Why do I feel so sad, post wisdom tooth extraction?

November 28, 2013 11:21 PM

I had a wisdom tooth extracted yesterday, surgically with IV sedation. I was very very nervous, but it went fine, and today the pain is under easy control from paracetamol. However, I feel not just completely drained (which is, I guess, understandable given how tense I was yesterday and the small physical trauma) but unusually sad. I can't remember the procedure due to the sedation, and I feel weirdly like I'm missing a bit of time that I shouldn't be. I feel ashamed that I was so nervous beforehand. But more than that I just feel so sad about nothing I can put my finger on. I take lofepramine for depression, which is generally pretty well under control. Would any of the drugs I might have been given yesterday counteracted it? Has anyone else experienced this?
posted by anonymous to Health & Fitness (17 answers total)

Iv sedation always makes me feel weird and sad afterward. I would personally give it three days till I worried about being overly sad or even crying. I'm not taking anything for depression though.

I'm glad your pain is under control! Cuddle under a blanket and watch telly if you can.
posted by mgrrl at 11:51 PM on November 28, 2013 [2 favorites]

I would give your anesthesiologist a call and let them know that you're feeling this way. They may be able to confirm if anything you had in your system for the surgery disabled your lofepramine or subdued its effects.
posted by These Birds of a Feather at 11:57 PM on November 28, 2013

I had a procedure that required IV sedation a couple of years ago, and I got very anxious and weepy too. Wound up Asking Metafilter what to do. I was on an antidepressant at the time but wound up being sick with what we think was a stomach virus at the exact same time, so I went about 3 days without keeping any of the antidepressant down. That might have played a role as well, but I think it was more the IV sedation (that I had NEVER had before, so I had no idea what to expect) and the fact my body was tired and off kilter from everything that did it.

I felt better around day 4...it also helped that the stomach virus abated around then and I could keep food down. But while I initially tried to fight through not only the roller coaster emotions but the pain and the stomach virus and pretend life was normal, I finally succumbed to the couch for a full day (New Years Day, to be exact) and did nothing but watch TV, sleep, and cry if I needed too.

So, you have my permission to rest, relax, and cry a bit if you need to release tension. It can take a full 24 hours or more to clear all of the sedation stuff out of your system, so don't fight it. Each day will get better as you heal.

Get well soon!
posted by MultiFaceted at 11:58 PM on November 28, 2013

Anaesthesia is a deeply weird experience that it is okay to feel weird about, and it's okay to feel afraid of surgery. Give it a couple of days before you start to be concerned, imo.
posted by empath at 12:23 AM on November 29, 2013

I felt like I'd been beaten up after I had two wisdom teeth removed. Small, sad and sore. I didn't go into the whys and wherefores of it much, just allowed myself to feel that way, called in sick, drew the curtains and took care of myself. It was about five days until I felt normal again.

Bon courage!
posted by ZipRibbons at 12:32 AM on November 29, 2013 [2 favorites]

All sorts of things can trigger my depression, many of them less serious than anesthesia. If I were in your position, I'd give it a couple days and expect to feel better then.
posted by professor plum with a rope at 2:41 AM on November 29, 2013 [1 favorite]

Totally normal for both strong painkillers and dental surgery in my experience. The anaesthetic I got at my old dentist used to make me feel like throwing myself out of a window, and my recent ankle surgery left me feeling very sad and tired and weepy. Be kind to yourself for a couple of days and it will pass.
posted by corvine at 3:59 AM on November 29, 2013 [1 favorite]

My father had a similar experience after a general anaesthetic for some knee surgery. He told me that when he came to in his hospital bed, he felt sad - and this is not a man particularly prone to talking about his emotions. Give it a little time.
posted by henryaj at 4:02 AM on November 29, 2013

If it makes you feel better, three days after recent surgery, I ended up emailing my uncle (who is an anesthesiologist) to say "Should I file for divorce? Because I am presently totally convinced my husband is a dick and I should totally file for divorce. PS: Pretty sure husband is not really a dick." He reassured me this was totally within the realms of post-operative normal and would lift. And indeed, 48 hours later, this was nothing more than hilarious.

PPS: My husband is actually fabulous, but anesthesia is a bitch. You need to give it several days to leave your system, which it will.
posted by DarlingBri at 4:06 AM on November 29, 2013 [1 favorite]

There's a reason you're advised not to make life altering decisions in the first 24-48hrs post surgery - and this is it. It definitely messes with you.

I woke up from my own wisdom tooth extraction (IV sedated) crying because the feeling of "missed time" bothered me so much. It's not normal to just have hours pass that your brain isn't keeping tabs on and it can certainly mess with your head. Give it a few more days and take care of yourself.

If you still feel worried about it, go ahead and call your oral surgeon and talk about it. It is a side effect of your surgery and they may have advice on how to work through it.
posted by sonika at 5:25 AM on November 29, 2013

Just a non-anesthesia related piece of data: In times when I've been really, really nervous or anxious or even really, really excited/happy, I often kind of crash and get hit with hard depression afterward. It's like my brain used up all my happy/excited endorphins for that one instance, and it's just drained. Maybe your nervousness triggered this reaction.

