Surgery and Depression

[Enzo & Ziti]

My AVR and root repair is scheduled for July 8th and I'm concerned about post surgery depression.

I'm already prone to depression but have been dealing with it for many years under the auspices of a doctor. However I do worry that the surgery will send me into a funk that will be tough to slog through.

I was wondering if anyone had any insights on this as regards their own experiences.

 

[Ross]

Let them know that before hand. They already know to expect it, but you may need some extra help, so give them some warning in advance.

 

[Superbob]

Some degree of depression is common after surgery. Ross is right that you should let the medical pros know ahead of time. I am wondering, though, if worrying a lot in advance about possible depression after surgery could worsen the problem -- self-fulfilling prophesy and all. I would just try to relax and concentrate on the surgery, and then everything will take care of itself. Just my perspective.

 

[Ross]

I was thinking the same thing Bob. For all we know, you might be the happiest camper this side of the KOA campsite. Depression may not rear it's ugly head, but it's very normal if it does.

 

[Mary]

Since you're being treated for it at this time, I imagine you should discuss it with the doctor treating you before your replacement. As Ross says, knowing in advance might help them treat it more aggresively if you discover it's a problem.

By the way, I put you on our surgery calendar for July 8, so you will have our support as you go through this.

 

[CathyK.]

I agree with the above. Try not to worry too much about it and who knows, you might not see much difference but by all means let your Cardiologist know. Good Luck! I personally didn't feel I experienced much if any.

 

[Christina]

I would not worry about depression until it happens. Worrying is a waste of time. The brain is very powerful and you only can control what thoughts you want to entertain and which ones to throw out. Many negative thoughts you can change and replace with positive ones.

Good Luck!

 

[ruth]

Welcome!

I've been battling the big D since I was 16. I've tried a lot of things, but for the past few years Effexor has been required to keep it at bay.

When I was meeting with the surgeon I asked if I should discontinue the Effexor and she said 'no'. She was emphatic on that point, given that I had such a long history, and was currently in a successful treatment, she was adamant that I not stop it just for the surgery. She cited what many here know, that surgery can bring it on so why would I choose to go off something that works right in time for a possible triggering event. I took it straight through and still do. I had no issues and was thankful for that. I hit a few bumps in my recovery, I'm really happy that I was able to focus just on getting better, and do so without having to battle depression at the same time. I don't know about you but for me battling depression takes/saps so very much of my energy.

Every year or so I stop taking my prescribed antidepressant for a month or more and then when I slip backwards (as always, sigh), I go back on. Maybe someday it'll go into permanent remission, one can only hope.

This is just my experience, the only advice I would give to you is to do whatever works for you and keep at it even through the disruption of the surgery and do so with the full knowledge of the cardiac and primary care team.

I wouldn't get yourself all psych'd out about it, you don't need a self-fulfilling event here. Just like other major life events, surgery can trigger depression. So what, tons of other triggers lurk in every corner, this trigger isn't bigger or badder than the others, it just is.

Tell the Dr's you work with and with their help and if available the help of a supportive 'other' they can help you with any depression that crops up. Think positive, it's going to work out just fine!

Peace,
Ruth

 

[ponygirlmom]

My AVR and root repair is scheduled for July 8th and I'm concerned about post surgery depression.

I'm already prone to depression but have been dealing with it for many years under the auspices of a doctor.

Do you see a counselor or psychologist as well as your psychiatrist? Maybe she can visit you in the hospital and speak with you on the phone when you are at home.

If not, I would try to meet a counselor who work at the hospital or with your doctor, and if you like him/her, arrange for visits and calls.

In fact, I would be surprised if some kind of counselor didn't stop by to see every patient at some point. When my daughter was in the hospital there was a counselor on staff who did this just to see if anyone needed help.

Both of my sisters-in-law suffer from anxiety and depression, and both have had surgeries. These were the kinds of plans they made. Also, one of them takes part in group therapy and she had the support of her group before and after surgery.

 

[Philip B]

Depression

Depression

I didn't even think about the depression stuff until it hit me a couple of months post-op. When it caught me it really hit me hard. After about six months of meds I beat it. The folks at my cardiologist's office told me it was a form of post-traumatic stress syndrome and very hard to beat without meds. I stopped taking the meds in December and haven't had any additional issues.

As others have stated, if you have a history of depression it would be a good thing to visit with your cardo doc about your history.

-Philip

 

[Jeeb1]

Hi--Regarding depression. I had severe depression after both of my OHS, one ten years ago at 34 and one last June. Both times I took Zoloft for three months and then was able to stop. It helped get me thru the rough patch of depression and obsessive worrying.

 

[Bryan B]

I would not worry about depression until it happens. Worrying is a waste of time. The brain is very powerful and you only can control what thoughts you want to entertain and which ones to throw out. Many negative thoughts you can change and replace with positive ones.

Good Luck!

With all due respect Christina, this statement is not true for everyone. If it were true there would be no such thing as depression as anyone who had the blues could just will themselves out of it.

