find themselves becoming depressed. In fact, depression after surgery is actually more common than what we may think. Depression is a possible complication that can happen after any kind of surgical procedure. It is a serious condition and should not be ignored. If you find yourself feeling depressed after having surgery, you should bring it to the notice of your doctor sooner than later as you may need treatment that can help you cope better with the circumstances. Here’s everything you need to know about post-surgery depression.

Overview

Any type of surgery, be it big or small, can take its toll on a person. While many people work towards recovering quickly from the surgery, others find themselves slipping into depression after surgery. The discomfort, possible pain, ongoing health problems, and the change in routine during the recovery phase are all possible factors that can contribute to depression. Research has found that mental health issues can adversely impact a person’s recovery after a surgery.(1,2,3) Depression after a surgery is also known to heighten the perception or experience of any type of postoperative pain.(4,5)

Understanding the underlying cause of depression after surgery and what you can do to make it easier to manage will help you recover faster. Depression is a common complication that can happen after any type of surgical procedure. However, it is a serious condition that should never be ignored. It needs to be addressed and brought to your doctor’s attention so that the correct treatment can be started.(6)

Symptoms of Post-Surgery Depression

While it is common for everyone to feel low once in a while, especially when you are recovering from surgery, but if your low mood continues to persist, it could be a sign that you have depression. Depression not only includes persistent low mood but several other symptoms as well. Common symptoms of post-surgery depression include:(7)

  • Persistent fatigue
  • Problems with memory and concentration
  • Difficulty making decisions
  • Sleeping more or less than you usually do
  • Eating more or less than you usually do
  • Loss of interest in activities
  • Slowed speech and movements
  • Irritability
  • Restlessness
  • Feelings of guilt, stress, anxiety, or a combination of these
  • Feelings of hopelessness or despair without being able to identify the exact cause
  • Thought of harming oneself or others
  • Thoughts of suicide
  • Depression also increases the chances of physical illness and delayed recovery from your surgery or injury.

Causes of Post-Surgery Depression

People who experience post-surgery depression never expect it to happen. Besides, doctors also do not always warn people about experiencing any form of depression beforehand. Here are some of the potential causes of post-surgery depression:

  • Already having depression before the surgery.
  • Chronic pain
  • The thought of facing one’s own mortality
  • Adverse reaction to anesthesia
  • Adverse reaction to pain medications
  • The physical and emotional stress of surgery
  • Feelings of guilt about depending on others for help
  • Anxiety about potential complications
  • Stress about the speed of recovery
  • Concerns that the surgery might not be enough to fix the health problem
  • Stress due to recovery, financial costs, the return home, etc.

At the same time, there are some surgeries that have a higher risk of post-operative depression, though it can happen after any type of surgery.

A 2016 research found that there is a connection between post-surgery depression and people who experience chronic pain during recovery.(8) It has been seen that post-surgery depression is also a predictor of the pain that will follow during the recovery phase.

Having depression before surgery is one of the biggest predictors of who can experience post-surgery depression. When a person is already depressed and anticipating surgery, the stress and anxiety are bound to worsen the symptoms of depression.

How To Cope With Post-Surgery Depression?

It is essential that you manage post-surgery depression in time to prevent further complications. Here are some tips to help you cope with post-surgery depression:

  1. Inform your doctor: If you feel you may have post-surgery depression, you should make an appointment to consult your doctor at the earliest. If your doctor finds it necessary, they may prescribe certain medications that will not interfere with your post-surgery care. They may also refer you to a qualified mental health professional. Even if you are thinking about taking some natural supplements for depression, you should still enquire from your doctor about whether they are safe to take and if they could interfere with your current medications.(9)
  2. Stay focused on the positive: Setting realistic and positive goals during your recovery period and celebrating your progress, no matter how small it is. Setting goals can also help you maintain a positive outlook as you heal. Focusing on the long-term recovery instead of feeling frustrated about not being to do things you want to or feeling disappointed about healing slower than expected will help you keep depression at bay.
  3. Try to go outside: Going outside will not only mean a change of scenery for you but taking in some fresh air can also help you manage many of the symptoms of depression. If your surgery or underlying health condition impacts your mobility, you can ask a friend or family member, or even a social care worker to help you go outside for some time. However, it is important to check that there is no potential risk of infection at whatever location you are planning to go out to.
  4. Regular exercise: The importance of exercise cannot be stressed enough, especially after surgery. However, you can only resume exercising once your doctor gives you the go-ahead. If you have had surgery for a replacement hip or knee, an exercise routine will be part of your recovery plan. Your physical therapist will help you with certain exercises that have been specifically designed to help with your recovery. For other types of surgery, you will need to get approval from your doctor. Your doctor will help you come up with an exercise plan that is best suited for your recovery period, depending on what surgery you have had.(10,11,12)
  5. Consume a healthy and well-balanced diet: Eating a healthy and well-balanced diet is very important to your recovery. A healthy diet will help you feel better and also manage your weight post-surgery. There are many essential nutrients that your body needs to heal, and eating healthy and nutritious will ensure that you are providing your body with these nutrients.(13,14) You should have plenty of:
  • Fresh vegetables and fruits
  • Whole grains
  • Healthy oils and fats
  • At the same time, you should avoid or limit the intake of:
  • Alcoholic beverages
  • Processed foods
  • Food with added sugar
  • Foods with added fats

