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How to Deal with Depression after Major Heart Surgery

written by: Dr. Jerry Kennard • edited by: Paul Arnold • updated: 6/6/2012

For many people who have had successful heart surgery, the operation is followed by a severe period of depression. The good news is that there are effective ways to treat depression after major heart surgery.

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    Depression After Major Heart Surgery is Common

    Considering the pain, discomfort and debilitating lifestyle suffered by many people in the lead up to major heart surgery, it may seem odd that depression after successful major heart surgery affects so many people. Current estimates put the rate at around one in every five patients. People with a history of depression, or people depressed around the time of surgery, are much more likely to suffer depression post-operatively.

    Depression after major heart surgery can appear almost immediately or there may be something of a time lag, even as much as a few months. It may be a mild onset or the symptoms may be far more severe.
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    Some Symptoms of Depression After Major Heart Surgery

    • Listlessness, irritability and feeling flat.

    • A general sense of pessimism.

    • Sleep disturbances (also fairly common immediately after surgery).

    • Aches, pains and digestive problems (again, some are common after surgery).

    • Loss of interest in surroundings, activities, sexual activities and former hobbies or interests.

    • A general sense of pointlessness or hopelessness.

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    Treatment Does Help

    Antidepressants

    Most people who receive treatment for depression feel the benefit. These may not be immediate, as in the case with antidepressants, but there is usually a gradual elevation of mood within four to six weeks.

    The most popular type of antidepressant falls into the serotonin reuptake inhibitor (SSRI) category. Serotonin is a naturally occurring neurotransmitter that tends to be concentrated in the brain. Depression is thought to come about as a result of varying levels of serotonin. The action of SSRI drugs is to inhibit nerve cells from taking up serotonin too quickly, so leaving more in the brain.

    The reality of antidepressants medication is that it doesn’t suit everyone. Some people simply don’t respond to antidepressants and feel even worse because they think nothing can help. Such people are referred to as ‘treatment resistive’, but this can give the impression that the patient is somehow at fault, rather than the medication being ineffective. It’s also the case that medication isn’t the only effective therapy and this brings us to psychotherapy.

    Psychotherapy

    It’s unfortunate that so many people still regard cognitive behavioral therapy (CBT) with a degree of suspicion. It is sometimes thought of as mechanical or little more than brain washing, but neither comes even close to the truth. CBT has a well established track record in the treatment of various psychological conditions, including depression.

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    Will CBT Work For Me?

    There is every reason to be optimistic. Because the underpinnings of depression involve the way we view the world and how we think about ourselves CBT can help to change both your thinking and your behavior in order to achieve a more balanced perspective. A full treatment package may be as short as six weeks, but could last six months. The pace of treatment is in your hands. With the help of the therapist it is you who will decide what you want to deal with and when. At no stage will you be asked to do anything you don’t wish to do.

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    References

    Two Non-Drug Treatments Appear to Reduce Depression after Heart Surgery. Medical News Today http://www.medicalnewstoday.com/articles/145256.php

    Reducing Depression after Heart Surgery. Psychcentral.com http://psychcentral.com/news/2009/04/06/reducing-depression-after-heart-surgery/5171.html

    National Heart Lung & Blood Institute. What to Expect After Heart Surgery. http://www.nhlbi.nih.gov/health/dci/Diseases/hs/hs_after.html