Enzo & Ziti,

Situational depression is quite common after major surgery...especially major heart surgery. But if you already have a history of depression you probably know that situational depression can trigger a major depressive episode. I had sternum complications after my surgery that kept me out of work (and on pain killers) for about 8 months. I started to get depressed because my recovery was going so well before the sternum complications started. By the time I had the problem corrected my job had been filled (i.e. they let me go) and the depression got worse. I ended up in a major tailspin that I continued to try and ignore for over a year until I was so miserable I sought out help. I guess my point is that if you're currently seeing someone for your depression stay in close contact with them and update them frequently on how you are feeling after surgery. If you're not currently seeing someone regularly, plan on doing so regularly after your surgery. My depression didn't really start to kick in until about 3-4 months after surgery when I expected to be "healed" and I wasn't yet.

 

[ruth]

We all hope for a smooth recovery, that a month out of surgery we'll be back at our jobs and running 10 milers again. I'm exaggerating of course but I know at least I went into surgery really hoping for smooth sailing afterwards, a slow steady recovery. If we hit bumps, as I did and other on this thread have, it's a disappointment and a scary one. This sets up a "perfect storm" for a depressive episode. It starts with the physical post-surgical disruption to the chemical balance of the body and the psychological post-traumatic stress effects of major surgery. To this you add the psychological disappointment that recovery just became a lot harder and the physical challenges of the complication.

A year ago, at the same time that the other folks on this board with surgery dates near mine were heading back to their lives and jobs I was just trying to make it through the each day feeling worse than ever before. I didn't have a crystal ball to see that 12 months later I'd be sitting here feeling better than I have in many years. Ironically, the invaluable support I found here was also a source of frustration as those with surgery dates after mine were recovered and I wasn't yet.

Then comes the worry, the Dr's visits, the tests, more poking and prodding at a time when you were hoping it would all be over and done with. Couple that with financial concerns, the loss of a job, etc and many folks are just plain destined to fall into a major depressive episode even if they don't have a past history of depression.

No amount of wishing or positive thoughts will make it go away. If the brain chemicals are out of balance then you can either suffer while you wait for them to hopefully correct on their own or try to correct the imbalance with medicine.

Recognizing these possibilities pre-surgery and planning ahead makes sense. Have you ever been too depressed to seek treatment for it? It happens. I've certainly been there.

Recovery, especially when there are rough patches, is aided by a strong will to live, a vision that life will in the future be better than it is at the moment, and a strong desire to get back doing the things that we love to do. All of those can be elusive in the midst of a major depressive episode.

I did not have any depression post op but I firmly believe it was because I was already in treatment. I'm actually pretty amazed by that when I look back on it and I'm thankful that my surgeon and cardiologist were so supportive. I'm always very sensitive to the folks out there, and yes there even are some in the medical profession, who think that depression can just be "wished away". I don't want to sound like a pill-pusher here, there are certainly forms of depression for which talk therapy alone is very effective. But, I honestly think, and I'm no medical professional, that post OHS depression is more likely to be a physical imbalance of brain chemicals than an exclusively psychological event. I also believe that many of us who have a history of depression, who were born holding the short end of the Seratonin stick so to speak, can benefit from medicine to help us through these times. I feel really sorry for people who have to add suffering from depression to their list of post operative complications and I think it makes sense to address the possibility up front in honest and open discussion.

OK, this post is too long already, I wish you all the best in your surgery and recovery.

Peace,
Ruth

 

[Ross]

I would not worry about depression until it happens. Worrying is a waste of time. The brain is very powerful and you only can control what thoughts you want to entertain and which ones to throw out. Many negative thoughts you can change and replace with positive ones.

Good Luck!

Umm yeah, what she said.

 

[Bryan B]

Originally Posted by Christina
I would not worry about depression until it happens. Worrying is a waste of time. The brain is very powerful and you only can control what thoughts you want to entertain and which ones to throw out. Many negative thoughts you can change and replace with positive ones.

Good Luck!

Originally Posted by Ross
Umm yeah, what she said.

Again I have to respectfully disagree. Unless you have experienced clinical depression, known someone close to you that has, or have researched it, you probably don't understand that all the will power and all of the positive thinking in the world often will not make a difference in the ability for someone to avoid depression after surgery. Perfectly healthy people end up with clinical depression and it has nothing to do with positive thinking or "willing yourself" to be positive in a stressful or difficult period in life.

You've got to understand the difference between situational depression and clinical depression. Situational depression tends to be temporary and will abate as the situation stabilizes. Clinical depression is far more complex and usually requires treatment. I would recommend that anyone who has experienced clinical depression in the past or is currently being treated for clinical depression have plenty of support (professional and family/friends) after coming home from valve surgery.

 

[khawkk]

E & Z...Hi!
I don't think this has been mentioned yet.
Please consider cardio rehab as soon as possible after your surgery.
The RN's are usually excellent and the other post op participants
are extremely supportive. The exercise is monitored and is good for you.
Exercise also helps in maintaining a healthy mind.
It's actually fun and your insurance(hopefully) will probably
pay for most of it.