Why does OHS cause depression?

[debster913]

Hi, all--

I'm sure I'm beating a dead horse here, but I'd like some insight into why some of us have suffered from depression following valve surgery.

My GP recently diagnosed me at my check-up with post-traumatic stress disorder, gave me a three-week sample of Lexapro, and scheduled a follow-up for next week. Turns out (duh to me!) that my weird mood swings, periods of restlessness and conversely, fatigue and all were depression. She says that I've been depressed since my valve surgery and never really acknowledged it. On top of all that, with my mother's illness, my emotional state has taken another hit. I recently fournd out that Mom's cancer has spread, and she has little time.

The Lexapro seems to be working well--I have more "want" to do things, I seem to be in a more positive frame of mind, and while getting together with some friends last weekend, the hubster says he hasn't heard me laugh so heartily in a long time.

But, what exactly is it about the surgery that triggers such a change?

Thanks,
Debi (debster913)

 

[Ross]

Short and sweet--It really stirs up and confuses your body chemistry. Everything has to reset and it takes time. The other part that some don't care to hear from me is that, I believe the heart is the gateway to the soul. They virtually messed with your soul and it's grieving over it.

 

[Cooker]

I really did not get depressed but I did get a bit worried when my recovery did not go picture perfect. I guess I you might say that I got a little down having to adjust to being on coumadin the rest of my life but even that cleared up when I stabilized and it was just another pill.

As Ross said, OHS messes with the entire body and all of chemical imbalances wreak havoc on many. I never really got 100% back physically until about 14 months post op. My S.O. says that I am more cheerful than during those 14 months so maybe I was depressed a bit and did not realize it. I know that it is very, very real for many, I hope that it improves for you soon. Maybe half the battle is recognizing what is going on.

Tom

 

[hensylee]

nobody on this board has ever been able to explain. We just know that from posts and from cardiologists that depression often goes hand in hand with heart issues. If someone has an answer, we'd all like to know what it is.

 

[sonavogel]

I think this is a VERY interesting topic, and one that most OHSers can address in some form or other. After all, if OHS messes with the body's chemistry, why does depression have to be the result--I mean, what about the other pendulum swing: eternal cheerfulness or a consistently upbeat mood swing? Has that ever been anyone's experience?

My dad had his mitral valve replaced when he was 80, and thanks to his negative, dour, fearful nature, heendured a protracted, 6-week ICU stay that resulted in the dreaded "ICU psychosis." At one point, they put him on Prozac, and my mother and I freaked at the change in him: He became sweet, cheerful, positive, a joy to be around. Once he began to rally physiologically, however, he was moved to a semiprivate room and taken off the Prozac, and he became Dad again.

So I'm curious as to whether the personality "disorders" can work either way post-OHS: depression OR Rebecca-of-Sunnybrook-Farm.

Any thoughts?

Best, Sona

 

[MikeHeim]

Deb-
Long time, no talk. I certainly don't have a medical explanation, but I think I know what got to me. There was so much stress leading up to the event, I had assumed that afterward I would feel nothing but complete relief that it was over. Every day I was supposed to feel a little better, and soon I was going to be as good as new. Fact is, when you get out of surgery, you feel like crap. The next day you also feel like crap. The third day isn't much better. Even as you do start to get better, the process is so slow that it is hard to bear. I remember thinking HUNDREDS of times that there was no way I would ever be "as good as new". In some ways, I'm still not sure. As everyone knows, your recovery always has bad days and weeks (from a physical standpoint). During those, I was constantly afraid that something was wrong, I would need another surgery, and I most certainly was not going to live long enough to experience the joys of later life, such as retirement, grandchildren, etc. I think all of that takes a toll and keeps your overall mood from getting too high. The fact that every day I visit this site and at least read through the recent posts shows that I have never really gotten over the fact that I am a "heart patient". I just think it starts to wear on you after awhile.

Be well.
Mike

 

[Bina]

Hi Debi,
I'm so sorry to hear that your Mom is having a rough time battling her cancer....what a difficult year you have had.

Post op I did okay for the first 2 months....I had a neighbour cooking for us, I had a home nurse coming in, people were calling to check on us, etc.
Then in January it kind of hit home that I was still recovering very slowly, my friends were thinking I should be back to "normal" and winter was in full swing.
It was VERY hard.....I actually hinted to God that I was fed up and would he just take me away in my sleep....I guess alot of that was also because I had lost my Mom 2 years earlier and life was seeming very unfair.
Facing death or our own possible mortality is a sad, scary place to be.
Then I would look at my hubby, daughter, and pets.....knowing that the nicest thing I could do was keep trudging along and give my recuperation the effort it deserved.

