Major surgery can shatter that image, and with it the concept of self-sustaining health. The feelings of mortality, of loss, and of vulnerability can be profound, and recognizing depression in surgery's aftermath becomes very important. Depressed patients have a significantly higher rate of complications. If you're not able to participate in rehabilitation, if you're not as active, the whole process of recovery just slows down. Delirium is another condition that can occur during the one or two days immediately following surgery, especially among older people.
Doctors recognize what's happening when patients become incoherent, disoriented, or hallucinatory.
Postoperative depression, on the other hand, is more likely to occur well after the crisis of surgery has ended and the patient is back at home or even at work. That can make it particularly difficult for patients to cope with feelings about what they've endured and what their future is likely to be, or for family members and physicians to see and understand their feelings. Stigma continues to surround depression, adds Vaccaro, and many patients may hide their state of mind from families and caregivers alike. Even among primary-care physicians, depression goes unrecognized about 50 percent of the time, Stern explains. Many doctors don't know the criteria, and don't speak with patients long enough to establish whether they have the symptoms of depression.