Beyond the Physical: The Mental Health Impacts of Surgery

When you think about surgery, it’s tempting to focus only on the physical body itself—the incisions, the recovery timelines, and the gradual return to physical health.

But surgery’s impact doesn’t stop there. Procedures of all kinds can take a significant toll on a person’s mental health, too.

Understanding the psychological risks of surgery, why they happen, and how to address them is a crucial piece of truly supporting your employees through one of the more challenging experiences of their lives.

Understanding surgery’s mental health risks

Any type of surgery (yes, even ones that don’t happen on the brain) can impact a person’s mental well-being. But how? Research explains this using three major “psychological burdens” of surgery:

• Preoperative anxiety: This is the sense of nervousness many patients feel ahead of the procedure, often related to worries about anesthesia or potential complications. This is fairly common, with almost one in every 10 surgical patients experiencing moderate to severe anxiety before their procedures. Unfortunately, this persistent unease can negatively affect their recovery.
• Postoperative depression: Recovering from surgery can be tough. Patients can experience physical changes or pain, long recovery times, or loss of function and independence—all of which can lead to depressive symptoms, something that 23% of patients report experiencing post-surgery. Unfortunately, this also complicates the healing process and increases the risk of surgical complications.
• Post-Traumatic Stress Disorder (PTSD): Particularly after challenging or risky surgeries, patients can experience PTSD symptoms like nightmares, flashbacks, irritability, difficulty sleeping or concentrating, and negative thoughts. Surprisingly, postoperative traumatic stress occurs in roughly 20% of patients following surgery.

These three burdens make it clear that mental health is involved at every stage of surgery—even long after the procedure is over. In fact, research shows that psychological distress often intensifies during recovery. While 10.9% of patients had high levels of psychological distress the day before surgery, that number climbed to 13.9% three months after surgery.

The stakes are even higher for more complex procedures. The more major the surgery (for example, a heart transplant), the greater the risk for psychological effects and the more severe those effects tend to be.

What makes this especially concerning is the cycle that it can create. Research shows that mental health influences surgical outcomes, and not in a small way. Patients struggling psychologically after surgery face worse health outcomes, longer recovery times, and a higher risk of complications. Depression alone is a frequent cause of morbidity in surgical patients.

Put simply, untreated mental health impacts don’t just affect how a person feels—they affect how well they heal.

Why does surgery affect mental health?

But why does surgery take such a toll on mental health? Reasons vary, but procedures can cause any or all of the following:

• Cognitive dysfunction (“brain fog”): Many patients experience postoperative cognitive dysfunction (POCD), including memory lapses, difficulty concentrating, slowed processing speed, and reduced executive functioning—especially after major or cardiac surgeries.
• Sleep disturbances: Anesthesia, hospital environments, pain, and stress can all disrupt circadian rhythms. Poor sleep after surgery is linked to slower physical recovery and increased mood instability.
• Loss of function: Nearly 60% of patients lose at least some of their independence after surgery (which, of course, varies based on the type of surgery they have).
• Identity disruption: Major surgeries can temporarily (or permanently) change a person’s ability to function, which can shift their identity or sense of self—particularly if they’re used to being largely independent. Reduced autonomy has been linked to depressive symptoms and adjustment disorders.
• Chronic post-surgical pain (CPSP): Unfortunately, some patients experience pain that goes beyond the typical recovery process—lasting more than three months after surgery. About 5-10% of patients who had major surgery go on to develop CPSP.

It’s these factors—whether it’s one or a combination of them—that can lead to the most common mental health impacts people experience after surgery: anxiety and depression.

How to help employees manage their mental health post-surgery

Supporting your employees through surgery isn’t just about approving their time off and welcoming them back when they’re cleared to return to work.

Employers who take a proactive role in supporting their employees’ psychological (and not just physical) recovery can make a meaningful difference in both their well-being and their outcomes.

Here’s where to start when coordinating benefits, offering relevant resources, and communicating with employees.

1. Integrate behavioral health support into surgical care

Mental health support shouldn’t be an afterthought—it should be built into the surgical care experience from the start. Some health systems are leading the way by embedding psychologists or behavioral health specialists directly into surgical care teams, so patients have access to mental health support as a standard part of their care (and not a separate service they have to seek out on their own).

It can be a beneficial step, with Cognitive Behavioral Therapy (CBT) demonstrating moderate to high effectiveness (in the range of 70-80%) in reducing anxiety and supporting recovery.

As an employer, you can advocate for health plans and surgical care partners that take this integrated approach seriously.

2. Encourage preoperative screening and early intervention

One of the most helpful things that can happen for an employee’s post-surgery mental health actually happens before they ever go under the knife.

Preoperative psychological screening has an 80% effectiveness rate in identifying patients at risk of anxiety and depression, allowing care providers to build more proactive treatment plans before problems come up. Preoperative counseling is another valuable tool, with research showing it improves surgical recovery outcomes and reduces complication rates.

Encouraging employees to ask their care teams about these options, or ensuring they have access to surgical care providers who offer them as standard practice, can make a significant difference in how they heal both physically and mentally.

3. Prioritize pain management and sleep support

Two of the biggest drivers of post-surgical mental health struggles—pain and poor sleep—are also two of the most addressable.

Poorly controlled pain significantly increases the risk of depression, anxiety, and chronic pain syndromes. While medications are important, effective pain management goes beyond prescriptions. Physical therapy, acupuncture, and other relevant treatments all play a role.

Sleep is equally critical. Research confirms that interventions supporting sleep positively impact both the psychological and physiological recovery of surgical patients. In the hospital, that can mean private rooms, earplugs and eye masks, or minimizing overnight disruptions. At home, it means educating employees about sleep hygiene, relaxation techniques, and appropriate sleep aids.

4. Build a structured return-to-work plan

For many employees, returning to work after surgery is its own source of anxiety. A large percentage worry that going back too soon could trigger complications or set back their recovery.

Employers can ease this stress with a few practical steps: gradual return-to-work programs, flexible scheduling, transitional duties, and clear communication throughout the process so employees feel supported rather than pressured.

How an employer handles the return-to-work process sends a powerful message about whether employee well-being is truly valued. A thoughtful, structured approach supports mental health and builds trust.

Surgery is a physical experience, but its impact goes well beyond the physical. Employees who feel supported—both mentally and physically—heal better, return to work more confidently, and are less likely to face costly complications down the road.

That’s exactly why Carrum Health has partnered with Lyra Health. Together, we believe that truly comprehensive surgical care has to address the whole person, not just the procedure.

Learn more about the Carrum Health and Lyra Health partnership.