Depression After Surgery: Symptoms, Treatments, & How to Cope

Depression after surgery is seldom discussed, but it is a normal reaction. Symptoms are manageable if addressed. The most important factor is “how well the patient is prepared to think and feel about the process.”¹ The length and severity of post surgical depression directly relates to the type of surgery and related recovery process. Counseling, medication, and consultation with physicians can help alleviate and treat surgically related depression.

What Causes Depression After Surgery?

Surgery can be a life altering event. Post surgery depression can be traced to a number of sources. It can be described as reactive depression. Patients can have a bad reaction to an anesthetic, ongoing pain, or a surgical outcome that did not meet their expectations. Fears about compromised life expectancy, thoughts about mortality, or long term health challenges can also lead to depression.

Causes of depression include:

Pre-Surgery Depression

People who have a pre-existing diagnosis of depression are at higher risk for experiencing depression post surgery. The stress of surgical procedures can trigger a new onset of depression.

Chronic Pain After Surgery

Researchers reported that the combination of ongoing chronic pain in conjunction with opioid use heightened the risk level of depression for the patients in this study.⁵

Other Risk Factors For Post Op Depression

Risk factors for developing depression after surgery include:⁵

• Younger age
• Being female
• Previous history of neurological disorder
• Chronic opioid use
• Higher income (those who earned more money might be more stressed about the possibility of their medical condition jeopardizing these earnings)

There is some evidence that there are differences in rates of depression depending on age groups. Anesthesiologists did research which demonstrated that in terms of non-cardiac surgeries, anxiety and depression in older adults was less common.⁴

Surgeries With a Higher Risk of Depression

Researchers have identified certain diagnoses and conditions where patients are at higher risk for experiencing depression, including the following:

• Up to 20% of patients who have undergone coronary artery bypass grafts (CABG) surgery experience major depression³
• Open heart surgery and heart attacks are also diagnoses closely associated with a much higher risk of depression
• A 13.7% incidence of depression on the first day of admission to the ICU²
• A 32% incidence of depression or PTSD of patients admitted to the unit after abdominal aortic surgery²
• The General Intensive Care Unit had clinically significant depression 28% of the time²
• Depression is common in patients with diabetes and increases the rate of complications for this disease²
• Depression after a stroke has an estimated prevalence as high as 80%²
• Men who are diagnosed with urinary, bowel, or sexual dysfunction after surgery are at a higher risk of experiencing depression²

10 Tips For Coping With Post Surgery Depression

Remember that all surgeries create some type of trauma, anxiety, or stress, even when the surgery is elective. Understand that depression is not an unusual outcome for surgical patients and is not considered abnormal.

Here are ten tips to accelerate your physical and emotional recovery after surgery:

1. Be Prepared & Understand What to Expect

It is important to educate yourself as much as you can about your depression, medical diagnosis, and surgical recovery protocols. Having this knowledge will help you prepare yourself to create more realistic self recovery expectations both physically and emotionally. It will also help you feel more control in terms of your body and your feelings.

2. Follow Your Doctor’s Orders Regarding Exercise

Exercise helps your physical recovery from surgery. Physical activity reduces depression and releases chemicals in the brain called endorphins that elevate your mood.

3. Get Enough Sleep

It’s commonly advised that anyone experiencing depression should work to regulate their sleep schedule and get more sleep. Sleep is incredibly important for healing, and sticking to a set schedule can be helpful as well.⁶

4. Eat a Healthy Diet

This will help maintain your weight and give you necessary energy and nutrition to help you heal.

5. Talk About Your Feelings

Find a close friend or family member you can discuss your depression, concerns, and fears with. This will offer some relief. In addition, counseling can offer insights, coping skills, and a greater understanding of your strengths and areas you need support. If you need to find a therapist, a good resource is an online therapist directory.

6. Be Patient With Yourself

Set realistic goals regarding your physical and emotional recovery. Consult your healthcare providers to help ensure your goals and time frames are appropriate. Achieving these goals will elevate your mood and your self esteem. Focus on your gains, not your losses.

7. Get Out of Bed Each Day

It’s important that you take small strides daily to achieve your treatment plan post surgery. Getting up each day on time and having a routine will help bring a sense of normalcy in an otherwise unusual situation.

8. Go Outside When You Can

Getting outside each day is just as important to include in your daily routine. There are a lot of benefits of nature on mental health. Even just fresh air can do wonders. Depending on your limitations post surgery, and ensuring it’s safe to go outside, making time to spend 20 minutes each day outside can be very healing.

9. Focus on the Positive

While there are going to be a lot of small steps to take and barriers to cross, focusing on how far you have come while honoring your whole experience is a good way to frame your recovery. It takes into consideration a mindful approach and living each day with gratitude and intention.

10. Set Healthy Goals

Think about setting and achieving healthy goals. Our goals are often long-term goals, but oftentimes after surgery, you have to set short term goals and tasks as milestones to reach the long-term goal. Thinking about how to break down your long-term goal into small goals that you can work toward is the best way to manage your own expectations of recovery.

When to Seek Treatment For Post Surgery Depression

If symptoms like hopelessness, loss of sleep, energy, or concentration, continue for two weeks or more, consider getting a mental health practitioner involved as quickly as possible. Keep in mind, depression after surgery may not be immediate. It often develops after patients have been home for a while and begin to recognize the challenges and limitations they must face and must try to overcome.

The sooner you can begin working with a mental health specialist the better it will be, because the longer you delay the more harmful it can be in terms of post surgical treatment and rehabilitation. The goal is for you to be fully engaged in rehabilitation to promote greater recovery and healing as quickly as possible.

