Postoperative depression is a common complication of surgery, though it's rarely talked about.

By Shabnaj Chowdhury
Updated February 07, 2019

In November of last year, after having surgery to remove abnormal cells from her cervix, 27-year-old Emma Wolf felt, well, depressed. The surgery, though invasive, was a minor one. In fact, her doctor told her a day of rest would be all she needed to feel like herself again. She wasn't warned, however, about the lingering emotional effects that would last for weeks.

“I felt disconnected from my own body,” Wolf tells Health. “I had a sense of guilt about not keeping up to my daily demands. I have a family and I have a life, so it was a struggle. I was not expecting that to happen.”

Wolf was experiencing a case of postoperative depression, a common complication following surgery that's rarely talked about.

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It can be difficult to tell the difference between post-op depression and normal feelings of sadness that come with recovery. Some symptoms overlap, such as fatigue and irritability, but post-op depression is persistent, lasting longer than two weeks. If left untreated, it can actually go on for months. Surprisingly, feelings of hopelessness can persist even when a patient had a successful surgery and is on their way to a full recovery.

“It doesn’t matter how small or large that operation is,” says Amy Vigliotti, PhD, founder of SelfWorks: Therapy Professionals and former supervising psychologist at Jacobi Medical Center in New York City. “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.”

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Vigliotti says putting your health in the hands of another person (in this case, a surgeon) makes you extremely vulnerable and can trigger an array of strong emotions. Surgery is an invasion of a person's body, which can be quite traumatizing, whether they realize it or not. Depression then comes on because of a number of things, including pain and discomfort, a lack of mobility, and increased dependency on others. For patients who have had an organ or body part removed, a feeling of loss can also play a role.

“We all have a certain amount of invincibility that we feel. We’re physically well and then all of a sudden, our bodies let us down and it surprises people," she says. "That brings a lot of feelings about physical well-being, mortality, and our vulnerability in the world.”

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Vigliotti adds that a lot of energy goes into preparing someone for surgery in terms of practical needs (like what to eat, wear, and how to manage pain), but there's not enough focus on emotional needs. She feels doctors and surgeons need to do more to educate and warn their patients about depression after surgery so they know what to expect. Plus, depression and anxiety can actually disrupt physical healing, making it slower and harder, according to a 2017 study published by the British Journal of Surgery.

Those who have a history of mental illness are at the highest risk for developing depression after surgery. Symptoms vary, but the most common are difficulty sleeping, extreme tiredness, hopelessness, feelings of guilt, irritability, loss of appetite or excessive eating, anxiety and/or panic attacks, and persistently low mood. It's important to speak to your doctor if you experience any of these symptoms.

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Vigliotti says having a strong support system is key to recovery. “Have someone to talk to that is a good listener,” she says. “It could be a therapist, or anyone you trust.”

Wolf agrees. “I was really needing the validation from others, like from my partner and family,” she says. “Like, yes, I am having a hard time, and I do need to take care of myself right now. And it’s OK to rest and not be up for doing everything all the time.”

Other things you can do to combat the condition include spending time outdoors (sunlight is a natural mood enhancer), getting enough sleep, maintaining a healthy diet, spending time with loved ones, and finding ways to pass the time, like listening to music, reading, or playing games, while you recover from your procedure. When your body is ready, you can slowly get back into your usual routine.

“When people are having a harder time, it’s because they’re burying these feelings and suppressing them,” Vigliotti says. “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.”

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