This week, I am writing about something that’s difficult to talk about sometimes. Unfortunately depression is relatively common for bc survivors in the short term. Here are my thoughts on this and what to do about it.
The links between cancer and depression and what to do about it
Cancer and depression are intertwined in several ways.
Shock and grief
Firstly, the diagnosis of cancer sends shock, grief, fear and untold emotions swirling around your body and mind. It can take a while – even years – to process, untangle and smooth out all of these feelings and thoughts. Grief really can come in waves and may creep up on you when you least expect it.
Change of identity
Changes to the body such as loss of hair, different hair growing back, loss of a breast or breasts and scars, coupled with aches and pains from medications or the illness itself can cause us to feel quite different about ourselves. These changes of identity may contribute to another type of grief for who we were before BC. Sometimes there is grief for the ‘old me’ as we find ourselves in a ‘new normal’.
Medical Side effects
Cancer treatments can cause depression such as the anaesthetics from surgery, chemotherapy drugs (and medications to manage their side effects such as some steroids), hormone therapies or radiation. All of these affect the body in many ways and many have depression listed as a side effect.
Are we there yet?
The process of going through a lengthy duration of cancer treatment can be depressing. Month after month or year after year of cancer treatment offers little respite and a year of resilience, braveness and strength may suddenly run out when treatment passes x mark or milestone. Most of us can keep positive for a few months but after a year of treatment, we cannot seem to find the positivity anywhere.
Low blood counts = low mood
What many of my friends have learned is that when you are feeling physically sick or with low blood counts or both, you inextricably also feel emotionally low. Often we can tell that our blood counts are low because we feel down. I have noticed that on the day that I stopped feeling nausea or pain, all of a sudden, I felt emotionally ‘up’. I realised that the two go hand in hand. Sometimes you do not have much control over your moods; I think feeling down or depressed might be nature’s way of keeping you away from viruses and bugs in the outside world when you’re most susceptible.
The new normal
We also stretch and grow in strange but beautiful ways during cancer and cancer treatment. We find ourselves perhaps wiser, stronger, deeper and very brave. We might yearn for old interests and friends but don’t find simpatico with them anymore. It can be quite confusing as we feel like we have lost an old life which we enjoyed and not really found our feet in a new life. Friends and partners may stay or go, relationships change in shifting sand and there can be overwhelming feelings of isolation or not being understood. We crave to get back to normal but for some, we never find that same normal again. People often call this the ‘new normal’. We arrive back to the life we left to find that that land no longer exists. It can throw us around a bit emotionally.
Treatment to recovery
And finally, when we get to the finish line (if there is one), it can feel so deflating. The last chemo comes and goes but instead of elation, we might feel loneliness, fear of recurrence and flat – as we graduate from the treatment stage into the recovery stage of cancer treatment. It can take months or years to fully recover physically and emotionally from cancer and its treatments, depending on how long your treatment went for. I found it surprising that recovery can take as long as or longer than the treatment stage.
Then sometimes when we finish treatment, we are also struck with the enormity of what we have just been through. When you are going through treatment, we often put one foot in front of the other and take chemo one by one. But now we see the whole cancer journey from a different perspective and it seems overwhelming. The grief of the entire experience suddenly reaches up and grabs us…just when we were hoping to start walking in a new direction.
Here it comes
Depression may come and go triggered by the above reasons or a lack of support, weariness on the journey, people going away, a new medication, loneliness etc… but depression may also stay longer. From talking to many women I know, many have experienced depression during or after cancer treatment (often afterwards). I have heard of many women offered anti-depressants routinely for this difficult time. We are all unique and if you are depressed, it is likely that the cause is a jumble of all of the above.
The good news is that you will feel better in time and there is lots of help and support out there for you.
For me, in both bcs, finding out that I needed to do chemo triggered some depression. With the first bc, I had a terrible time with the AC chemo and felt trapped – to do or not do chemo. It also seemed to last forever..each chemo dragging and dragging. With the second bc, I felt depressed again in finding out that I had bc again and needed chemo again. But luckily, a survivor spirit rose up and has helped me through most of the treatment. Every now and again though, I feel down about the whole experience. I don’t think it is possible to feel happy about cancer or happy about cancer all the time.
With the first bc, it took me two years to get my spark back after chemo and Herceptin ended. I went on a big holiday with friends to Brazil and Argentina and had fun, adventures and felt like I got my confidence back. So with this second bc, I am realistic that it will take some months before I feel jumping with joy.
What to do about depression
5 Tips for Support
- Professional help. Talk to your GP, counsellor or medical specialist. Sometimes it can be hard to ask for help but you are very important and if you seek help now, you receive help sooner.
- Good friends. Talk to those friends who will really hear what you are saying.
- Medication. On discussion with your GP or specialist, you may want to consider a medication in the short term. Also talk to your GP and Oncologist as some medications may be causing depression e.g. some steroids made me very depressed.
- On-going counselling or therapy. Talk to someone and choose a modality that you feel comfortable with e.g. Art therapy or counselling. Find out why you are feeling depressed and this awareness can change everything.
- Cancer Society support. Talk to the specialist nurses to get more information and the Cancer Society also offers free counselling.
11 Things you can do for you
- Exercise every day, even if is a 20 minute walk around the block. But get in to nature if possible as you feel even better.
- Eat as well as you can as you need all those nutrients.
- Plan some fun activities and things to look forward to.
- Spend time with people who care about you. Having some philosophical chats with good friends. E.g. a friend of mine recently said to me that life.
- Express yourself – write, paint, draw, take photos etc.
- Meditation and mindfulness can help, especially if attending a supportive programme.
- Rest. Getting enough sleep and rest to help your body heal.
- Keep a gratitude journal. Positive psychology describes noticing what went well as really important for mental health.
- Take a break from your routine. A holiday can really rest and inspire the soul.
- Get into nature. Walk by water, on a beach and marvel at the beauty of nature.
- Check out these websites called The Lowdown and Making Australia Happy with great exercises to help.
The Big Picture
- Be patient and realistic. You have been through a lot and sometimes, time is the greatest healer.
- Understand that life is not meant to be smooth or in a straight line (contrary to what a lot of the current goal setting theories espouse). I also read a quote that said we are meant to progress through life picking up scars as we go. I resonated with that. Another friend sent me a quote “no matter how hard the past, you can always begin again” from Buddha. I loved it.
- The Survivor spirit is really important for your recovery. However, we all have down days. The important thing is taking a step to get you back into feeling good about life. Have hope. You can get through this.
- Happiness again. You will bounce back with your old spark.