I had surgery, it made me unstable, to say the least. Help!
September 29, 2009 9:36 AM   Subscribe

I think having surgery made me anxiety prone and depressed. Is this possible and will I go back to being myself after I fully recover from the surgery? I know YANAD.

Let me first apologize as this will probably go long. I had major foot surgery in the last few months. About 4 hours after getting home from the surgery, I had a panic attack (rapid heartbeat, sense of impending doom, the works) due to the cast. It was making me very claustrophobic, not being able to move the foot, etc. I was yelling at my husband to take me to the ER to get it off. I was able to calm down, but had several more panic attacks that first week. I finally broke down and saw my family doctor who prescribed an anti-anxiety pill (Klonopin). This made me feel better and I take it as needed. I now feel like I'm starting to get depressed, though.

Some relevant facts:
1) Before all of this, I considered myself to be emotionally stable, no anxiety, depression, no other health problems, not on any type of medication.
2) I did have some mild claustrophobia prior to this - I don't like MRI machines or any kind of restraints (like those over-the-head things on roller coasters), but it didn't really interfere with my life.
3) I have not worked in 8 weeks, which probably doesn't help my state of mind since I HATE sitting at home, but my desire to go back to work is zero. I am scheduled back in the next week.
4) I thought after I progressed through each step with my foot I would feel better, but this hasn't really been the case. For example, when the cast came off, I felt better for a short time, then had anxiety due to the pain of transitioning to a walking cast. I just came out of the walking cast and again I felt momentarily better, but the longer the recovery goes on, the crappier I feel.
5) I would prefer not to be on anxiety medication for long. My physician keeps telling me how addictive it is and how horrible the withdrawal is. She says that if I continue to need it, she will transition me to an anti-depressant.

I know I should probably see a therapist and psychiatrist, but I was wondering if anyone had gone through something like this after surgery and how you dealt with it. Even if you didn't, I'll take any personal insight you might have about dealing with anxiety and depression.

Anonymous because I don't really want to share the ordeal with some people who may read this. My husband is the only person who really knows the whole story right now and I'd like to keep it that way for the time being. Hope that makes sense. Throwaway e-mail: foot_bad@yahoo.com. Thanks.
posted by anonymous to Health & Fitness (14 answers total) 2 users marked this as a favorite
I had surgery on my neck a couple of years ago and I had a TON of anxiety afterwards. It didn't last as long as yours - only a few days, in my case - but it was pretty bad. Getting back into your regular schedule will probably help. (IANAD.)
posted by tamaraster at 9:44 AM on September 29, 2009

Me too, I had neck (thyroid) surgery about 9 years ago.

I think the anesthetic made me kind of whacked out for a while. I was completely under for the surgery. It took a few weeks for me to feel okay mentally. I think (although I don't know for sure) that was from getting the anesthetic out of my system. Plus, I had never had any kind of surgery before and it freaked me out. I was really tired too, and had just started a new job, and I had no paid medical leave accrued yet. So I worked half days and then would go home completely whipped. I slept a lot. I mean, a lot.

Rather than attribute your anxiety and panic to the cast, I would suspect the medication for anesthesia. I have had panic attacks in the past, and they totally suck, but mine have gone away mostly. I only have them now every few years. And the best thing about seeing a psychiatrist is that they can help allay fear. The good ones can. So even if you are fine, it might be worth it to talk to someone just for the emotional support.

Good luck.
posted by chocolatetiara at 10:17 AM on September 29, 2009

One thing to consider is a different anti-anxiety med. I'm prone to panic attacks. Klonopin makes me feel depressed. Ativan does not.
posted by chez shoes at 10:19 AM on September 29, 2009

I did not have surgery, but I was in the hospital with severe pneumonia earlier this year which was brought about by a traumatic event, and was hospitalized for a week and forced to stay at home for another week after that.

I had many of the psychological symptoms you describe, but did not recognize them as they were happening. I've only just now gotten over it by recognizing that I'd had a major thing happen and though it may not have been life threatening, it was certainly scary and by not dealing with the emotional repercussions, I'd gotten very anxious, felt weird in public even when out with just friends, and pretty much only hung out with my boyfriend in our apartment except when at work.

My recommendation is to try to be as social/public facing as you can stand, and to recognize that healing your mind is definitely part of this process.

I haven't seen a professional about this, but I'd recommend doing so or talking to your physician to see if they have counselling for this exact situation (post-surgery).
posted by MCMikeNamara at 10:20 AM on September 29, 2009

Everyone deals with this stuff differently. There is no set way to deal with it. What works, works. I have a history of depression so I was in bad shape after surgery. Some of the things that helped me cope were:

Order. I like order and I can't stand it when things don't go according to schedule.
Simplicity. Self-explanatory.

a. My two closest friends back then came to visit just about every day. Mainly a lot of talking, board games, and food. They'd help me get to the park about 10 minutes away about three days a week.

b. I dedicated about 4-5 hours a day to writing. I'm not a writer, but I had a lot of things to get off my head. I typed up in all about 300 pages of material. The writing actually evolved into a long term personal project I still work on today.

c. Conscious avoidance of depressing things like the news or people in very bad moods who always complain.

d. I listened to comedy everyday. I tuned into a Internet radio channel that had comedy running all day.