 

[briansmom]

I know what I went through as mom of the patient. I can only imagine what all of you have gone through.

I find it interesting that Adam did not go through it as bad as other patients. I would be curious to know if other 12 steppers had the same experience. As a 12 stepper, Adam has already learned to "accept what can not be changed".

Also, I had a near death snorkeling accident a few years ago and I had a problem with PTSD a few months afterwards. I think that facing your own mortality, especially when earlier than expected, seriously messes with your head. Add to that all the drugs and invasiveness of OHS and there is a recipe for depression.

Be patient and forgiving with yourself. I think that you are on the right path.

 

[tenndon]

I am also one who never experienced the depression that comes with OHS. I think part of that was because I had to fight to survive the complications and had a very strong will to live. But even beyond that it was my faith. I knew that whatever the outcome from surgery or recovery I was going to be a winner. There is no doubt in my mind that is why I came through with a smile.

Also, when I got home the hospital where my wife works went on strike the next day and she had to pull 12-14 hour shifts because she is management. So in order to help her I pushed myself to get active and do more than I really wanted to. It helped me very much though. Like cooking her supper made me feel needed and able, not like someone who just had 3 surgeries.

You must also remember I am the type of person that will have fun and be happy locked in a dark closet or in the middle of a crowd.

Hope you start feeling better soon.

Peace of Christ,
Don

 

[Philip B]

Post-Traumatic Stress

Post-Traumatic Stress

Welcome to the world of post-traumatic stress...

The folks at my cardiologist's office attribute post-traumatic stress disorder following OHS to the stressor chemicals (they have a name for the chemicals, but it escapes me right now) that build up in your system as you deal with both the mental and physical trauma of the event. According to them it's very common.

It hit me when I was over a month post-op. Mentally and physically I was doing really well and then it hit me like a hammer. When I called the cardio's office and spoke to my nurse about it she immediately asked me what had happened to trigger the release of the stressors. She told me the stressors are just sitting there waiting to be released. In my case, the trigger was having to let a long-time employee go.

All this said, I tend to agree with Ross about the heart being one's soul. If your soul is messed with, problems result. It's simpler than the chemical explanation.

-Philip

 

[Sagebrush]

the soul

the soul

I actually went to a counselor about work issues and we talked about my heart surgeries. She said there was a book about this: depression and the soul, but wouldn't you know I can't find the little piece of paper she wrote it on.

 

[Freddie]

My doctor call it a "Medical Adjustment". Everything was said and done in 10 days. And it was a lot to take in, since I had no symptoms. I took long walks, and pushed myself on doing things that I used to enjoy.

I still have to push myself, but its getting better...........slowly. Its been 4 months since my OHS.

I also started a journal and wrote all my thoughts and fears down. It helped me clear my mind and generally just made me feel better.

One more thing, the people on this forum are the most informative bunch. They will help everyone with everything.

Give yourself time.......it will be okay

 

[Marguerite53]

W When I called the cardio's office and spoke to my nurse about it she immediately asked me what had happened to trigger the release of the stressors. She told me the stressors are just sitting there waiting to be released. In my case, the trigger was having to let a long-time employee go.


-Philip

I wonder how long the stressors hang around waiting to be released! I'm 15 months post op. For the first year post op I was Rebecca of Sunnybrook Farm! But 2 months ago I had to reassess where my 87 year old father was living, deal with administrators whom I felt were doing him wrong, hunt down a new facility for him, deal with his failing mental (and now drugged) state, face doubling the cost of his care (and if anyone knows about "points"...this is just the early stages of cost). Anyway. He's my best friend on the planet next to my husband and children. I have been way over stressed (medicating on chocolates and before-dinner drinks) and I think, grieving some, too, since he is falling away from me. Anyway. From some of the things you have decscribed, I'm beginning to wonder if I'm not experiencing one of these types of depression. I have NO motivation and my normall everyday sparkle is poof! gone. I've been giving the dust time to settle (he is moved, and the place is wonderful....heaven on earth actually!) but 3 weeks seems long enough.......

Thank you for starting this thread Debi. It has certainly been a help to me. I hope you are able to enjoy the time you have with your mother and that she isn't suffering too much.

Marguerite

 

[hensylee]

we have spoken of after surgery depression, but from what I have gleaned in my searches, depression goes along with any heart issue, even with no surgery involved.

I, too, like some others here did not have depression issues. I got along just fine and was anxious to be up and back to doing everyday things. It's a toss up, I guess, as to who has it and who doesn't.

