Surgery can be physically taxing but can also take a toll on the patient’s mental health. We’re not only talking about postoperative delirium and the side effects of anesthesia, that last for a few hours or a day or so. We’re talking about the depression that can come from being incapacitated after a big ticket surgery, which can sometimes – if ignored – grow into full-blown psychosis.
If you or a loved one has recently been through surgery, or is about to go through surgery, you are taking the first step in the right direction by doing your research. Awareness and mindfulness are critical in maintaining optimal mental health.
Here are some measures to avoid depression in the short term and psychosis in the long term.
Spot the symptoms
It is important for caregivers to observe any change in the patient’s patterns post-surgery. Look for any of the following telltale signs:
Sleep
Excessive sleeping (that carries on after anesthesia side effects have worn off) could be a sign that the patient is depressed, as could a feeling of fatigue, that could in turn contribute to excessive sleeping.
Eating habits
A loss of appetite post-surgery should not be ignored. If you feel guilty ‘forcing’ your loved one to eat, provide for foods and beverages that are on their favourites list (so long as these are not obstacles to their recovery).
The caregiver and patient need to recognise that nutrition is essential to a well-paced and complete healing after any surgical procedure. If the patient is unable to rationalise this and act accordingly, it might point to post-surgical depression.
Mood
The patient’s mood and behaviour should return to normal after any postoperative delirium runs its course. Higher-than-usual levels of irritability, anxiety, stress and hopelessness (that might represent itself as being quieter than usual of sleeping excessively) are some symptoms to watch for.
Understand the causes
To make any headway in coping – or enabling coping – with poor mental health after a surgery, one needs to understand its causes. This insight can drive better success in both, spotting the symptoms and developing coping mechanisms.
Pain, is obviously the first reason that contributes to poor mental health after a surgery
This in turn contributes to
- Hopelessness
- Worrying about whether the surgery was successful
- Stress about complications and not getting better after everything
- Anxiety over the pace of your recovery (and social media doesn’t help because it’s easier to make comparisons and panic).
In addition, painkillers also have a role to play in a person’s moods and sleep habits – especially when the medication is stopped.
And then there’s also
- Guilt and embarrassment over not being able to work/ perform one’s daily chores
- Guilt and embarrassment over depending on the caregiver and others
Additionally, it could be that the patient suffered from depression even prior to the surgical procedure. However, that’s no justification for letting it slide.
Enable and support coping
Well you’ve taken the first three steps. You have upped your awareness; learnt to spot the signs and you have wrapped your head around the mindset behind post-surgical depression.
Beautify (or least tidy up) surroundings
This is exactly why people send flowers for “a speedy recovery”. Tidy up and beauty the room or area that will be used by the patient after their surgery. It’s best to complete this prior to the surgery.
Get some sunshine/ fresh air
There’s nothing like stepping outside for some sunshine and fresh air if the patient’s condition allows it and there’s no chance of complications or infection. In other words, do this only if it does not compromise their recovery.
If not, at least draw the curtains or open the blinds; open up doors and windows to allow some circulation in the room. Don’t let them stew in a dark room.
Encourage social interaction and have visitors who keep the patient cheerful (again, only if this does not compromise their physical recovery)
Talk it out
The patient must thrash out feelings of hopelessness, guilt and anxiety with their caregivers, friends and family. They must be allowed to express how they feel about their circumstances.
Police own thoughts
The patient and the caregiver must be conscious that expressing feelings does not cross the line and become negative thinking or wallowing in self pity. One eye on the prize (that is recovery from the surgery) always
Exercise, if possible
Exercise is one way to combat negative thoughts and feelings. Physiotherapy, which also qualifies as exercise – is part of the recovery strategy in some types of surgeries.
For heart surgeries and other surgeries related to organs, one should insist on finding out what physical activity is acceptable and what is not.
If for any reason, zero exercise is recommended, one can at least exercise mentally – the patient can read or be read to, play card or mental games, or watch something fun or enriching.
Eat right
Whatever surgery you have had, avoid junk food, processed food, beverages and foods with added sugar (including alcohol). Eat nutritious and healthy food instead.
Have a ‘look forward to’ schedule
Plan something fun for everyday, and to celebrate milestones in recovery. For example, “When I’m fully recovered, I will go visit my family member/friend or go to dinner at x place.”
And “This afternoon we’ll have this special home-made treat with lunch.”
And “Next weekend/when I’m a little better, we’ll watch this/ read this/ engage in x activity.”
Get into a routine. Quickly.
A daily and weekly schedule should be implemented and practiced right after the anesthesia side effects and postoperative delirium has worn off. Don’t allow a poor routine to get a footing.
Practice gratitude and positive reinforcement
Gratitude on the part of the patient who can develop a positive mind frame with the use of this mechanism. And positive reinforcement of small victories on the part of the people surrounding the patient.
Be in touch with the concerned medical professionals
The patient’s progress or the lack thereof should be reported to the doctor who called for the surgery and to any physiotherapist involved. If depression persists, it is important to involve a mental health professional.
