I started counseling before surgery and continue to go see a therapist twice a week. What I am finding is that this process is very hard and when I slip up, I feel an even deeper sense of inadequacy. Before surgery I used alcohol and food to help me deal with my feelings and now that those are physically not an option, I feel like I lost 2 of my best friends.
My advice would be to be honest with yourself and your own feelings. It makes it easier to confront and deal with those issues when they come up. I don't feel like the surgery increase my depression. I feel like it revealed to me how unhealthy my coping strategy was, and that was probably exactly the revelation that I needed.