Misery with a capital C: how I beat post-cancer depression
Medical advances may be saving lives, but the emotional trauma of the disease can create another world of pain
Before being diagnosed with cancer for the first time, low-level emotions came and went in response to the usual ebbs and flows of life. Depressed at a break-up, anxious if I was late.
I was considerably under-prepared for the enormous emotional impact cancer would create and leave behind; each of my three diagnoses generating intense feelings that I had no idea how to manage, let alone recover from.
Cancer first punched its way into my idyllic life in 2003 when I was 38 and 30 weeks into my second pregnancy; it couldn’t have been more inconvenient. Fear completed a lap of my body before the consultant finished his diagnosis. I could not make sense of the world I now found myself in. The life I loved and enjoyed was replaced with appointments and conversations, all of which seemed more difficult than the last. Gone were the joyful afternoons in the park and meeting friends near our home. I was now being defined by an illness and its treatment.
I felt sad, I felt angry, I felt lonely, and I felt terrified. Chemo began two weeks later, in an attempt to halt cancer’s march, and was repeated three weeks later. Those choices were the most difficult and guilt-ridden of my life. I felt angry that my blissful pregnancy had become a medical conundrum. I felt terrified at what lay ahead. I felt guilty at choosing to have chemo while I was pregnant. My baby’s precious kicks, just inches from the cancer in my breast, kept me going through those hellish weeks.
My daughter Bonnie was born from my hairless body, mid-chemo cycles, her piercing scream announcing her departure from the poison around her. I enjoyed the first few hours and then a dark depression rolled in like a fog.
My fear that I would die before she and my other daughter Poppy, who was 14 months old at diagnosis, would remember me, prevented me from fully bonding with them.
Half of the UK population will receive a cancer diagnosis at some point in their lives and most people will know someone who has been affected. But when talking about cancer we tend to think about the physical side-effects. Although medical advances are saving lives, less consideration is given to the emotional trauma that cancer creates. The grounding relationships with my friends, family and husband became a distant memory as cancer isolated me, my life so very different from theirs. I felt awkward in my relationships, my fear of dying and intense sadness blocked my connection to others.
How my body looked and functioned changed daily. Each treatment and appointment traumatised me until I was on the edge of a mental breakdown. The physical and emotional recovery from 10 months of treatment was slow. In an attempt to speed things up I created a bucket list that I worked on manically in a bid to rid myself of the anger and fear cancer had created. The isolation was channelled into volunteering to help other people facing a cancer diagnosis in the hope I would find a meaning to my life within the world I reluctantly found myself.
As time passed and my children grew, I created memories with and for them. And to some degree, the depression passed and the anger subsided, but the paralysing fear would be triggered again by my three-monthly medical appointments.
However, cancer reappeared in the lymph nodes above my collar bone 10 years later, in the appointment in which I was due to be discharged by my oncologist.
I knew from previous late-night googling sessions that the location of the tumour didn’t bode well for my long-term survival. Once again I felt angry at what cancer changed, terrified at its unpredictability. This time round I fought less and cried more. I knuckled down with the treatment of four gruelling cycles of chemotherapy and 15 sessions of radiotherapy, and hoped for the best. I emerged, four months later, feeling hopeless and depressed.
The treatment, medically induced menopause and a diagnosis of osteoporosis all took their toll, physically and emotionally. I once again scrabbled around to build a new life from the ashes left in cancer’s wake. It was harder to muster hope this time; what was the point if cancer was going to keep visiting? I felt suicidal but I hid this from my family and friends as I felt they had been through enough. I toyed several times with antidepressants, but I had the most amazing and gentle therapist who helped me gradually find and put back the pieces of my life.
The third cancer diagnosis, in February 2016, which by comparison was a minor skin cancer, was the one that broke me. I had nothing left to give. I could not run any more. I needed to face the one thing that I had been running from over the past 12 years and that was accepting my death; at some point it was going to catch me.
The anxiety this cancer created was so overwhelming I couldn’t function, and knew something had to change. I realised that no matter what I did, I couldn’t control death, and instead invested my time and energy into what I could control. In the past 16 years of living with cancer, I still haven’t found a way of managing the anxiety any appointment, test or symptom creates and so accept I become emotionally unstable at these times.
I don’t consider myself to be all clear, in remission or cancer-free, but I prefer to say “I feel healthy today”.
There is a lack of understanding about the long-term emotional impact of cancer and, like any other trauma, it takes not only time to process these emotions but also to feel safe again and find new meaning. All the time living with an unpredictable illness.
Recent findings have revealed that 84% of women with breast cancer in England are not told about the possibility of developing long-term anxiety and depression by healthcare professionals. I was given a leaflet about a local cancer support centre, which was wonderful, but the medical profession did not mention at any time the emotional impact. I was prescribed tranquillisers for the anxiety from chemo, but what might have been more beneficial was support, instead of just medication.
There is a great deal of loss to process with cancer; my whole life changed, cancer had affected every part of it, including my relationships. Once I had expressed the anger and isolation, I found new purpose. I was a stay-at-home mother when first diagnosed, but in 2012 I qualified as a counsellor with first-class honours.
There have been some plus sides to cancer: it has become an effective filter for what I do and don’t want in my life. Situations and people that cause me stress are easily deleted. I learnt resilience and determination, reminding myself that if I could get through three cancers, I could get through anything.
There is also a gratitude and an added focus to life. My children are 15 and 16 and are normal challenging teenagers, and I have spoken openly to them about cancer and its impact on me.
I hope for greater understanding and awareness of cancer’s emotional impact and for long-term, easily accessible support to help patients have a good post-cancer life, albeit different to the one they had before.
– © The Daily Telegraph