Laura Drury, MSW, LICSW, clinical director of Social Services at Butler Hospital and Clinical Faculty, Brown University Department of Psychiatry, discusses the connection between cancer and mental health from the perspective of a cancer survivor and clinical social worker.
Can getting a cancer diagnosis be a trigger for becoming depressed?
Yes, it can; however, feeling frightened and overwhelmed is a normal and common reaction to learning you have cancer. When first diagnosed with cancer, you can't help but fear that it may be a death sentence. There is so much information in the media; not all of it is accurate. We've all seen the pictures of little children and women with no hair, and the latest cancer rates and death statistics featured on the evening news. Sadly, many of us have known family or friends who have died of cancer. It is a challenge to both accept and manage the myriad of feelings you experience when you have cancer. Cultivating a positive attitude is difficult but very important.
So how does someone do that? How do they honor the normal feelings of sadness and fear and not let themselves slip into complete darkness?
The first thing is to understand that when you are facing such a serious risk to your health, these difficult thoughts and feelings are normal and natural, so be gentle with yourself. One thing that helped me was taking control of the things that I was able to control, like my medical care. I became knowledgeable about breast cancer and did extensive research to find a cancer institute and physician who specialized in treating breast cancer. While this was a positive process, likely giving me the best chance at survival, it was also difficult and confusing. There were times that I would minimize the seriousness of my illness and question whether it was really necessary to see a specialist or get a second opinion.
We know there's a mind-body connection. Are there things you did physically that helped you mentally?
Exercise is a great way to stave off depression. At first I was using my Nordic Track like crazy feeling, again, that I was going to do everything I could for my health. My physician was supportive of my exercise plan. The first few months I felt strong and very positive about my prognosis. As my treatments continued, the cumulative effects of the chemotherapy and radiation resulted in my losing energy and stamina. At this point, I needed to listen to my body and rest. During these times I would take it easier. I would read spiritual books, or go outside for some fresh air. My German Shepherd, Tasha, would keep me company as we walked around the back yard.
What other steps did you take to care for your mental and emotional needs?
My family – my husband and daughters – and friends were incredibly supportive. I connected with other women who had breast cancer. There is something special about interacting with someone who lives it first hand and who is having similar experiences. You don't have to explain anything. There is a "knowing" that goes beyond words. They understand. The connection is automatic.
Understand that you're going to have good days and bad days; days when you feel on top of it and days when you don't. Just take one day at a time....and sometimes one hour at a time.
Laura far left, pictured at her daughter's wedding with her new son-in-law, and husband, Jeff
Determined not to miss out on the important moments, even when she was not feeling her best, Laura said, "I had a lovely wig that I was planning on wearing to my daughter's wedding. The night before the wedding, my two daughters approached me saying there was something important they needed to talk with me about. Of course, I became concerned that there was something wrong. Imagine my surprise when they said, "We've thought about this a lot, and we don't think you should wear that wig to the wedding." I was totally caught off guard and asked them how they would like a bald-headed mother appearing in all the wedding pictures. They insisted that they preferred the "real" me, and said, "We're proud of you, Mom, and think you are beautiful just the way you are." And so, the wig stayed home.
How did your cancer affect your family and friends?Understandably, my husband Jeff was scared that he might lose his wife. My daughters, who were in their twenties at the time, were fearful that I might die. They had a close friend who had recently lost her mother to breast cancer. We were able to give each other support and talk about our concerns. If you have young children, they know something is going on; it is best to talk with them in ways that are reassuring so that they don't imagine the worst. It is best not to go into frightening details, just encourage open and honest communication.
I talked with Jeff about things that were hard to discuss, like how our marriage might be affected if I had to have a mastectomy and whether or not I would feel whole again. He had to carry it all and be strong for me. I was blessed to have so many friends who gave me ongoing support and hope, but it was rare for someone to take the time to check in with Jeff and see how he was doing and give him a chance to share his concerns. Living with someone with cancer isn't easy. While he never complained, I know it was difficult for him when I couldn't do much but rest.
What can friends and family do to help keep someone's spirits up?
Being remembered by friends throughout my ordeal gave me reassurance and hope. I appreciated receiving phone calls and cards. On days when I wasn't feeling well, getting cards in the mail was nice because it didn't require an immediate response when I was just not up for talking.
Do you have any advice or insight on what it is like to move forward as a cancer survivor?
What folks with cancer face, even when remission is achieved (which means a "successful" outcome) is living with the reality that the cancer can reoccur. That's the most difficult part for me as a survivor. You've been through a lot and want it to be over. Lifestyle changes, exercise, healthful diet, and periodic cancer screenings are vital in maintaining your health and reducing cancer recurrence risk. Talking with other cancer survivors can be helpful. Support groups are a good option for some survivors.
Finally, there is every reason to be hopeful that new cancer treatment research will serve to mitigate cancer risk, promote effective treatment, and even find a cure for cancer.
|Take-aways for the patient:|
» Be gentle with yourself if you're feeling sad or scared. Understand they are normal and natural feelings, especially under these conditions.
» Take control of the things you can control, like your medical care.
» Find a doctor you trust.
» Be careful of information on the Internet. While accessing the internet for information can be helpful, it can also be misleading and provide inaccurate or out-of-date information.
» Ask your doctor or a social worker on your cancer treatment team to recommend a reputable website or book if you want to learn more.
» Exercise is great, but also listen to your body when you're tired and rest.
Take-aways for caregivers and loved ones:
» Check in with the people who are close to those dealing with cancer, too. They need support, encouragement, and someone to listen to.
» If you are the patient, encourage your loved ones to do things for themselves too, like take an evening out with their friends.
» Caregivers understand it's okay to feel tired and frustrated and not be ashamed to have those feelings, or sometimes feeling like Who needs this?! Use those feeling as a sign that it's time to also take care of themselves and do something fun.
» Send cards to patients and caregivers to remind them you're there. It doesn't require any action on their part and serves as a reminder that people care.
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