I never saw it coming. Then it hit me. Like a brick wall or a Mack truck, or any other large, unyielding object you can think of. A Supermoon, perhaps.
I don’t even know specifically what triggered it. I wish I did, because that would be some pretty important Need to Know Information to pass on.
It was June 2007. Chemo had ended in late July, 2006, and I’d had my final reconstructive surgery in December. My breast cancer had been a Stage 1. The tumor was the size of a blueberry and hadn’t spread to my lymphatic system. The surgeons got it all — I had what they call “clear margins.” The percentages were so in my favor — 98 percent cure rate — that I should have bought a lotto ticket.
I had the best possible case scenario in a very scary diagnosis.
Still, I had what could probably best be described as a nervous breakdown that summer of 2007.
I couldn’t eat. Everything tasted like sand. I lost 30 pounds in two months. I couldn’t sleep. Couldn’t function. Couldn’t do much more, really, than cry most of the time. Yet, I wasn’t able to articulate why.
Don would come home on his lunch hour just to try to get me to eat something, anything. I’d sit at the island in our kitchen, a PB&J on a plate in front of me, as Don coaxed me bite by bite.
To everyone around me, friends, family, my behavior seemed, well, peculiar. It didn’t jive. Why now? they asked, kindly, compassionately, but curiously.
I didn’t have an answer.
But, little by little, I did summon the energy to do one of the things I do best – find resources, someone who could help.
I called a friend of a friend who is a genetic counselor at the University of Michigan. I knew I sounded like a nut case. Heck, I was a nut case.
That’s when I found the piece of the puzzle that had thus far eluded me. And here it is: About 50 percent of cancer patients wind up with clinical depression after they’ve gone through treatment. This, from the University of Michigan Department of Psych-Oncology (note that there is an entire department dedicated to this phenomenon):
“Am I going crazy?” Cancer patients often ask themselves this question, but according to psychiatrist Michelle B. Riba, M.D., M.S., the answer is usually no. “The distress is most difficult right at diagnosis and after treatment is complete, when the person re-enters his or her normal routine,” says Riba.
Emotional distress can be caused by any number of factors, including uncertainty about the future, pain, side effects of treatment, feelings of isolation or guilt, information overload, worries about recurrence, physical limitations, as well as financial and family problems. In addition, there may be psychiatric symptoms that pre-date the cancer diagnosis.
Furthermore, patients often don’t realize that chemotherapy, surgery and other treatments can directly cause or contribute to their psychological condition.
So is it normal for cancer patients to be depressed and anxious?
Riba says depression and anxiety are very common; 50 percent or more of cancer patients have depressed mood or anxiety or both at various times. Symptoms may include difficulty concentrating, inability to carry out one’s usual daily routine, intrusive thoughts and fears about their diagnosis and the future. “But it’s very important for people to seek professional help if these symptoms last for more than a few weeks,” she says.
I saw one of my chemo buddies at the infusion center last Tuesday, and something she said made all of this come rushing back. Last Friday was her last day of chemo. She was, of course, elated. But she was also feeling a bit tentative. Suddenly, she was going to be out in the world once again, on her own, no doctor looking over her shoulder every few days.
And that’s scary.
“I know they’re going to be checking me every three months,” she told me. “But what if? What if something happens in the meantime?” Like me, she’s a young woman with a young child and a husband to think about.
That’s when the summer of 2007 came rushing back.
It’s important for cancer patients and their friends and family to know this truth: Treatment doesn’t always end at the sounding of the last chemo bell. The physical part of the treatment, sure. But many of us need mental health support services at some point. We need to know how to reenter the world, go on with our lives, after having the pants scared off of us.
For me, that summer, it was the University of Michigan Psych-Oncology. That’s when I met Patty, who I still check in with about once a month. I am so grateful that we found each other. She has helped me to navigate many a twist and turn in my life and I thanked God she was still a part of my life when I got my most recent diagnosis.
If you’re a cancer patient or a close friend or family member, don’t overlook this important piece of the healthcare puzzle. There are people who can help. Give them a call, make an appointment, touch base.
Getting better truly is about treating the whole person, physically, emotionally, psychologically.
I blog for The Pink Fund every Monday. This post first appeared there on March 21, 2011. Look for more of my writing there.
Copyright 2011, Amy Rauch Neilson