Depression After Surgery

Posted: February 16, 2018

Depression After Surgery

If you are planning to undergo a gender confirmation surgery, or for that matter any surgery, this is something you really should give serious consideration to. We see it very regularly in the days and weeks after surgery, and sometimes it is so overwhelming that patients attempt to take their own lives. It is something you must watch out for, and be ready for, and have a plan in case it happens to you.

Why does it happen?

It seems counter intuitive! So many people are so excited about their gender confirmation surgery. They’ve worked so hard, to get here and finally the day arrives, all goes well with the surgery, they are recovering physically well afterwards, but are feeling terribly low, and why is that?

These are some of the reasons I believe why patients struggle with depression after surgery:

  1. Pain
    There are a lot of real physiological things going on. Surgery is a massive stressor, in that you are dealing with pain. We try to do everything we can to make our patients as comfortable as possible, but unfortunately pain will always be there, hopefully not too overwhelming.
  2. Hormones
    Around the time of surgery, depending on what surgery you have, you can have a massive fluctuation in your hormones. For example for our MTF bottom surgery patients, we have them hold off their hormones before surgery to prevent blood clots and then at the time of surgery, again if they are having testicles removed we can see huge swings in these hormone levels. This results in patients feeling tired, lousy and tearful.
  3. Loss of daily routine
    Always you are away from the familiarity your daily routine and find yourself in alien surroundings, instead of enjoying a coffee in the work canteen you are sitting in a hospital bed, you are not seeing your usual social contacts only unfamiliar people and all this can be very upsetting.
  4. Anxiety
    There is always going to be an element of anxiety, this overwhelming feeling of “what have I done to myself”. This, from what my patients tell me, is pretty much the norm and can last quite a long time as well. This is not necessarily regret but just a scary feeling that goes with all these new unfamiliar routines and changes in your anatomy. What is clear from all of the above is that a plan is needed for after surgery. This may be a quick and easy way to check in with your therapist, if you are beginning to feel overwhelmed, or at least knowing that your support system is there.This is a serious issue, unfortunately we see it a lot after surgery, know that it is temporary, know that it is quite a normal part of recovery for a lot of our patients. I hope this helps you to understand post operative depression, what to do to prepare for it, and be reassured that it is normal.

Dr. Sidhbh Gallagher
University Gender Affirmation Surgery

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