Zeev N. Kain, MD, MBA, MA (Hon), FAAP

The Anxiety of Medicine

How to Mentally Prepare for Surgery and Recover Faster

Tips for the next time you or a loved one is preparing to undergo surgery

Posted Dec 09, 2017

Piron Guillaume/Unsplash
Source: Piron Guillaume/Unsplash

Within the next year, about 50 million people will undergo surgery in the United States. And with rare exceptions, all of these people — both adults and children — will suffer from anxiety beforehand. But what most people don’t consider are the deeper rooted psychological issues that can be caused by preoperative anxiety, an understated side effect that plays a critical role in the success or failure of surgery.

High levels of anxiety before surgery not only causes hardship on the day of the procedure, but also have a profound impact on a person’s recovery. Statistics show that 40 percent of all adults undergoing surgery experience high anxiety and adverse effects, both during and after the surgical event. While there is no doubt that medicine has advanced significantly over the past few decades, the challenge of high anxiety remains significant and, in fact, has even increased over time.

There are many reasons for this trend. One of the most significant is that health care today is driven by the bottom line. As a result, many hospital-based psychological preparation programs for people undergoing surgery have been eliminated.

We’re also experiencing a trend that encourages the merging of hospitals. This creates larger facilities that are less focused on the emotional well-being of patients. In addition, traditional social structures, such as family or friends, are eroding as a go-to source of support, despite a large body of research that points to their unparalleled benefits.

More than 50 years ago, psychologist Irving Janis conducted studies with Yale students that showed how increased anxiety before surgery is associated with delayed recovery after surgery. Since then, multiple studies have replicated these findings, reporting that the more anxiety a person experiences before surgery, the more pain medication a person requires after surgery, which often leads to a delayed discharge from the hospital. For some people, this preoperative fear can last for years and can impact their willingness to engage with any future medical encounter.

So how do we go about managing preoperative anxiety? Here are some tips for the next time you or a loved one is preparing to undergo surgery.

1. Learn as much as you can about the procedure using reliable medical sources — not random blogs. Many hospitals even offer YouTube videos for patients who are about to undergo common procedures, such as hip or knee replacement.

2. Prepare a list of questions and review the details with your medical provider. Generally speaking, studies show that the more information you have before surgery, the less anxious you will be at the time of the procedure.

3. Speak with your surgeon and anesthesiologist about the availability of medical drugs before surgery, such as Ativan or Midazolam (Benzodiazepines). Not everyone needs to take these sedatives, but it's always nice to know they’re available.

4. When speaking with your anesthesiologist, be sure to understand your options for pain management after surgery, as planning is key for recovery.

5. Use guided imagery. There are ample sources on the web that instruct you on the use of guided imagery and various breathing techniques for anxiety. Practicing these methods can be extremely helpful before surgery.

6. Music is a wonderful tool that has proven to be highly effective. Rather than worrying in the holding area, listen to your favorite music.

7. Other techniques such as scent therapy, touch therapy, clown therapy, and pet therapy are commonly used as well. However, there is no consistent, valid scientific data that promotes these therapies on a routine basis.

8. Finally, I can’t overemphasize the importance of social support systems surrounding the surgical event. Friends and family are crucial throughout this time.

Anxiety before and after surgery is a well-described problem that can hinder your psychological and recovery process. But there is some news. Slowly but surely, medicine in the U.S. is becoming more patient-centric, which will ultimately lead to more attention to this overlooked issue, among others.

More Posts