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Surgery, Depression, and Anxiety

Allan Schwartz, LCSW, Ph.D.

Surgery, Depression and AnxietyFor most people here comes that time in life when it is necessary to face surgery.  The need for surgery may vary according to the seriousness of the diagnosis. A more serious diagnosis brings with it a more severe emotional reaction.  For example, is common for people facing heart surgery, to feel extremely anxious and depressed about the outcome.  The same is true for an individual who is facing surgery for the removal of a cancerous tumor. This is where mind and body very much come together.  Medical procedures are not separate and apart from issues of mental and emotional health.  We know that people with diabetes often feel depressed.

Very recently, I faced the need for surgery on my left shoulder, because I suffered a rotator cuff injury.  While the diagnosis was not a serious, as one that is life-threatening, I nevertheless experienced a lot of anxiety leading up to the operation.

What were the reasons for my anxiety?  I knew that this was not a life endangering procedure.  I had full confidence in my surgeon.  I saw my MRI pictures and clearly viewed the injury.  I also had a lot of pain and reduction in motion of my left arm and shoulder as a result of the injury.  Therefore, I was very confident in the fact that I needed arthroscopic surgery for this problem.

I let my feelings be known to my family and closest friends.  Working in mental health all of these years.  I knew it would be better for me to talk about my feelings rather than suppress them.  Each time I brought this up with my wife, adult children, and very good friends, I was left with a feeling of dissatisfaction with their sincere responses.  These are people I know and trust.  All of them assured me that I would get through the surgery and be fine.  So why was I bothered by this response?

I came to realize that it wasn't worried about getting through the surgery, and I wasn't worried about whether or not the procedure would be successful.  Instead, I came to understand that it was the anticipation of the pain after surgery was all for that I was distraught about.  This was especially true because I was told that I would need 6 to 8 weeks of physical therapy in order to regain full functioning in my arm.

A lot of this became clearer to me after the surgery was over, and I met with my physical therapist.  Things crystallized in my head when I asked him if it would hurt?  Is immediate answer was direct and to the point, yes.  It was going to hurt.  Rather than feel alarmed or upset by his answer I actually felt relieved.  I did not like either from him that I would be okay.  Instead, I wanted the honest answer that he provided me with.

What you can learn from my experience:

1. If you need surgery your doctor with great care.  It is important that you have full confidence in him or hire.

2. Learn all you can about your illness.  Knowledge is power, and the more you know ahead of time, the more in control, you will feel.

3. Ask your doctor lots of questions about what to expect  prior to, during and after the surgery.

4. Be open and honest about your feelings.  At the very same time, do not expect too much of other people.  Loving and caring people will do the best they can to understand you and help you.  However, there was just so much they can do.

5. Accept the fact that anxiety about surgery is normal.  If you believe that you are getting panicky about surgery consult a psychologist to help you reduce either anxious or depressed symptoms.

6. It is also a very common for people to experience depression and anxiety after surgery is over.  If you stop and think about it that is not surprising. Surgery is an intrusion into a person's body.  The very process of surgery requires that an individual passively submit to the procedure.  That temporary need for passivity is what causes depression.  No one likes to feel helpless.  In addition, remember that surgical procedures are traumatizing in nature.  Trauma brings about all kinds of stress and emotional reactions.

7. If necessary, seek psychotherapy is feelings of anxiety and depression processed long weeks after recovery.

What are your experiences with surgery?  How have you responded to loved ones and friends when they have faced surgery?

Your comments and questions are strongly encouraged.

Allan and Schwartz, PhD