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Postoperative depression

General

Almost everyone feels that major operations are very stressful. Often the physical complaints are so in the foreground of the action that the psyche of those affected can easily be forgotten. Unfortunately, mental health and surgical management are neglected in many hospitals. Such impairments can strongly influence the progress of recovery.

In this context, one often speaks of postoperative depression. The term has not yet been able to establish itself in psychology or psychiatry in German-speaking countries. In the USA, on the other hand, research has been carried out for a long time on the exact causes of postoperative depression.

definition

Strictly speaking, the actual term postoperative depression still exists in specialist circles Not. However, the phenomenon is well known! Ultimately, postoperative depression is a response to a severe stress in a person's life. One speaks therefore more generally of a Adjustment disorder, also called reactive depression obsolete.
In contrast to, for example manic depression a concrete connection between an event (operation) and the complaints can be established.
Conversely, it can be assumed that, without surgery, there would be no depression in the respective patient.

Symptoms

Often, patients with postoperative depression experience an increased need for sleep.

Central symptoms can be depressed mood, joylessness, decreased drive or loss of interest. Affected people are very often not able to put their emotional situation into words. They report a strange "emptiness" and numbness. The lower interests usually affect all areas of life, be it private, professional or daily political events. For example, personal hygiene can be neglected.
Patients also often have a "Compulsion to brood“, That means your thoughts revolve continuously around the same topic without finding a solution. Relatives report that their affected relatives are withdrawing more and more. Hospital visits are barely noticed and conversations are becoming increasingly difficult.

Typically that goes up Need for sleep enormously. In principle, some patients overslept all day! Often they change Eating habitsso that either there is no longer any appetite or people are constantly eating.
Actually simple decisions such as the choice of breakfast can no longer be made and result in a big one indifference.

Postoperative Depression or Just Exhausted?

Many sufferers and their relatives are unsure when it comes to distinguishing between postoperative depression andUpset"Or"exhaustion“Goes. Because when thinking about operations or hospitals, many people automatically feel uncomfortable. If the symptoms described occur, many sufferers blame the operation and the resulting physical complaints. Loss of appetite is explained by the side effects of the medication, and tiredness by the after-pains Anesthetics or the listlessness with pain in the operating area.

To some extent, the descriptions often apply. Major operations are an enormous physical challenge!
However, if they exceed a certain level or a proportionality, a postoperative depression can be considered as a diagnosis. Of course, the time frame is also decisive. If symptoms appear right after surgery and resolve within a month, there is nothing to worry about. However, if the symptoms last longer, maybe even years, it could be postoperative depression.

prevention

To prevent it from occurring, patients can take some supportive measures before the operation.
The central point for many of those affected is the feeling of being fear. The uncertainty and lack of ideas about the time after the operation cause great uncertainty. Therefore it is strongly recommended extensive discussions with the attending doctors and surgeons. Ask all the questions that are on your mind about the post-operative period! Out of shame and fear, many patients simply do not trust each other. Sometimes it can help to have a friend or family member with you during the educational meetings. Additionally, it is wise to ask important questions note, as aspects can quickly be forgotten in the excitement.

In the ideal case, you can finally get a fairly precise picture of the time after the operation and do not run the risk of being thrown back by excessive expectations. Openly address the fear of developing postoperative depression! In this way you are already sensitizing your surroundings and you don't run the risk of being overlooked.
Friendship or family relationships are extremely important after the operation. It can help to plan fixed visiting rituals and create structure before the operation. There are also in all hospitals pastoral staff, which offers calls without being asked.

In which procedures is postoperative depression particularly common?

Since the anesthetics are of great importance in triggering postoperative depression, there is generally a higher risk with operations that are performed under general anesthesia than with operations that only require regional or local anesthesia. In addition, the risk is greater with larger and longer-lasting interventions than with small operations. However, special interventions that generally have a higher risk of postoperative depression could not be reliably proven.

therapy

Postoperative depression can be treated in different ways and therapy is adjusted according to the severity of the symptoms. First of all, it is advisable to seek an open conversation with the doctor. Often notice Relatives make the changes first and contact the specialist staff.Sometimes detailed discussions with the attending doctor are sufficient, but a psychotherapist / psychologist can also be called in.

Often those affected are already relieved when the problems come up. It can help to relate surgery in terms of a life-changing event to your current mental state. Memories of past life crises successfully overcome can also give the patient new strength. When drug treatment come in the first place Antidepressants for use.

How long does postoperative depression last?

No general statement can be made about the duration of postoperative depression. Some patients have only a short episode of depressive mood after the procedure. This often only lasts a few days to a few weeks. In some cases, however, depression also occurs after an operation, which persists for a long time and requires treatment through psychotherapy and possibly medication. On the one hand, it is possible that a first-time depressive episode is triggered by the intervention. On the other hand, people who have already suffered from depression can have their symptoms recur as a result of the operation. The question of the duration of postoperative depression is made more difficult by the fact that many connections in this area are still unexplained and there is a need for further research. In any case, it is advisable to get help if you have a long-standing postoperative depression (e.g. more than two weeks). The contact person can be, for example, the family doctor, a psychologist or a counseling center.

Conclusion

After operations, attention is usually only paid to the patient's physical condition and his psyche is disregarded.

Postoperative depression is a growing problem. In our society, psychological complaints are unfortunately often put behind physical well-being. Out of shame and fear of Stigma (“To be pigeonholed”), many of those affected deny their suffering and thus enter a vicious circle. It is therefore extremely important to distinguish between postoperative depression and normal fatigue. Because only if timely Therapy measures are taken, there is a prospect of improvement!