Just n-thing that this is normal and to give yourself a break and take care of yourself for a few days.
posted by shortyJBot at 5:39 AM on November 29, 2013 [1 favorite]

Did you get much sleep after? A similar thing happened to me after I had my wisdom teeth out and sleeping for a while really helped. I remember thinking I'd gone from feeling like a hole in a mouth attached to a person back to being a person again.
posted by mlle valentine at 5:55 AM on November 29, 2013

Even though anesthesia as a concept is a great and wonderful amazing thing that I am very grateful exists, it's not actually very good for you - on a day-to-day basis - to do drugs until you are unconscious (and then keep doing them). That's a pretty gnarly hangover you're going to get from something like that, and any serious hangover is going to come with exhaustion and free-floating shame and generalized anxiety. You've kind of been poisoned, so you're going to feel crappy.

Completely separate but simultaneously is the physical trauma, so you've got two separate streams of neurological alteration going on.

The good news is that as long as you don't have any complications it usually only takes a couple of days of rest and good nutrition (do the best you can to get some vitamins, but don't push yourself; do drink water to keep hydrated) for your body to return to a pretty normal level of daily functioning. Don't be shocked if a few symptoms linger that mean you're not at your best - it may be a week or more before your sleep is really good, and there may be constipation and/or the opposite as you get it all out of your system - but you shouldn't feel so sad for more than a couple of days. If you do, let your oral surgeon and prescribing physician know.
posted by Lyn Never at 7:55 AM on November 29, 2013 [1 favorite]

I think that this depression-like reaction is not only very normal, but often useful. After a significant episode of stress and trauma, rest is the the number one thing that your body requires for recovery. "Depression," like pain, is one of the body's most effective ways of enforcing rest. Like a runny nose that flushes gunk out of your nose, it's a marvelously intelligent defense, even though it's temporarily unpleasant. Accepting it as part of the healing process, and giving in to the body's mandate for rest, seems to let it pass more easily.
posted by Corvid at 1:36 PM on November 29, 2013 [1 favorite]

There is another possibility. You may be experiencing neurological effects not from the anesthesia, but from the tooth extraction. It has been known for a long time that there's some kind of relationship between tooth loss and mental decline, dementia and possible Alzheimer's. That was not very surprising, because it was thought to be mediated through some kind of inflammatory process or the result of other effects of periodontal disease (the primary reason for tooth loss).

However, there have been very surprising results showing an effect of mental decline along certain dimensions, such as f.ex. memory, that are the result of tooth loss or removal that is not connected with losing the teeth to a disease process. The more teeth lost, the worse off the patient was. It didn't matter how the tooth was lost, including through the extraction of a healthy tooth, such as a molar / wisdom tooth. It appears there is some kind of connection between a tooth and neurons in the brain (possibly because of feedback from chewing - down to very specific area).

There was a Swedish study that looked extensively at this correlation in humans, but I can't find it at the moment. A quick google search shows however how this works in rats - molars were extracted in rats and that led to a direct loss of spacial memory, probably through an effect on the hippocampal cell density:

Effect of tooth loss on spatial memory and trkB-mRNA levels in rats.

"The mechanism by which tooth loss accelerates spatial memory impairment is unknown. The purpose of this study was to test the hypothesis that tooth loss affects trkB-mRNA levels and leads to an accelerated decrease in the hippocampal cell density in rats. A radial maze was used to evaluate the spatial memory of male Wistar rats that were categorized based on the number of extracted molar teeth. Number of hippocampal pyramidal cells and the trkB-mRNA expressions in the amygdala, perirhinal cortex, thalamus, and the hippocampal CA1, CA3, and CA4 areas, were evaluated using molecular biological techniques. Seven weeks after tooth extraction, maze performance was significantly lower in each tooth loss group than in the control group, and the number of extracted teeth was inversely proportional to the induction of the trkB-mRNA and the hippocampal cell density. The average weight of rats increased by controlled feeding throughout the experiment without showing a significant difference between the control and experimental groups. The results indicated that, in rats, the spatial memory-linked trkB-mRNA was reduced in association with the tooth loss; this supports the hypothesis and suggests that teeth have a role in the prevention of spatial memory impairment.[PMID:18446825]"

Since you had wisdom teeth extracted, you might be experiencing neurological effects of losses in brain areas associated with memory or other effects.

I am not saying the anesthesia is not the primary - or only - reason for how you feel. I am saying that there is another possibility - neurological effects of cell loss in the brain following the extraction of any teeth.
posted by VikingSword at 2:13 PM on November 29, 2013 [4 favorites]

I know I'm a little late in the game with my reply but I distinctly remember crying (yes, tears and everything, CRYING) shortly after having my wisdom teeth removed under IV sedation because I could not properly eat my milkshake due to numbness in my mouth. Retrospectively, the story fascinates me but I do blame the drugs. And the deliciousness of that milkshake.
posted by Stan Grossman at 12:31 PM on December 2, 2013

Mod note: This is a followup from the asker.

I just wanted to let you all know, and anyone who searches this question in future, that I felt a little better the following day and now, 4 days on, am almost right (and the physical pain went away days ago!).

I'm surprised that this seemingly not that uncommon side-effect wasn't in the list that they gave me (dry socket, swelling, nausea etc). I've contacted the hospital and I'm going to see if there's any way of getting it added. I feel like for anyone with a more serious risk of depression, or a more fragile mental state, this could be a higher risk than just a couple of awful days.

Sincere thanks to everyone who answered. It stopped me from thinking I was going mad to know that you guys or your loved ones were unfortunate enough to have had similar experiences. Thanks for being there for me x

posted by cortex (staff) at 1:59 PM on December 2, 2013