Is Depression After Surgery Real? How Post-Surgery Affects Mental Health
When you schedule surgery, you may be prepared for the physical challenges you’ll experience as you recover. However, you might not be aware of the mental health concerns that can arise after a procedure, such as depression after surgery.
Minor to intensive operations can lead to periods of inactivity, physical pain, and stress, which may cause or worsen symptoms like low mood, lack of motivation, and fatigue. If these feelings persist, you might be experiencing symptoms of postoperative depression. This mental health condition can significantly affect your emotional well-being and ability to move forward post-surgery, which is why being able to recognize the signs and then seek treatment can be essential. Here, we’ll discuss depression as one of the potential types of postoperative complications; an overview of this condition’s key symptoms and treatment methods will follow.
Postoperative depression or depression after surgery
Postoperative depression is when symptoms of depression arise in a person after they undergo a surgical procedure. This condition is not listed officially in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), but depression is an official DSM-5 diagnosis and can have many potential triggers, including surgery. Postoperative depression is a documented phenomenon that can impact people of any age or gender.
Symptoms of depression after surgery
Also called post-surgical depression, postoperative depression has similar signs and symptoms to major depressive disorder, including but not limited to the following:
- Changes in appetite and energy levels
- Low mood
- Fatigue
- A sense of hopelessness or despair
- Difficulty concentrating
- Loss of interest in previously enjoyed activities
Depending on the type of surgery performed and any pre-existing mental health challenges, certain people may be more prone to specific depressive symptoms after a procedure. If you believe you’re living with post-surgery depression, a healthcare professional can provide an evaluation and treatment as needed.
To learn more about this condition, you might consult Postoperative Complications: An Overview, a gathering of peer-reviewed studies and information about depression and other potential complications during the surgery recovery process.
What causes postoperative depression?
Scientists are still unsure of the exact causes of postoperative depression, but some potential risk factors include:
- Pain or chronic pain following surgery
- Unexpected postoperative complications
- Changes in cognitive function after the operation
- A high amount of stress before, during, or after the procedure
- Poor sleep and nutritional changes after surgery
- A prior history of depression or other mental health challenges
Some peer-reviewed studies suggest that general anesthesia may also contribute to or put a person at higher risk of postoperative depression. Anesthetics are potent medications, and while they’re essential for many major surgeries, they may cause temporary mood alterations and other depression symptoms after a procedure.
Treatment for postoperative depression
Depression and postoperative depression are typically treated with psychotherapy, sometimes in combination with medication. A therapist can provide you with emotional support as you navigate the challenges of postoperative depression. They can guide you in identifying other sources of depressive symptoms, any comorbid mental health concerns, and coping strategies that may work for you as you move through this stage. You do not need to have a mental illness or diagnosis to talk to a therapist, and over 41.7 million U.S. adults currently see such a provider, with the number rising every year.
How to cope with postoperative depression
Depression and postoperative complications related to mental health can present unique challenges that other forms of depression may not, potentially preventing you from utilizing certain coping strategies. Still, there are several techniques you may incorporate into your everyday life as you recuperate from an operation. Your physician can help you determine which of the following methods best works with your plan.
Prioritize rest
Rest can be a crucial aspect of recovery from surgery. It can also be vital to your ability to foster mental wellness. Sleep disruptions are common after an operation, and they can exacerbate depressive symptoms. Depending on your specific surgery and your doctor’s instructions, you may benefit from spending more time sleeping or resting at home. Whatever your situation, experts often recommend sticking to a regular sleep schedule of seven hours a night for adults.
In the first few days or weeks after your surgery, your routine might become disjointed as you adjust to changes. However, as you regain physical strength, re-establishing your usual schedule—including your bedtime, waking routine, and mealtimes—can be important. According to peer-reviewed studies, a regular sleep schedule in particular may help decrease depressive symptoms and rebuild the energy and strength you need to recover fully from an operation.
Practice mindfulness for mental health post-surgery to reduce stress
The association between mental and physical health is strong, and studies suggest that it may be a crucial part of your ability to recover from surgery. For example, findings from a 2017 study suggest that preoperative psychological health may influence physical healing in patients with surgical wounds. Mindfulness—a form of meditation focused on helping individuals foster a sense of presence—may be a helpful tool for mental health post-surgery.
Research suggests that mindfulness may decrease stress, lower blood pressure, and reduce pain—which may alleviate depression and contribute to the healing process following surgery. In a review of studies, researchers also indicate findings that suggest that mindfulness interventions can improve sleep, enhance physical function, and decrease depression symptoms in participants who have undergone a procedure.
You can utilize a brief mindfulness exercise while sitting or lying down, making it a convenient practice when recovering from surgery. Consider the following steps:
- Focus on noticing your physical and emotional sensations and feelings without judgment while breathing deeply. Are you happy? Bored? Restless? In pain?
