Many people experience depression after surgery. Ongoing health problems, discomfort, and a change in routine can all contribute.
Understanding the cause of depression after surgery and what to do about it can make it easier to manage. Here, we look at the link between surgery and depression. We investigate why it happens and give some tips about how to cope.
Depression involves an ongoing low mood and other symptoms, which may include:
- difficulty making decisions
- problems with memory
- eating more or less than usual
- sleeping more or less than usual
- a loss of interest in activities
- irritability and restlessness
- slow movements and speech
- feelings of anxiety, guilt, stress, or a combination
- feelings of despair or hopelessness with no specific cause
- thoughts of suicide or of harming oneself or others
Depression can also increase the risk of physical illness and delay recovery from an injury or operation.
There are many reasons why depression is common before and after surgery.
Depression before surgery
When a person is anticipating surgery, various factors can make depression symptoms worse. For example, a person may feel more anxiety and stress because they are concerned about the procedure and issues such as finances and childcare.
Having depression may make surgery less likely to be effective, according to the authors of a 2016 review. For example, they note that people with depression may seek medical treatment at a later stage of illness.
The authors of the review noted that postoperative depression was common and proposed screening for depression after surgery to ensure that people receive appropriate support.
Levels of mental, physical, and emotional stress can be high before and after surgery.
Common causes of stress include:
- anything that results in pain, including illness and surgery
- a diagnosis of a serious illness
- trying to balance work, social, and personal life during the treatment period
A doctor may offer advice about reducing and coping with stress.
Depression after surgery
After an operation, factors that can increase the risk of depression include:
- reactions to anesthesia
- the effect of antibiotics
- pain and discomfort while recovering
- reactions to certain pain relievers
- physical, mental, and emotional stress resulting from the illness, the surgery, or both
- concerns about the impact on the quality of life or lifespan
Both surgery and depression affect individuals differently. Talking to a doctor can help a person prepare for and manage the situation.
The following tips may help reduce the impact of depression after surgery.
Understanding what to expect
Being aware of what to expect before, during, and after surgery can help reduce symptoms of depression. For this reason, it is important to raise any questions or uncertainties with the doctor.
A person may feel more in control of their health and the overall situation if they:
- know how long recovery is likely to take
- understand what medications do, how to use them, and how to spot any side effects
- have a clear plan for follow-up appointments
- keep a list of emergency numbers handy
- monitor any symptoms or changes
Noting down any fluctuations in pain and mood can make it easier to explain concerns to a doctor. The doctor may suggest ways to adjust the treatment plan.
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Getting up each day
It can be tempting to stay in bed after an operation, but getting up helps:
- a person feel more independent and in control
- establish a routine and give purpose to the day
- differentiate between day and night, which encourages better sleep
- with bathing and changing clothes, which can make a person feel more comfortable
- vary tasks and activities
Reaching out to friends and family
When possible, talking to friends and family can help. Having company can provide distraction and lift a person's mood. It can also remind a person that they are not alone.
Also, friends and family can sometimes help with chores, childcare, and other practical needs.
A healthful diet with regular meals can help a person:
- feel better physically and mentally
- manage their weight
- get the nutrients that they need to heal
Also, eating with others can be a chance to interact with family and friends.
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Depending on the surgery, light exercise may help prevent depression.
- help strengthen the body
- improve energy levels and mood
- encourage a person to get out and about and breathe fresh air
- increase self-esteem by setting achievable targets each day
Even a short daily walk can boost a person's overall quality of life.
After some procedures, such as a knee or hip replacement, the doctor will recommend an exercise plan to help become mobile as soon as possible.
It is important to follow this plan, even when it feels difficult, as it can improve the long term outlook.
Having a regular sleep routine
Establishing a regular sleep pattern can reduce fatigue. It can also help a person recover and support physical and mental well-being.
Tips for better sleep include:
- going to bed and waking up at the same times every day
- avoiding daytime naps, if possible
- keeping the bedroom dark and at a comfortable temperature
- leaving mobile phones and other devices outside the room at night
Many people experience anger, sadness, and frustration after surgery. Finding a suitable way to express these feelings can help.
This may involve talking to a friend or loved one or asking a doctor to recommend a therapist or counselor.
Unhealthful choices can aggravate symptoms of illness and have other negative effects.
It is important to:
- quit, reduce, or avoid smoking
- limit or avoid alcohol consumption
- follow a doctor's instructions precisely
Setting improvement goals
Being aware of how their recovery is progressing can help people manage their depression.
Setting realistic improvement goals, however small, can keep a person motivated. It can also help them focus on how far they have come, rather than how far they still have to go.
Focusing on rest and patience
Letting go of the daily routine during recovery can be frustrating.
However, if possible, try to:
- be patient
- keep in mind that the recovery process will come to an end
- avoid returning to tasks and responsibilities until the recovery is complete
Serious surgery of any kind can trigger postoperative depression.
Factors that can increase the risk include:
- chronic pain or illness
- other ongoing treatments that cause discomfort, such as chemotherapy
- a long recovery time
- a major change, such as reduced mobility
Some surgeries are more likely to lead to depression. Examples of procedures that can have a major impact on a person's mental health include:
- heart surgery, such as for coronary artery disease
- bariatric surgery, such as a gastric bypass
- spinal surgery
- surgeries for cancer
- amputation after a trauma
Additional factors can also contribute to changes in thinking and mental health after surgery. For example:
Diabetes: People with diabetes have a higher risk of depression, and surgery can increase this risk.
Intensive care: People who spend time in intensive care units may also have a higher risk of postoperative depression, which can persist for several months.
Early Alzheimer's disease: People with early Alzheimer's but no previous symptoms may experience changes in thinking after surgery.
Aging: Postoperative cognitive decline is relatively common among people aged over 60. This can affect memory, attention span, and the ability to focus.
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During follow-up visits, a doctor may ask about symptoms of depression.
Their questions may concern:
- eating or sleeping habits
- emotional changes
- energy levels
- thought patterns
If signs of depression appear, the doctor can provide help, including referrals, if necessary.
Recovering from surgery can take time, but most people return to a full life, even if this requires making some changes. If a person experiences depression, this can lengthen the recovery time.
Anyone who experiences depression after surgery should notify their doctor, who can provide help.