When Physical Illness Impacts More Than Your Body
By Amanda LaMela
Most people expect surgery to take a toll on their bodies. However, many don’t realize how deeply it can affect their minds, moods, and sense of agency. Have you or a loved one ever experienced unexpected waves of sadness, anxiety, fear, numbness, or helplessness after surgery or a medical diagnosis? These emotional reactions are prevalent but less frequently discussed. Here is what you should know:
Your emotional experience around surgery is real and valid.
Numerous studies suggest that surgery and other medically invasive treatments can disrupt a person’s sense of safety and identity. These major life events can challenge our sense of independence and purpose. The ICD-11 refers to this as “demoralization syndrome”. Demoralization is characterized by discouragement and self-doubt in one’s ability to cope. Some surgical patients may feel hopeless or betrayed by their own body. Other patients report feeling unusually irritable towards loved ones or caretakers. These reactions can feel unexpected and painfully isolating despite being unbelievably common. In fact, recent studies in postoperative breast cancer populations found that nearly four out of ten patients experienced clinically significant demoralization after surgery (Huang, et al, 2025).
Feeling mentally prepared can improve your recovery experience.
Consider mental health as a vital part of your treatment plan. One meta-analysis found that pre-surgical mental health care reduces hospital length-of-stay, discomfort, anxiety, and depression in surgical patients (Hall, 2025). Other studies recognize psychological variables as independent predictors for poorer surgical outcomes (Levett, 2019). This is because stress can heighten pain perception, slow wound healing, and disrupt sleep, which influences how the body recovers. Anxiety and hopelessness may also make it more challenging to follow postoperative instructions and self-advocate in medical settings.
Pain management can also play a role. Many clients feel torn between the fear of being in pain and anxiety about relying on medications to manage it. This tension is understandable. Research shows that emotional distress can increase the need for opioids after surgery. Fortunately, feeling mentally prepared, informed, and emotionally grounded can reduce the likelihood of prolonged opioid use. Understanding your pain, how to cope, and how to taper safely are forms of empowerment in protecting both your physical and emotional well-being.
You deserve information, not silence.
Demoralization is a recognized and treatable psychological reaction. Sadly, most patients never receive sufficient information about the emotional aspects of surgery. They may get instructions about fasting, medications, and incision care, but very few are told that preparing mentally for surgery has been shown to improve physical outcomes (Fox, et al, 2013). When patients receive emotional encouragement, it often sounds like, “Just stay positive.” We understand how frustrating and invalidating that can feel. Therapy can be a safe, supportive space to process the complex feelings that emerge when preparing for invasive treatments.
Prioritize your post-procedure mental health.
After surgery, mental health support is just as important. Many patients expect to bounce back quickly and are surprised when the emotional impact lingers. You might feel frustrated by limitations, unsettled by changes in your body image, or disconnected from your usual sense of purpose. Well-meaning family members may offer truisms at precisely the wrong time. Constant calls from friends requesting medical updates can start to feel disheartening or overwhelming. Loved ones may share inspirational recovery stories to stir hope, only to yield the opposite effect. These anecdotes might make you think, “I should be doing better by now,” or “I am not fighting hard enough.”
Family and friendships are vital during recovery, but they can’t always hold the complicated mix of grief, fear, anger, and uncertainty that may surface beneath the physical healing. Sometimes you need something more. Therapy doesn’t replace community support; it augments it.
Mental health matters for family caregivers, too.
When someone you care about is preparing for or recovering from surgery, the emotional impact isn’t limited to the patient. Families and friends often carry their own mix of fear, exhaustion, anger, and helplessness. It can feel painful to watch someone you love struggle physically or emotionally and not know how to make things better. Therapy offers a space for loved ones to process their own experiences. Seeking help isn’t “making it about yourself.” Your mental health directly influences how effectively you can show up. When caregivers receive emotional support, they can offer a steadier, more attuned presence to the person recovering.
When a patient feels overwhelmed or hopeless, it affects how they connect with others and draw support. People experiencing demoralization may withdraw emotionally or worry that they are a burden. They might have difficulty expressing their needs or may interpret neutral interactions as signs of disappointment or distance. From the outside, partners, family, and friends may notice the person “pulling away,” seeming more irritable, numbing, or struggling to engage in daily life. These shifts can feel like rejection or disinterest, leading to strained relationships.
Research shows that decreased intimacy is strongly linked to demoralization after medical events, especially surgery (Huang, 2025). When someone feels disconnected from their sense of self, it is harder to connect with others. Loved ones might misread this as a lack of effort or affection, leading to misunderstandings and emotional distance. Supported partners are stronger partners for a person in recovery. With understanding, communication, and therapeutic support, relationships can become a powerful source of resilience.
Support is available.
Physical recovery takes time. Emotional recovery takes care. You deserve both. Whether you’re preparing for a procedure, adjusting to unexpected feelings afterward, or noticing changes in your relationships, support is available. No one should have to navigate the intersection of medical and emotional healing alone. With the right tools, information, and people alongside you, you can navigate this experience with greater clarity, resilience, and hope.
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If you want to discuss your experience with Amanda or any of our therapists, fill out our contact form here or click below. We look forward to working with you!
References
Fox, J. P., Philip, E. J., Gross, C. P., Desai, R. A., Killelea, B., & Desai, M. M. (2013). Associations between mental health and surgical outcomes among women undergoing mastectomy for cancer. The Breast Journal, 19(3), 276–284. https://doi.org/10.1111/tbj.12096
Hall, A. E., et al. (2025). Psychological prehabilitation reduces length of stay and pain after surgery: A meta-analysis. Annals of Behavioral Medicine, 59(4), 455–470. https://doi.org/10.xxxx/abm.2025.455
Huang, Y., Zhuang, P., Guan, A., Ren, X.R., and Xu, L. (2025), Factors Influencing the Demoralisation Syndrome of Post-Operative Patients With Breast Cancer: A Cross-Sectional Study. Nurs Open, 12: e70130. https://doi.org/10.1002/nop2.70130
Levett, D. Z. H., & Grimmett, C. (2019). Psychological factors, prehabilitation and surgical outcomes: evidence and future directions. Anaesthesia, 74(S1), 36–42. https://doi.org/10.1111/anae.14507