You should also increase your intake of water. Make sure to enquire about any particular diet you need to follow after your surgery before you leave the hospital.

Conclusion

Depression is a common side effect of surgery, and it can often affect people when they least expect it. For anyone who is about to undergo a surgical procedure, it can be helpful for their friends and family to be aware that there is a possibility that depression can set in during the post-surgery recovery phase. Recognizing the signs of depression if they occur can help them seek medical help so that the affected person can get early treatment for depression. It is usually observed that as a person’s physical condition begins to improve, the depression may also lessen. However, if it does not, it is better to consult a doctor about it.

References:

  1. Orri, M., Boleslawski, E., Regimbeau, J.M., Barry, C., Hassler, C., Gregoire, E., Bachellier, P., Scatton, O., Mabrut, J.Y., Adham, M. and Vibert, E., 2015. Influence of depression on recovery after major noncardiac surgery. Annals of surgery, 262(5), pp.882-890.
  2. Carr, E.C., Thomas, V.N. and Wilson-Barnet, J., 2005. Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective. International journal of nursing studies, 42(5), pp.521-530.
  3. Connerney, I., Shapiro, P.A., McLaughlin, J.S., Bagiella, E. and Sloan, R.P., 2001. Relation between depression after coronary artery bypass surgery and 12-month outcome: a prospective study. The Lancet, 358(9295), pp.1766-1771.
  4. Ghoneim, M.M. and O’Hara, M.W., 2016. Depression and postoperative complications: an overview. BMC surgery, 16(1), p.5.
  5. He, J., Xiong, W., Li, F., Luo, W. and Gao, S.C., 2017. Depression influences pain and function after cervical disc arthroplasty. Journal of neurosurgical sciences, 61(1), p.39. Fusar-Poli, P., Lazzaretti, M., Ceruti, M., Hobson, R., Petrouska, K., Cortesi, M., Pozzi, E. and Politi, P., 2007. Depression after lung transplantation: causes and treatment. Lung, 185(2), pp.55-65.
  6. Comstock, G.W. and Helsing, K.J., 1977. Symptoms of depression in two communities. Psychological medicine, 6(4), pp.551-563.
  7. Ghoneim, M.M. and O’Hara, M.W., 2016. Depression and postoperative complications: an overview. BMC surgery, 16(1), p.5.
  8. Cauffield, J.S. and Forbes, H.J., 1999. Dietary supplements used in the treatment of depression, anxiety, and sleep disorders. Lippincott’s primary care practice, 3(3), pp.290-304.
  9. Kaminsky, L.A., Arena, R. and Myers, J., 2015, November. Reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: data from the Fitness Registry and the Importance of Exercise National Database. In Mayo Clinic Proceedings (Vol. 90, No. 11, pp. 1515-1523). Elsevier.
  10. Bandholm, T. and Kehlet, H., 2012. Physiotherapy exercise after fast-track total hip and knee arthroplasty: time for reconsideration?. Archives of physical medicine and rehabilitation, 93(7), pp.1292-1294.
  11. Gignac, M.A., Cao, X., Ramanathan, S., White, L.M., Hurtig, M., Kunz, M. and Marks, P.H., 2015. Perceived personal importance of exercise and fears of re-injury: a longitudinal study of psychological factors related to activity after anterior cruciate ligament reconstruction. BMC sports science, medicine and rehabilitation, 7(1), p.4.
  12. Lau, C., Phillips, E., Bresee, C. and Fleshner, P., 2014. Early use of low residue diet is superior to clear liquid diet after elective colorectal surgery: a randomized controlled trial. Annals of surgery, 260(4), pp.641-649.
  13. Nygren, J., Thacker, J., Carli, F., Fearon, K.C.H., Norderval, S., Lobo, D.N., Ljungqvist, O., Soop, M. and Ramirez, J., 2012. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clinical nutrition, 31(6), pp.801-816.

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