Three weeks post op and I feel flat instead of happy. Please tell me the post-surgery blues are a real thing

I don't really know how to write this one. Surgery was mid May, vaginoplasty, after four years of referrals and letters and waiting rooms. Physically I'm doing fine, the follow-up call said everything is healing as it should, dilation routine is going okay, my flat is set up, my brother brings shopping. On paper this is the best month of my life.

And I feel NOTHING. Worse than nothing some days. I cried at a soup advert on Tuesday. I keep waiting for the wave of joy I was so sure about, the one I'd rehearsed for four years, and instead there's this grey flatness, like the volume got turned down on everything. Then comes the guilt, because people are still waiting for what I just got, and here I am unable to feel it.

The worst part is the 2am thought: does this mean I regret it? I've checked, honestly checked, and I don't. When I think about undoing it I feel sick. I just can't seem to feel anything else either.

Did anyone else get this? When did it lift? Is it the anaesthetic still washing out or is something wrong with me?

Rosa T said:

I keep waiting for the wave of joy I was so sure about

Oh Rosa. Pull up a chair, or rather don't, but sit with me anyway: this was me last summer, almost word for word.

Mine started around day five, once my sister went home and the get-well messages slowed down. I lay there thinking I should feel triumphant, and instead I felt tired and weirdly homesick for a fight that was over. I'd spent years being someone who was WAITING for surgery, and suddenly that person had nothing to do. It took me a while to work out that some of the flatness was grief for her, strange as that sounds.

What I can tell you from the far side: it lifted, gradually, somewhere between weeks three and six, in no particular order and with some backsliding. I never once stopped wanting what I'd done, I just couldn't feel anything about it for a while, and those turned out to be different things. The two small habits that helped were naming it out loud to one friend, so it stopped being a secret I was ashamed of, and putting one tiny thing in every day, a walk to the postbox, a row of knitting. I managed about four rows a fortnight at first and counted every one.

Adding a data point from the top surgery side, because mine had a schedule you could set a watch by. Days 3 to 10 were the pit, and looking back it tracked exactly with coming off the stronger painkillers and sleeping in 90 minute scraps. Once I was off them and sleeping in real blocks, the fog thinned week by week.

The thing I wish someone had told me: I assumed feeling low meant I regretted it, and that assumption frightened me far more than the feeling did. It was wrong. My body was doing chemistry, not delivering a verdict. Four years on, that operation is still the best thing I ever did for myself, and week one me cried into a pillow about nothing at all.

Rosa, thank you for writing this so honestly, and I want to answer it properly, because what you're describing has names, causes, and a usual course, and knowing them takes away a lot of the 2am fear.

Surgical teams often call it the post-operative blues, and it is common after major surgery of every kind, not only this one. There is a physical layer first: a general anaesthetic takes days to fully wash out, the body's inflammatory response to surgery produces genuine fatigue and low mood through the same signalling that makes you feel grim with flu, stronger painkillers being tapered have their own dip, and broken sleep multiplies all of it. That layer typically bites somewhere between day 3 and day 10 and eases over roughly two to six weeks, which is exactly the window Sam and Mara have described.

On top of it sits a psychological layer that this particular surgery serves up in double measure. Psychologists sometimes call it the arrival fallacy: mood reliably dips after reaching a goal you have organised your life around, because the anticipating machinery that carried you for years switches off before anything has grown to replace it. Four years of waiting is a lot of scaffolding to come down at once, and Mara's grief for the waiting self is a very apt way to put it. None of this is contradicted by the numbers, which remain firmly on your side: satisfaction with this surgery is high and regret is around 1 in 100, and an early dip does not predict being in that 1. The site's piece on the emotional adjustment after surgery covers how the lift usually arrives, slowly and unevenly, on a different clock from the wounds.

One boundary to hold onto: blues lift. If low mood is severe, still deepening past the first few weeks, stops you eating or caring for yourself, or brings any thoughts of harming yourself, that is beyond the expected dip and your surgical team and GP want to know promptly, mid-recovery, not at the next scheduled appointment. Mentioning your mood at every follow-up is not making a fuss; we ask about wounds and we should be asked about this.

Quietly grateful for this thread. Mine is booked for August and I realise I'd planned freezer meals, cushions, and a grabber tool, and precisely nothing for this. I've just warned my sister to expect week two tears that mean nothing, and I've added the emotional preparation guide to my reading pile next to the practical lists. Rosa, holding your hand from the waiting room side.

Update, because I promised myself I'd write one whichever way it went. Week eight now. The lift came the way Mara said, gradually and out of order. Somewhere around week five I noticed I'd hummed while making tea. Last weekend I put on a summer dress and there was no commentary in my head at all, it was just getting dressed, and I stood in the kitchen and laughed.

I told the nurse about the flatness at my follow-up and she didn't even blink, said she'd be more surprised if I hadn't had it. Wish someone had said that BEFORE, hence this thread staying up for the next person at 2am. It's not regret, it's weather. It passes. See you on the other side of it.