- Take note of your surroundings, focusing on the sensations they produce for you.
- If you notice your thoughts drifting from the present, try to bring them back gently. If you notice pain, acknowledge it.
- Focus on your breath as you inhale and exhale slowly.
Connect with your support system
Support from friends and family members can be crucial after surgery. Your loved ones may be able to provide you with emotional support as well as more tangible forms of care, such as cooking meals for you or completing your household chores. In addition to having someone help you with daily tasks, you may find it beneficial to have friends visit you throughout the week, particularly if you feel lonely or down at certain times.
If you don’t have a particularly large social support system, you might consider joining an online support group for people experiencing depression or people who have recently had surgery or health challenges. You might find that talking to people over a video call can be as meaningful as having someone in person to talk to.
Note that a common symptom of depression is social withdrawal. However, trying to connect in some way nevertheless can be vital, even if you’re only texting or calling a friend. You might also try joining a group, calling a hotline, or talking to someone you haven’t contacted in a while. A mental health professional, like a therapist, can also be a significant resource for support.
Practice self-care
Some people who experience significant physical health challenges struggle to engage in basic care tasks, which can lead to worsening depressive symptoms and other complications. As you return to a more consistent routine, pay special attention to self-care, which can include any activity that nourishes your body and mind. Tending to personal hygiene, eating regular and nourishing meals, and engaging in activities you enjoy can help you show yourself compassion on the road to recovery.
Stay active
While rest can be crucial as you recover from surgery, experts often recommend participating in physical activity to some degree after your doctor has given you the go-ahead. In addition to helping with recovery from surgery, exercise may help alleviate depressive symptoms. Physical activity can release mood-boosting endorphins and provide you with a distraction from complicated feelings related to your procedure, depression, or other concerns.
Your physician can help you determine how much and what type of exercise may be safe and healthy for you given the type of surgery you underwent and your specific circumstances. Physical activity does not have to be high-impact to positively affect your mental health, and research suggests that even walking regularly may help improve or prevent anxiety and depression. Just be sure to seek medical advice from your doctor before engaging in any type of physical activity after surgery.
Navigating the symptoms of depression and other stress-related conditions with mental health support
While meeting with a therapist can benefit those living with depression, it can be challenging or even impossible to attend in-person appointments when you’re in bed recovering or are unable to operate like you used to. If you’re living with mental health concerns following an operation, you might consider connecting with a licensed therapist online.
Online therapy
With an online therapy platform like BetterHelp, you can work with a licensed mental health professional remotely. This format can be more convenient because its remote nature allows you to meet with a therapist from home. It’s also often more cost-effective than traditional therapy.
In addition, a growing body of research suggests that online therapy can often be as effective as in-person treatment options in addressing mental health challenges like depression. For instance, the findings of a 2020 study suggest that an online therapy program led to significant reductions in depressive symptoms and a higher quality of life based on a clinical trial of 460 participants. The study also notes that online therapy can be more affordable and convenient than in-person therapy and can be used to effectively treat other mental health challenges, like anxiety.
Takeaway
How do you stay mentally strong after surgery?
In the field of psychiatry, postoperative depression can present unique challenges that other forms of depression may not, potentially preventing you from utilizing specific coping strategies. Still, there are several techniques you may incorporate into your everyday life as you manage postoperative depression symptoms.
- Prioritize rest
- Maintain a regular sleep schedule
- Practice mindfulness
- Try deep breathing exercises
- Lean on your support system
- Stay active, if you can
Why do I feel bad after surgery?
Minor to intensive operations can lead to periods of inactivity, physical illness or pain, and stress, which may cause or worsen symptoms like low mood, lack of motivation, and fatigue. Studies have shown that pain may cause alterations in synaptic connectivity in the prefrontal cortex and hippocampus. Pain may also alter dopamine signaling from the ventral tegmental area, which can trigger symptoms of depression among patients. Depending on the type of surgery performed and any preexisting mental health challenges like anxiety and bipolar disorder, certain people may be prone to feeling down after a procedure.
Postoperative depression can be a significant public health concern, impacting the recovery and well-being of patients. If you believe you’re living with postoperative depression, a healthcare professional can provide you with screenings and determine whether further assessment for a depressive disorder may be beneficial. It may be that you are living with a form of situational depression, which experiences like surgery can produce. Either way, it’s often crucial to receive quality help before it can develop into other comorbid diseases or thoughts of self-harm and suicide.
Why do some people get depressed after surgery?
