The topic at hand is about dealing with stress and depression after undergoing a permanent ileostomy surgery. The person who started the discussion had their surgery in October 2018 and has since noticed that everyday stress affects them more deeply, often leading to depression. They didn't have a history of depression before the surgery and are curious if others have experienced similar feelings and how they manage them.

Here are some helpful pieces of advice and insights shared by others:

1. Professional help
- It's often recommended to seek counseling or psychotherapy as a first step. Many people have found improvement once they involved a psychologist, counselor, or psychiatrist, especially when stress was identified as post-traumatic. Early intervention is important, as it tends to lead to better outcomes.

2. View it as trauma or grieving
- Surgery can be like a traumatic event and might trigger responses similar to PTSD. Understanding this can help normalize your feelings and guide treatment. Some people also compare the emotional journey to a cycle of grief, including stages like why-me, anger, frustration, and acceptance.

3. Identify root causes
- Try to pinpoint what specifically is causing your stress, whether it's work, family, finances, or body image. Addressing the root cause rather than just the symptoms can provide longer-lasting relief.

4. Build support networks
- Lean on trusted friends, family, significant others, or peer groups for support. It's important to distance yourself from unsupportive or stigmatizing relationships and surround yourself with people who understand the day-to-day realities of living with an ostomy.

5. Set achievable goals and stay active
- Engage in structured activities that offer a sense of accomplishment, like walking, hiking, swimming, or hobbies. Achieving small goals can boost your confidence and help counter negative thoughts.

6. Adopt attitude and perspective tools
- Practice gratitude and maintain a perspective that acknowledges others may have it worse. Creative outlets like writing, poetry, or philosophy can help express feelings and promote insight.

7. Practical ostomy management can ease the emotional load
- Using reliable supplies can reduce fears of odor or leaks. Some people have found that using certain products, like Convatec pouches, has helped them regain social confidence.

8. Remember it is common and often temporary
- Many people experience similar emotional challenges after surgery, sometimes even years later. However, most report gradual improvement over time with acceptance and the strategies mentioned above.