Understanding the Often-Ignored Case of Post-Surgery Depression
Depression isn’t unusual or surprising after surgery or after a diagnosis that leads to an operation. Learning that your health isn’t perfect and surgery is needed to rectify it, the financial burden that a health problem entails, and feeling physically unwell can be triggers to an episode of depression (or can worsen an already existing one). Feeling unwell physically and feeling bad emotionally often go hand-in-hand.
Amy Vigliotti, PhD, former supervising psychologist at Jacobi Medical Center in New York City and the founder of SelfWorks: Therapy Professionals explained that a lot of energy goes into preparing the patient for their practical needs (such as what to wear, what to eat, the cost of the procedure, and how to treat the pain), but the emotional needs aren’t getting enough attention. She said that surgeons and doctors also need to focus on educating and warning their patients about post-surgical depression so that they know what to expect. She adds, “It doesn’t matter how small or large that operation is. It could be removing a mole or removing a tumor. It’s perfectly normal to have an emotional reaction to an operation on your body.”
WHY THIS DEPRESSION?
Putting our health in the hands of another (in this case the surgeon) makes us immensely vulnerable and can trigger various emotions. Whether we acknowledge it or not, surgery is an invasion of our body –which can be traumatizing. Depression creeps in because of several factors, including: lack of mobility, discomfort and pain, losing normalcy of life, and increased dependence on others. For those who had a body part or organ removed, a feeling of loss also contributes.
Depression can strike right after the operation or even weeks after surgery when we thought we’re finally getting back our normal life. Surgery is often a harsh reminder of how fragile life is where at any moment a diagnosis/medical procedure can turn our world upside-down. For some it can mean dependence on a medical device for life or a series of surgeries over a period of time. There are other things as well that we need to adjust to: having to be away from home and work or school, the difficulty of getting a good sleep while in the hospital, and the stress of expected medical bills.
What compounds the situation is that depression and anxiety actually makes us more susceptible to infection and disrupts physical healing –making it slower, according to a 2017 study published by the British Journal of Surgery. In addition, it can diminish the ability to: think and make decisions, focus on a task, learn new things, and remember information.
SYMPTOMS OF DEPRESSION
Signs to look out for include:
-fatigue
-irregular appetite (eating less or more than usual)
-irregular sleep (sleeping less or more than usual)
-loss of interest in activities/things that you used to enjoy
-restlessness and irritability
-slower movements/speech
-feeling that family/friends are better off without you
-thoughts of suicide/harming yourself/harming others
-feelings of hopelessness and despair with no specific cause
-feelings of overwhelming stress, anxiety, guilt, or a combination
All these (or a combination of symptoms) typically occur longer than 2 weeks.
SURGERIES WITH HIGH-RISK DEPRESSION
Any type of surgery can trigger depression but some are more likely to lead to it, such as:
-brain surgery (e.g. hydrocephalus)
heart surgery (e.g. coronary artery disease)
spinal surgery
cancer surgery
bariatric surgery (e.g. gastric bypass)
amputation after an accident/trauma
HOW TO COPE
1) See your doctor/surgeon to talk about what you’re going through post operation. They can prescribe medications that won’t interfere with your post-surgical care.
2) Get outside and let nature heal you. A breath of fresh air, a change of scenery, and a short walk can improve your mood. If you aren’t able to do it by yourself because of your situation, you can ask a friend/family member to set aside time to help you with getting outdoors.
3) Stay positive and focus on what you can do. Set realistic goals (no matter how small) and celebrate your progress. Acknowledge every milestone and don’t focus on what you can’t do.
4) Keep a gratitude record. In your journal, write 2-3 things you’re grateful for in each day. This steers your mind away from your limitations.
5) Exercise. Consult your doctor about how and when you can exercise after surgery, then do it as much as you can. Your doctor can help you come up with an exercise plan that’s suited for you.
In addition, Vigliotti suggests that having a strong support system is essential to recovery.
“Have someone to talk to that is a good listener. It could be a therapist, or anyone you trust. When people are having a harder time, it’s because they’re burying these feelings and suppressing them. That’s the last thing we want people to do. We want them to be able to talk openly about these experiences, and more often than not, that’s what’s going to help get them through it.”
If you (or a loved one) are struggling with post-surgical depression, the mental health professionals at Jarvis Hypnotherapy are always available and have the tools to help.
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