Posts filed under ‘Depression’

A Quiet Enemy to Recovery–Depression

Daryl Tomlin made a startling statement in an article published December 23, 2008 called “Depression After Open Heart Surgery.” He explained that “The greatest injustice done anyone facing open heart surgery is the lack of information and preparation for the depression that may follow.”  Well, sure, a 38-year-old adult may go through depression after such a major operation but what about our children?  Do they suffer depression after open heart surgery?

I discovered that the risk of depression after surgery for children is real and often present and overlooked.  A study performed in Korea at three major cardiac centers found that in 231 adolescents between the ages of 13-18, depression was a problem for 62% of patients (2008).  Some studies suggest that females have a higher incidence of depression following open heart surgery.

In 1998 the Alberta Children’s Hospital and the University of Calgary conducted a similar study.  This study contained similar results with more information regarding depression after open heart surgery.  Their study found that children with cyanotic heart defects (a defect resulting in deoxygenated blood passing through the body–often giving a blue appearance) were more likely to suffer from depression.  Their study stated that “children with cyanotic forms of congenital heart disease demonstrated more fears of the unknown, physiological anxiety, depression, and delinquent behaviors than the acyanotic children with congenital heart disease.”

While every child is different and every operation and recovery unique, parents of children and adolescents undergoing open heart surgery should be aware of this possibility.  Knowing the reasons and signs to watch for may help in the recovery process.

Some health professionals feel that their may be physical reasons behind this depression.  Tomlin states that some people believe the heart-lung bypass machine, no matter how safely screened the blood is, produces tiny air bubbles called emboli that are introduced into the body.  These tiny air bubbles can travel to the brain and block blood flow to the brain.  If too much air is present, mini-strokes or major strokes can occur.  Many feel that patients on the heart-lung bypass machine experience this mini strokes that alter areas of the brain slightly, causing depression.  Additionally, having decreased blood flow and higher oxygen levels in the brain can cause depression.  This may account for why children with cyanotic heart defects suffer more depression than those with acyanotic defects.

Others feel that the sheer volume of drugs and medications used during and after open-heart surgery may be to blame for the depression.  Tomlin states that blood thinners, pain medications, IV fluids, blood and blood products, and other drugs all received within a few days may “lead to a change in brain chemistry that could exhibit itself as depression.”

Depression is often hard to pinpoint.  For a child who has undergone open-heart surgery, complaints of pain, fears, sleeping problems, and other unusual symptoms may be present for two to three weeks after surgery.  These symptoms are normal and nothing to be alarmed at.  The body must adjust and heal before the patient feels “normal” again, however; if symptoms persist after four weeks, depression may be to blame.

Signs to watch for include:

*Apathy–apathy is a lack of interest or lack of enthusiasm for anyone or anything in the child’s life.  Apathy presents itself in a complete boredom or disinterest in all things that used to interest or excite the patient.

*Anger–anger now and then is normal for anyone.  Severe anger should be watched closely though, especially in a usually agreeable and calm child.  If unusual anger persists four weeks after surgery, you should talk to your child’s pediatrician.

*Feelings of doom–children may show strange fears of natural disasters or show feelings of sure destruction and doom.

*Desire for prescription medication–older children may develop a need for prescription pain medication.  They may look forward to taking it and  take it as often as possible.

*Seclusion–children may want to be left alone or stay in their rooms for hours alone.  They may not want to attend events where other people are present and may exhibit a desire to stay home and secluded.

*Persistent sadness–sadness that doesn’t seem to go away or a lack of happiness in usually happy activities can signal depression, especially in children.

*Persistent sleep problems–children who sleep too much, exhibit a fear of sleeping, or can’t fall asleep may have depression.

These signs are good to know and watch for following open-heart surgery.  Any of these signs that linger more than a month after surgery should be discussed with a pediatrician or other caregiver.

While some people feel that depression is inevitable in those who will develop it, other studies have shown disagreeing results.  The study conducted in Korea found that children with previously demonstrated resiliency to new situations, attentive and caring parent or parents, and proven high academic or personal achievements seemed to have less depression and psycho-social problem following surgery.  The study stated “that adolescents with higher resilience and an affectionate parent were less depressed.”

Additionally, some psychologists and therapists believe that having and learning coping abilities before surgery and, practicing them after surgery, may help children overcome depression.  Music therapy, meditation, relaxation, and deep breathing may help to relieve patients of depression and anxiety following open-heart surgery.

In his article, Tomlin stressed that if Cardiac Rehab is available, this can also help overcome the effects of depression.  Tomlin wants others to know that “if you or someone you know are facing open heart surgery, remember that depression is likely and a very dangerous enemy during recovery from open heart surgery.”

Ask for help if your child needs help.  Make sure their recovery from open-heart surgery leaves them with a Perfect Broken Heart both physically and emotionally.

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May 25, 2010 at 4:57 am 2 comments


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