Experts are still unsure of the exact causes of postoperative depression, but some patient related risk factors may include:
- Chronic pain following surgery
- Changes in cognitive function after the operation
- A high amount of stress before, during, or after the procedure
- Poor sleep and nutritional changes after surgery
- A prior history of depression or other mental health challenges, like anxiety
Some research in the field of psychiatry suggests that general anesthesia may also be one of the risk factors associated with postoperative depression. Anesthetics are potent medications, and while they’re essential for many major surgeries, they may cause temporary mood alterations after a procedure.
How long does post-surgery fatigue last?
Postoperative fatigue is common among patients, especially following a major surgery like bariatric surgery or heart surgery. The duration of fatigue can vary significantly from person to person depending on several factors, but it is typically correlated to the degree of surgical trauma and chronic pain. Depending on various factors such as the type of surgery, the patient’s age and health, the type of anesthesia, acute postoperative pain, and postoperative complications, fatigue can last several days or weeks. For example, fatigue may last longer following cardiac surgery or an extended stay in intensive care units compared to bariatric surgery or an outpatient procedure. Despite the lower duration, studies still suggest psychological complications for individuals who underwent bariatric surgery, including depression and anxiety.
Why do I cry so much after surgery?
Though little research has been conducted on the topic, crying is commonly observed after surgery and anesthesia. There are many reasons people might have an emotional reaction after surgery, including the stress of surgery, postoperative pain, infections, medications such as anesthesia, or feeling disoriented after the treatment. If you continue to feel overwhelmed following surgery, it may be beneficial to reach out to a mental health professional or seek out support groups to manage your emotions. You can learn more about depression symptoms and treatment options on the American Psychiatric Association website. Getting yourself informed about depression, its risk factors, comorbid disorders and diseases, and other associated conditions may be crucial if you know someone dealing with thoughts of self-harm and suicide.
What is the mental fog after surgery?
The mental fog some people experience after surgery is a form of cognitive impairment. Patients over the age of 65 are at increased risk of mental fog, even following a successful surgery, and the impairment can last for varied periods of time. Patients may experience issues with memory, attention, judgment, and perception. In that case, patients may consult their surgeon or doctor about the symptoms they experience after surgery.
Why am I so tired two weeks after surgery?
The first week or two after patients undergo surgery is referred to as the immediate postoperative period. At this point, the body is working to heal and recover, which requires significant energy and may cause patients to feel unusually tired. It's not uncommon for patients to feel tired during this time. However, if fatigue persists for several months after you’ve undergone surgery or is accompanied by other symptoms such as changes in appetite, low mood, a sense of hopelessness, difficulty concentrating, or lack of interest in previously enjoyed activities, you may be experiencing major depression. Patients may seek professional help to address these symptoms, especially if they already experience other comorbid diseases, pain, and even thoughts of suicide.
Can post-surgery delirium be permanent?
Though post-surgery delirium can occur, it is not a frequent complication following a procedure. Most people who experience post-surgery delirium recover within one to six months, but a small number of people, such as older patients, may be at higher risk of experiencing lasting problems with thinking and memory. Patients may plan and prepare before surgery to know what to expect, prevent negative thinking, and increase their resilience from the risk of post-surgery delirium. You may inform your surgeon if you have preexisting diseases and mental health conditions like anxiety, as well as whether you take medications.
Can depression happen after a surgery?
Yes, patients may experience depression after their surgery; this is called post-surgical depression or post-operative depression. In the field of psychiatry, some risk factors that may contribute to post-surgical depression include physical changes, medications, acute postoperative pain, reactions to anesthesia, infections, hormonal fluctuations, and other social and psychological factors. Other factors also include preexisting mental health conditions like anxiety and bipolar disorder, as well as physical diseases, including brain stroke, heart failure, failed back syndrome, and diabetes.
Some procedures may carry a lower risk compared to others, and other techniques and strategies can also help mitigate the risk. According to the American Heart Association, studies indicate an increased potential for post-surgical depression to develop after cardiac surgery among a portion of patients. Studies also suggest an increased risk of depression in patients who have undergone bariatric surgery, and in those who have diseases like diabetes, acute coronary syndrome, and brain stroke.
Surgeries such as coronary artery bypass grafting may also increase the risk of postoperative delirium, cardiac events, and hospital admissions. A 2007 study that explored patients discharged from the hospital also suggested that depressive symptoms were associated with infections, poor progress in recovery, impaired wound healing, and impaired quality of life.
Is depression a side effect of anesthesia?
Post-surgical depression can occur as a temporary side effect of anesthesia, but it’s not patients’ normal experience. If symptoms persist, patients with post-surgical depression may seek professional help to receive a targeted intervention and quality treatment for depression, which may include antidepressants and psychotherapy. Some patients may not respond quickly to medications, especially after a long history of failed treatments, and this may affect their quality of life.
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