I do believe that anyone who has ever had a heart problem, no matter what it is, lives with it every day and if something goes wrong with us, the first thought is 'is it my heart'? betcha

 

[dot4toto]

It'll get better

It'll get better

I wasn't told I could get depressed, so after my last surgery (7yrs ago). I was shocked to know I was. It took a year for me to realize (kinda slow).

I had some complacations with my leg(heart/lung mech.) nerve damage and the pain was almost more then I could take. That got better over 6 months but my leg never got all the strength back. I think I just wanted to be my old self and it just takes time. And medicine for me, balance my chemicals back out. We never know how we're going to do.Everyone goes through surgery and recovery differently.

I have surgery again, but this time I'm already doing better because I'm on meds for depression now. It's helping me so much.
I hope you continue to feel better and laugh.
I'm sorry to hear about your Mom. I bet she likes to hear you laugh...
Take care,
Tina

 

[surfsparky]

"I do believe that anyone who has ever had a heart problem, no matter what it is, lives with it every day and if something goes wrong with us, the first thought is 'is it my heart'? betcha"[/QUOTE]

I agree with this completely. When myself or our 3 little ones get a cold we are not too concerned, but when Chris catches it we are constantly on the lookout for signs that it has developed into a chest infection and therefore will need antibiotics straight away.
And if he has anything out of the ordinary eg. niggling pain, dizziness, our first thought is, 'is it the heart?'.
Heart conditions live with you everyday. Concerned thoughts come up constantly, we just try not to dwell on them. Which is quite easy most of them time with 3 giggling youngsters around to distract us!

Yolanda

 

[Adam 12-21-05]

I don't know about most of you...

But, I call cardiac depression the 'Black Hole' of heart valve surgery recovery.

I was doing great for the first three weeks post-op and then...

SLURRRRRRRRRRRRRRRRRRRRRRRRRRRRP!!!!!

The 'Black Hole' sucked me in for several weeks. Luckily, I had some great caregivers and doctors who showed me the light. Phew!!! That was a miserable time full of gloom and doom.

FYI, there have been a bunch of studies on the frequency of cardiac surgery in OHS patients. I have seen research reports citing 30%-75% of all OHS patients experience some form of cardiac depression.

When I ran a survey earlier this year on the topic, the results showed that 32% of the sample group of former heart valve surgery patients experienced the 'Black Hole'.

I'll try and embed the chart here.... Let's see if Mr. Computer Clutz can do it...

Anyways, I hope that helps some.

Cheers,

Adam

 

[catwoman]

I think part of the reason we experience depression is also because a working heart is crucial to life. When it ain't working, it's scary -- regardless whether you acknowledge it or not.

You really come face-to-face with your mortality.

It takes courage to go through OHS.
Yesterday, I spoke with a woman who just lost her son that morning due to complications after an LVAD implantation, which was successful in itself. Her son was hoping to get a heart transplant. I told her that her son was courageous. And she said, yes, he was.

 

[VikiVix]

post op depression

post op depression

I had depression too. I would just start crying for no reason. The doctors said it was normal and put me on Zoloft for 3 weeks which I didn't like at all so we stopped it.
I still feel weird and depressed now and then but don't know why.
A friend suggested this.....no one has ever "touched" your heart before or invaded that internal space. So I believe maybe our hearts are what are expressing the sadness of the wounds they've had.
I also believe the joy will return as we heal. Laughter and love is the best medicine for all of us.
And I hope a little love makes it through all the posts here to you along with the humor.
May each day brighten for you!
Viki

 

[Elcarim]

Wow, this has been very interesting for me to read. I have an appointment with my psychologist in half an hour. I am being treated for PTSD.
My last surgery was nearly 2 years ago. It came at a time when I should have been looking after my newborn second child. So I missed out on a lot of time with him. I also had only had my tissue valve for 5 years. I had nerve damage from the surgery and ended up with a pacemaker as well. So it was a pretty rough time.
I was fine for months and months, until my pony badly injured himself and I was not able to ride. Riding had been my coping mechanism, without it I was unprotected and I got severe anxiety. I thought I was dying.
Physically, after 18 months, I should have been recovered from the surgery. I felt better than I ever had.
So I do not agree that it is because your body chemistry is messed with or your soul is poked. It is because you have been given a good reason to doubt that everything will be okay, because for you it almost wasn't. You have looked death in the face. It changes you and it is very scary. Coming back from that is easy for some people and not so easy for others. Some people can smile and get over it, or rely on their faith, but some of us can't. We need to process it and come to terms with it. That takes time. Sometimes we need to change the way we think about things in order to move on. That can't always be done without help.