What You Need to Know About Surgery Anxiety

A journalist once told me that stress obviously can’t affect your physical body. I was shocked! Surgery anxiety in the operating room has real dangers to your physical body. Why should you care about your anxiety around surgery? Your anxiety state can affect your pain, nausea, wound healing, infection risk, and more.

Your body also reveals its mental health state while you're under anesthesia, even when you're unconscious!

So many causes for surgery and anesthesia anxiety

So many things around surgery can cause anxiety, like the nerve block, epidural, spinal, breathing tube, general anesthesia, pain, recovery challenges, etc. Your surgery anxiety may also come from the reason you need surgery, be it cancer, osteoarthritis, pain, etc.

The good news and bad news about surgery anxiety

Let’s start with the bad news (boo!).

Why you should care about anxiety in the operating room

Even though anxiety exists in your mind, it can have powerful effects on your body. This can create challenges to your surgery and your body under anesthesia. The mind-body connection is very real, and nowhere is it more apparent than in the operating room during surgery and anesthesia.

To summarize, high surgery anxiety can lead to worse pain, nausea, anesthesia side effects, infections, and cosmetic scarring. And your body reveals its anxiety when you're under anesthesia.

Also, anxiety, and the medications used to manage it, can increase your anesthesia resistance and possibly increase the risk of being awake under anesthesia.

The good side of stress and anxiety?

Interestingly, there’s a certain amount of stress that can be beneficial to surgery recovery! In medicine, we say the dose makes the poison. I’ll make a whole video on that one day!

In surgery, the dose of anxiety makes the poison

What you can (and should do) about Surgery Anxiety

There’s incredible potential for your body to overcome and control your anxiety. And it’s more possible in the operating room than most patients think! It’s because there’s the potential for you to set a discrete goal.

That sounds cliché and cheesy, doesn’t it?

You’d better believe it, because the stress of surgery can catalyze a transformative healing experience for many patients. But it takes the right preparation!

Some powerful examples of mental health transformations after surgery or anesthesia are quitting smoking cold turkey, hypnosis using fewer medications (and saving money), overcoming depression, and major abdominal surgery while fully awake – despite major anxiety.

There’s a lot of incredible stuff going on in the operating room. It’s a novel, new environment.

Unfortunately, humans are trained to be fearful and suspicious of new things. But this suspicion can be redirected to oneself during surgery and anesthesia. With the disinhibition that anesthesia provides, there’s a powerful opportunity to gain valuable knowledge about yourself.

And one of those powers is to reduce anxiety!

Ways to reduce surgery anxiety and make anesthesia safer

There are lots of ways to reduce anxiety. The standard of care is to give medications, like benzodiazepines. These work great in the moment for acute stressors. But they have side effects, like delirium and excessive sedation. We also don’t know if these medications contribute to cognitive deficits after surgery or memory problems after surgery. I always err on the side of caution when dealing with these potentially devastating side effects, especially if there are safer alternatives.

Some of my patients use drugs before surgery to calm their nerves, like alcohol and marijuana. This can be dangerous, and definitely should be avoided in the weeks leading up to surgery.

Safer alternatives to reducing surgery and anesthesia anxiety

There’s a giant list! Most of these methods don’t involve medications or supplements because we don’t want our patients taking supplements before surgery or anesthesia! That’s because there can be dangerous interactions under anesthesia with some natural and herbal supplements.

That’s okay, because there are so many non-pharmaceutical anxiety relieving techniques.

• My favorite is breathwork, because you have to do it anyways before you fall asleep! We need to fill up your lungs with oxygen before you fall asleep, and it’s a valuable opportunity to get into a relaxing breathing flow. Patients can, and should, do the same in the days leading up to surgery, too!
• There are meditation techniques. These are powerful to train with in the weeks leading up to surgery. Mindfulness based stress reduction (MBSR) is a particularly powerful tool.
• Other meditative techniques include physical activity, like yoga, qigong, and tai chi. These can have the double benefit of improving your physical fitness before surgery!
• Aromatherapy can have relaxing effects, and many of these can be safe to use before surgery. I’ll talk specifically about those in other articles, but lavender is a powerful one! But always talk to your doctor before taking any supplements, especially before surgery!

Then there’s the importance of sleep. Anesthesia totally disrupts your normal sleep-wake cycle and also your REM sleep. Proper sleep before surgery is important not just for mental health, but also for your surgical recovery! Gentle sleep aids like melatonin can have benefit, but always discuss with your doctor first, especially around surgery!

We can go on and on, like talking about an anti-inflammatory diet and physical activity (to possibly release natural endorphins), but you get the idea.

You can take this with you after surgery

When patients discover the incredible power they have to control their anxiety before surgery, they learn a powerful skill that they can use outside the operating room. I call this discovering your inner healing potential. It takes 3 parts: a wake-up call (like surgery), a guide (like your anesthesiologist), and a catalyst (like anesthesia medications). How convenient that all three are in the operating room with you during surgery!