How Post Surgery Depression Is Treated

Our physical health and well being are closely connected to our mental and emotional health. Seeking psychological support when needed can improve your physical and mental healing after a surgery.

Therapy

Therapists can help patients create a plan to identify and cope with depressive symptoms and surgical outcomes. They can also help to create realistic goals for your rehabilitation process. Counseling can teach you skills to manage and reduce stress stemming from this healthcare crisis.

Online therapy for depression is widely available and easily accessible from the comfort of your own home. Importantly, the effectiveness of online therapy vs. in-person therapy is being shown to be on par, so it’s a great option for those still in recovery after surgery.

Medication

Talk to your doctor to see if you are a candidate for medication for depressions to help reduce stress and depression resulting from surgery. Your doctor will help determine what medications will not interfere with your post operative care.

Support Groups

Support groups and online chat rooms can be helpful resources, as you can reach out to peers who have a similar diagnosis and relatable experience. They can share tips, insights, and information based on their personal experience that can be very meaningful to you.

How to Get Help For Depression After Surgery

The first step is to talk with your doctor. If your doctor does not bring up post operative depression, ask about the incidence of depression in relation to the type of surgery you need. Talk to your doctor about other anticipated emotional reactions and mood changes related to your surgery.

Knowing that depression is a possible outcome will help you feel less stressed or anxious about it happening. If you have a previous history of depression it is important to let your doctor know about it. You may want to revisit a mental health practitioner you previously worked with if the therapeutic relationship was a good one.

If you don’t know of any mental health professionals, ask the doctor about recommendations. Working with a mental health professional can be very helpful. Try to find a mental health practitioner who has experience working with people who have chronic or acute medical problems that are similar to yours.

Friends or family may be aware of potential referral sources. The hospital or clinic you are working with may also have staff that can offer counseling and support. Additionally, you could use an online therapist directory where you can filter by location, expertise, and insurance.

What to Ask Your Doctor When Seeking Treatment

It is important to be honest and transparent with your doctor if you are depressed. Be prepared to describe your symptoms and how long you have been experiencing them. Share your medical history.

If they aren’t aware already, it is important for your doctor to know you have had surgery, when it was done, and why it was necessary. Bring information regarding what medications you are currently taking and the dosage. Your doctor needs all this information to be careful about not prescribing additional medication that might interact poorly with other medications.

When seeking treatment for depression after surgery, ask your doctor these questions:

• Based on what I have told you, what do you think my diagnosis is?
• Should I take antidepressants? If so, which ones?
• How will they interact with my current medications?
• How long can I expect to be on this medication?
• Do you think I can benefit from getting therapy?
• Do I need therapy and medication to feel better?
• Does this medication have any side effects I should watch out for?
• How quickly can I expect to begin to feel better?
• Is there anything I need to avoid while using this medication?
• Will I be able to stop taking this medication when I am feeling better?

How to Help a Loved One With Depression After Surgery

One of the most common mistakes caregivers make is not taking care of themselves, too. If you’re taking care of someone post surgery, it may entail helping them with mobility, self-care, and responsibilities at home. Pay attention to pain and muscle aches in your own body. You may need to ask for help from a friend, family member, or healthcare professional if the physical demands are too great.

Caregiving can also take an emotional toll. If you’re caring for a loved one who has a dual diagnosis of depression and a medical condition, it can create new and unanticipated challenges. Be aware of changes in your mood, increased stress, loss of sleep, anxiety, irritability, or your own depression. Get emotional support for yourself to avoid caregiver burnout.

Here are tips for how to help a loved one after surgery when they’re depressed:

• Prepare your home: be prepared so when the post surgical patient comes home it is set up to promote their maximum independence and safety. This will reduce the risk of future complications like falls. It will help their self esteem if they can do more for themselves and this will elevate their mood and yours.
• Be a good listener and observer: it’s hard to know the right things to say to someone who is depressed. Be positive and point out medical and physical improvements you see post surgery and in terms of mood. Allow the person you are caring for to openly discuss their feelings. Listen without judgment. Be supportive and offer encouragement when needed. Celebrate each achievement and milestone.
• Communicate with healthcare providers: caregivers who notice that a loved one continues to not adhere to healthcare provider recommendations should take action. Let the healthcare providers know this is happening so the appropriate interventions can be made. Left unchecked, non compliant patients can suffer physical and emotional setbacks that will lengthen recovery and diminish any potential progress.
• Reduce isolation: surgery can isolate both patients and their caregivers. It is important to maintain social connections with family and friends that are positive and offer emotional and physical support for all concerned parties.
• Find creative ways for your loved one to spend time: if you can, find things you can do together. Examples include playing music, reading, games, watching a movie, doing crossword or jigsaw puzzles. Go outside if possible. All these activities can be great distractions and can make everyone feel better emotionally.

Final Thoughts on Depression After Surgery

Recovering from a surgery can be incredibly difficult, so if you or a loved one are experiencing depression after a surgery, know you’re not alone. Make sure your support team knows how you’re feeling, and don’t be afraid to reach out to a therapist.

Depression After Surgery Infographics

For Further Reading

• Anxiety and Depression Association of America: This organization offers education, resources and online community support
• Mental Health America: This organization does patient advocacy, education, public policy, and does peer support and support groups
• National Suicide Prevention Lifeline: Offers 24 hours a day/7 days a week counseling hotline at 800-273-8255, community support, education, advocacy, on line peer contact
• Substance Abuse and Mental Health Services Administration: Provides 24/7 hotline counseling services at 800-662-4357. Also offers treatment center locations, education, advocacy and advises on public policy