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Autoimmunity – the Hidden Link.

Post-Operative Depression

Depression and/or anxiety are often experienced after surgical procedures, at various times post operatively (immediately or months later). Intensity can range from mild dysphoria to major depressive symptoms.

John Lauerman in the January 2000 issue of Harvard Magazine, addresses this topic in

“An Understandable Complication…Coming to terms with postsurgical depression.”

The article talks about emotions before surgery as being expected and often handled quite well. Problems can also crop up in the recovery period which are not expected. After major surgery, according to the article, feelings of mortality, of loss, and of vulnerability can be profound. Shortly after surgery, depression can be attributed to pain, a problem with anesthesia, a sense of loss or another underlying cause. Post-operative depression, well after the crisis of surgery, can make it difficult for patients to cope with what they have endured. There might also be uncertainty about the future, or lack of understanding on the part of individuals close to them. This article points out the importance of communicating feelings of depression to medical professionals who may not be alert to symptoms, in order to have all possible causes of depression investigated.

In the April 15, 1997 issue of Annals of Internal Medicine, Herbert Waxman, M.D. relates his experience with depression following surgery. In “The Patient as Physician”, he discusses his post surgery symptoms. Occuring several months after surgery, he experienced “dysphoria, sleep problems, joylessness and feelings of unworthiness.” When he returned to work, he realized the importance of honest communication and sensitivity to patient concerns and believes the experience made him a much better physician.

Typical Reasons For Post-Surgical Depression

Post-surgical depression can be from:

  • the after effects of anesthesia (anesthesia seems to bring out our sensitive sides and our anxiety)
  • medications
  • post-surgical traumatic stress syndrome
  • constipation from the medications
  • and a general sense of disarray.

Plus being instructed to stay in bed and restricted to low impact activities, doesn’t make things any better. Throw on top of that that you are all bruised up and sore. Well, no wonder you’re feeling down.

Pain and discomfort can really affect some patients. As mentioned above, the pain medications (and antibiotics) can cause constipation and other temporary digestive problems and can disrupt your system and make you feel bloated and sometimes even cause you abdominal pain.

That Period of Feeling “Let Down” The number one reason for depression is usually the adrenaline period is now over, also known as the “Surgical Let Down Period.”

Keep in mind that almost any form of surgery can adversely affect one’s notion of health and invincibility. In some ways it’s like being afraid to drive again after a motor vehicle crash. For some, after either of these events, they’re back in the saddle and able to pick up where they left off. For others, this experience sends waves of disruption through every aspect of their lives. The result may be an episode of depression that can be brief or long lasting. For some, just recognizing there may be a cause and effect relationship is liberating enough to offer hope for eventual resolution without intervention. For others, especially if the symptoms worsen or show no sign of relenting after a few weeks, consultation with your doctor is definitely in order.