How to Cope With Depression After Surgery

Having to undergo surgery can be frightening and the recovery process can be painful. It can be a difficult experience for just about anyone.

While some people find that their mood improves if their medical symptoms are better after the surgical procedure, others may develop post-surgical depression, says Jeffrey Zabinski, MD, a consultation-liaison psychiatrist at Columbia University Irving Medical Center, who works with medical patients that also need psychiatric care.

This article discusses the symptoms, causes, and effects of depression after surgery, as well as some treatment and prevention strategies that may be helpful.

Symptoms of Depression After Surgery

These are some of the symptoms of depression you may experience after surgery:

• Feeling sad or numb
• Feeling hopeless or pessimistic
• Feeling restless or frustrated
• Feeling anxious or irritable
• Feeling guilty or worthless
• Losing interest in hobbies or activities
• Lacking energy and feeling lethargic
• Having difficulty paying attention or recalling things
• Struggling to make decisions
• Sleeping too much or too little
• Being unable to fall asleep or waking up too early
• Experiencing unplanned changes in weight or appetite
• Having thoughts of death or suicide

Broadly speaking, the symptoms of depression after surgery are not different from symptoms of other types of depression, although certain symptoms like restlessness, fatigue, and irritability may be more pronounced, says Dr. Zabinski.

However, he notes that it's important for healthcare providers to distinguish between depression and delirium (a consciousness disorder characterized by confusion that is brought on by an underlying medical cause) in post-operative patients.

Causes of Depression After Surgery

These are some factors that can contribute to the development of depression after surgery, according to Dr. Zabinski:

• The type of surgery and the outcome
• Physical pain and discomfort due to residual symptoms
• Poor experiences with previous surgeries
• Uncertainty about treatment outcomes
• Existential questions about life
• Confrontation with one’s own mortality
• History of depression and anxiety

Effects of Depression After Surgery

Experiencing depression after surgery can affect not only your mental health but also your physical health. Research shows that post-surgical depression is linked to negative outcomes such as:

• More post-operative symptoms and complications
• Poor physical function
• Greater risk of relapse
• Increased risk of subsequent hospitalization
• Greater need for medical interventions and support
• Greater functional decline one year after the surgery
• Lower quality of life
• Higher chances of mortality

Treating Depression After Surgery

Dr. Zabinski shares some treatment and coping strategies that may be helpful if you’re experiencing depression after a surgery:

• Seek professional help: Prolonged symptoms of depression that last over two weeks should be evaluated by a mental health professional and may require psychotherapy and/or medication for treatment.
• Consult a specialist: There is a sub-specialty known as ‘consultation-liaison psychiatry’ that is specifically dedicated to the psychiatric care of people with medical conditions, which includes post-surgical depression. Ask your surgeon or primary care doctor for a referral to a consultation-liaison psychiatrist near you.
• Take medications as prescribed: Depending on your symptoms and your circumstances, your healthcare provider may prescribe medications such as antidepressants to help treat the depression. Take the medications as prescribed and report any side effects to your healthcare provider. Do not stop taking the medication without consulting them first.
• Attend therapy sessions regularly: Psychotherapy, often in the form of cognitive behavioral therapy, can treat depression and help you cope. Attend your therapy sessions regularly and work with your mental healthcare provider toward your treatment goals.
• Take part in physical therapy: Physical therapy is an important part of the recovery process after surgery. Give your physical therapy sessions your best effort and make sure to do any follow-up exercises you’re supposed to do on your own.
• Join a support group: Depending on the health condition you have or the type of surgery you experienced, there may be specific or general support groups near you that you can join. Support groups can be a valuable source of advice, inspiration, and shared experiences.
• Maintain a healthy routine: Make sure you get enough sleep and work on ways to maintain a healthy, balanced diet. Resume exercising as soon as your healthcare provider says it is safe to do so. 

Preventing Depression After Surgery

If you or a loved one are going to undergo surgery in the near future, Dr. Zabinski suggests some prevention strategies that can help minimize the chances of experiencing depression after the surgery:

• Learn about the recovery process: It can be helpful to familiarize yourself with the potential timeline and trajectory for recovery after surgery. This can help you be more prepared for what’s to come and feel more in control of the process. You can read up about the surgery and ask your healthcare providers any questions you have.
• Build a support system: Build a support system by identifying people in your life you can count on, including friends, family members, and colleagues. Let them know you may need extra help while recovering. Depending on their ability to pitch in, they can help you with rides to medical visits, home-cooked meals, and assistance with daily activities, or simply provide company while you’re recovering.
• Prepare activities to keep you busy: Collect some books you would like to read or prepare activities that you enjoy doing to help keep you engaged after the surgery. It may be helpful to pick simple games or activities that are not very cognitively taxing, so you can do them even when you’re not feeling too well.

If you or a loved one develop depression after undergoing surgery, it’s important to take it seriously and seek treatment for it because it can affect your mental health as well as your physical health. Remember that there are evidence-based treatments and trained professionals who understand what you’re going through that can help you feel better.