Depression After Surgery: Symptoms, Causes, Coping

Some people experience postoperative depression—also known as post-surgery depression or “postoperative blues.” Post-surgery depression is not an official type of depression, however. The surgeries, like other major life events, can instead be the triggers for depression.

Statistics vary depending on the type of surgery, but about 13% to 47% of people who have had an operation experience it. Research has shown that some people can develop depression after surgery because of a lack of support system, financial strain, physical discomfort, and more. Read on to learn why people can develop depression after surgery, symptoms, and how to get support.

In general, post-surgery depression symptoms are similar to other types of depression. Those symptoms may include:

• An overall sense of hopelessness—even when someone has a successful surgery and makes a full recovery
• Anxiety
• Changes in appetite and sleep patterns
• Difficulty concentrating or remembering
• Irritability
• Loss of interest in activities
• Sadness

Of note, it’s normal to experience strong emotions after surgery. Post-surgery depression, however, is persistent and lasts longer than two weeks. If left untreated, post-surgery depression can last months.

There are many underlying causes of depression following a surgical procedure. Certain surgeries have a higher risk than others, but any procedure can lead to depression. The following are some (but not all) procedures that may result in post-surgery depression:

• Bariatric surgery: Weight loss surgeries, like gastric bypass or sleeve gastrectomy, may result in depression due to significant lifestyle changes and body image issues.
• Brain surgery: Surgeries involving the brain, such as tumor removal, can affect cognitive ability and emotional functions.
• Cancer surgeries: Research has shown that surgeries involving organ removal due to cancer can trigger depression.
• Cardiac (heart) surgery: Procedures like coronary artery bypass grafting (CABG) and heart valve replacement are often associated with patients’ experience of depression afterward.
• Major orthopedic surgeries: Hip and knee replacement surgery can be physically and emotionally demanding.

Research has found that risk factors of post-surgery depression may include:

• A history of depression
• Changes in body image
• Feelings of anxiety, guilt, and stress
• Financial strain
• Lack of a support system
• Physical discomfort and pain
• Reactions to medications or anesthesia

Coping with the effects of surgery and recovery can vary drastically from person to person and even by procedure. Talk to a healthcare provider about how long your recovery could be so you know what to expect.

Family Support

Research has indicated that family support, whether it’s someone’s biological or chosen family, can improve the recovery process. Examples include the following:

• Individuals who had surgeries due to digestive cancers not only reported higher family support scores but experienced a better quality of life following the surgeries due to that support.
• Participants either received standard care or an intervention focused on family support prior to having major abdominal surgeries. The individuals who received the family support intervention had better recovery one and two weeks after their procedures.
• People who underwent an ​​open cholecystectomy (gallbladder removal) surgery in Spain recovered more quickly if they had family support.

Group Support

Peer support groups are other helpful resources. Reach out to see what your hospital or other local organizations offer to find peer support groups. You might even look into social media groups that focus on post-surgical complications.

Individual Therapy

Talking with others via individual therapy if you develop depression after surgery can be helpful. Consider having a psychologist or a psychiatrist on your healthcare team, especially if you have a chronic illness that requires frequent surgeries. Therapy services may be available where you received a procedure, or the facility may have mental health professional referrals they can recommend.

Cognitive behavioral therapy (CBT) may be especially beneficial as it is a common type of talk therapy, or psychotherapy, for depression. Research has suggested that this type of therapy has been effective for individuals following procedures for the heart or endometriosis, for example.

Another type of therapy that may be helpful is acceptance and commitment therapy (ACT). ACT involves accepting and experiencing thoughts or feelings while focusing on goals based on individual values. Some researchers found that, for women with breast cancer, one session of ACT before surgery had a positive outcome on their pain and anxiety following their procedures.

Other Tips

Here are some ways, in addition to interpersonal and professional support, to cope with post-surgery depression and pain:

• Do low-impact exercises: Gentle stretching and walking may help with recovery and elevate your mood if a healthcare provider permits it.
• Eat a nutrient-rich diet: Getting plenty of fruit, healthy fats, lean protein, vegetables, and whole grains may alleviate pain and reduce depression symptoms.
• Get plenty of rest: This helps give your body ample time to recover.
• Pace yourself: Another beneficial action you can take following a procedure is to ease into a previous or adjusted routine, or activity pacing. Activity pacing ensures that you have a balance with how much activity you’re doing.
• Stay informed: Try learning more about your surgery and the recovery process beforehand to reduce anxiety and uncertainty.
• Take antidepressants: A healthcare provider might prescribe this medication to manage feelings of depression and anxiety.
• Use non-medication pain treatments as appropriate: Pain, especially chronic pain, and depression can also be connected. While a healthcare provider may prescribe pain medications following surgery, you may also be able to use non-drug treatments to help, like relaxation therapy, cold, heat, or massage, as appropriate.

Know the signs and symptoms of post-surgery depression if you are caring for a loved one who’s about to have or recently had surgery. You can support them by:

• Aiding them in their recovery process (e.g., helping them make follow-up appointments and reminding them to take medications) 
• Encouraging them to eat regularly and get low-impact physical activity if possible
• Listening to and accepting their needs
• Maintaining friendly body language
• Reading more about depression
• Remaining calm and patient
• Treating them with respect

You may advise your loved one to talk to a healthcare provider if you notice they are not eating and drinking enough, taking care of their hygiene, or taking medications as prescribed. Get medical attention right away if your loved one experiences new or worsening thoughts of self-harm and suicide.

Post-surgery depression is not uncommon after surgery. The severity and duration of symptoms can vary widely from person to person. Several factors can increase your risk, including the type of surgery, your mental and physical health history, and availability of support and resources.

Consult a mental healthcare provider if you develop persistent feelings of sadness after surgery. The appropriate treatment and support you can help manage and recover from post-surgery depression.