This topic is about the emotional and mental health challenges that some people might face after having ileostomy surgery, particularly concerning depression, anxiety, and possible changes in serotonin levels. The original poster, who has lived with an ileostomy since 1978 due to ulcerative colitis, is curious if others have experienced similar issues and whether they needed medication. They are also interested in understanding if the removal of the colon could affect serotonin production, as most of it is produced in the intestinal tract. Here are some insights and advice shared by others:

- It's common to experience depression, anxiety, panic attacks, and post-traumatic stress symptoms after major bowel surgery. Many people report these feelings can persist or recur even years after the surgery.

- Antidepressant medications, particularly SSRIs and SNRIs, have been helpful for many. One person mentioned that Cymbalta (duloxetine) was beneficial and safe to use around the time of surgery.

- For acute panic, medications like Ativan (lorazepam), Valium (diazepam), and Xanax (alprazolam) have been prescribed, though users warn about the risk of dependence.

- Some have found cannabis or marijuana effective for mood control, with fewer side effects compared to traditional antidepressants, though availability depends on local laws.

- Faith-based coping strategies, such as prayer and spiritual support, have helped some individuals manage depressive episodes.

- PTSD-focused care is important, as symptoms like hyper-vigilance, avoidance of medical settings, and mistrust of authority can occur after traumatic medical experiences. Recommended treatments include trauma-informed psychotherapy, group therapy, and reducing exposure to triggers when possible.

- Monitoring nutrition and blood work is crucial, as ileostomates might become deficient in vitamin D, iron, and other nutrients that affect mood. It's advised to have lab checks every six months and take supplements as needed.

- When using Total Parenteral Nutrition (TPN), ensure that only prescribed nutrients and medications are added. One person had serious complications when antibiotics were added without their knowledge.

- Connecting with ostomy communities and sharing experiences can be very helpful. It's important to remember that emotional responses can vary greatly between individuals.

- For those who cannot afford commercial ostomy pouches, such as a member in the Philippines using plastic food wrap, the community may be able to provide surplus supplies.