Don't get me wrong. I was still somewhat miserable, but I prize order and a sense of purpose over happiness. I don't like being happy and aimless.
posted by fairykarma at 10:24 AM on September 29, 2009

I had a parotid gland tumor removed almost two years ago. It was the most emotionally fraught time in my entire life, and I've given birth twice. Those were cake walks compared to the surgery I had on my face.

I was terrified of possible permanent side effects, like paralysis on one side of the face. I was also anxious about the possibility of the tumor being malignant. I was also completely and utterly terrified of the general anesthesia. So much so that I had a panic attack when the anesthesiologist came in and he had to give me a sedative to calm me down.

The surgery itself went fine; the tumor was benign, and I began the recovery process. I spiraled into depression because the pain was so much worse than I had anticipated. I couldn't eat, not even soft foods, because even opening my mouth hurt like hell. I wasn't sleeping because my favorite sleep position is on my left side, and the surgery was on the left side of my face. I was swollen and paralyzed and I felt like shit. My kids were afraid to look at me because the scar was awful.

Fast-forward a few months and things were much, much better. The pain was mostly gone, the paralysis was mostly gone, and I was able to sleep again. The depression eased considerably. Now, almost two years later, I can look back at that time objectively and I know the pain and the sleep loss were the biggest contributors to my depression and anxiety. Plus, the unknown variables of "will this get better?" and "will I be permanently paralyzed?" (I wasn't, by the way.)

Surgery can really mess with people. Talking with a therapist or your doctor might be really helpful for you.
posted by cooker girl at 10:30 AM on September 29, 2009

Oh, one more thing: a good friend who is a doctor told me that it can take sometimes take a few months (!!) to recover fully from general anesthesia. I wish I could remember what she told me the reason was, but I certainly experienced that. It took me forever to feel normal again.
posted by cooker girl at 10:32 AM on September 29, 2009

I wonder if you had a waking experience yet don't remember it? A therapist wouldn't be a bad idea. Sorry you're going through it.
posted by stormpooper at 11:09 AM on September 29, 2009

As a data point.... my acupuncturist and shiatsu therapists agreed with each other that any kind of surgery (ie - cutting into the body) represented a trauma by definition. Thought being that the experience required a little "working through" in one way or another.

Maybe consider some kind of holistic care or therapy?
posted by jbenben at 11:21 AM on September 29, 2009

Lack of exercise can lead to anxiety/depression symptoms in many people, and I'm guessing that you haven't been doing much exercise with the cast on your foot. I'm guessing that running is still out of the picture, but you'll probably feel a ton better if you can get on a bike (stationary or not) for 30-60 minutes 3-4 times per week.
posted by ripple at 11:34 AM on September 29, 2009

I've been through this too and watched my mom go through it too. I recommend Andrew Weil's book "Spontaneous Healing." Practicing his breathing exercises worked wonders for me. You should also try whatever gentle strectching you can manage. If you can find a restorative yoga class, that would be ideal. And give yourself time. Surgery is a major trauma that has physical and emotional consquences. It sucks, but you will get back to normal eventually.
posted by JennyK at 11:57 AM on September 29, 2009

The side-effects of anti-anxiety drugs can be depression. Talk to you doctor.
posted by damn dirty ape at 12:21 PM on September 29, 2009

Here's a theory based on psychology/scientologist hooey and some personal experience - take it for what it's worth:

General anesthesia just makes you unconscious; it doesn't do anything about pain signals to your brain. So if you were put under (I don't see that you say so) and then operated on...you were unconscious but your brain was still awake and feeling every cut of the knife. That would be traumatic and would cause anxiety and depression symptoms.

It's sometimes a justification for why people are afraid of the dentist, even if they get work done under general anesthesia - to your conscious mind, you just go and sit in the chair, get put under, then wake up and feel sore; to your brain/unconscious mind, going to the dentist means you sit down, get rendered helpless, and then caused a great deal of pain. No mystery why dentists would cause anxiety, or why thinking about your foot operation would do the same.

I know that when I had to get an emergency appendectomy and was under general anesthesia for an extended operation, I woke up from it not just disoriented/woozy, but actually combatitive. I wanted OUT - of the bed, the hospital...I even tried to take a swing at a nurse trying to calm me down. It was as if I had been kidnapped or something and wanted to escape my captors. Even after that wore off in a few hours, I had the experience described by other above, that I didn't feel "right" mentally for almost a year after being put under for the operation.

A lot of people seem to deal with this differently, just as some people seem to deal with other traumatic events differently. Maybe you'd feel more OK about not feeling OK if you though of it as "well, I got knocked out and my foot cut open; even though it was voluntary, maybe my body/subconscious are still pretty freaked out about that" and approach dealing with it that way?
posted by penciltopper at 12:58 PM on September 29, 2009

In a hurry, so haven't read all responses. My doctor warned me when I was contemplating back surgery that surgery can sometimes cause depression. She told me she herself always has pretty severe depression after surgery and she thinks it is anesthetic-related. So, yeah, it happens. Probably wouldn't hurt to try short-term medication.
posted by threeturtles at 3:42 PM on September 29, 2009

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