I live with manic depression and will soon have surgery.  My mood has been stabile for quite a while now, but I am concerned that surgery may set off some cycling, or worse yet, a horrible depression or psychosis.  Is there anything special I should do or anything I should look out in order to prevent or minimize increased cycling?  I am very anxious about my upcoming surgery.

Dear Ms. L'
Stress can trigger episodes, all right, but I'm surprised that in my patients I've not seen surgery be a sufficient stress very often.  What I do is look for early evidence of cycling and add a little more mood stabilizer; and use medications for sleep, as when that is disrupted, instability is more likely (e.g. lorazepam or Ambien, but work closely with your p-doc' and surgeon to make sure you don't get oversedated with these and pain med's too). 

Dr. Phelps


Published July, 2001