Archives for posts with tag: fear of recurrence

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Today is the American Psychological Association’s Mental Health Blog Day. Since I am a clinical psychologist, not to mention a member of APA, I am republishing a post I wrote last fall, “I can deal. As I’ve disclosed in the past, I have a history of major depression. I have not had a depressive episode in over ten years. I attribute my years of good health even with enormous life stress to a combination of treatment (ongoing medication and psychotherapy, as needed), exercise, mindfulness meditation, good coping skills, and wonderful friends and family. One of the reasons I write about my own history of mental illness is that so many people fear it so much that they avoid getting support or even admitting that they have challenges. As a mental healthcare provider, I also know that people in my own field tend to either embrace the support that our field offers or to avoid using services or even the support of friends. If you are suffering from mental illness or even just unhappiness, what’s the worst thing that could happen if you sought out support? And what’s the best thing that could happen? You could get a lot better or at the very least, you would no longer have to suffer alone.

 

Today, my brain feels pretty functional and I feel calm despite the fact that I still have a number of unknowns in my life including the results of my MRI from last Friday. I spent a good 2-3 weeks up until last Friday on a roller coaster of anxiety. I can’t remember if it was Wednesday or Thursday of last week but on one of those days I was a mess for a few hours. I was so worried about my MRI and the prospect of going through cancer treatment all over again. I have had plenty of sadness and fear. This was different than in times past. As I have written, I have felt storms of emotion at different times during the past 1 1/2 years. But at my core there was a sense of peace and calm.

How was my core different this time? In addition to the stress around the MRI being scheduled, then cancelled, then rescheduled (I hate that kind of stuff), about a week or two into that whole mess, my energy dipped precipitously. I was really really fatigued. Like everyone else, I have a low energy day every once in awhile. But I had several in a row. And the fatigue felt different to me, it was the kind that can pull me down into very sad places. This scared me. Anxiety followed by prolonged fatigue is how my depression has started in the past. And I have had periods of time, especially in the winter when I experience this fatigue and although I can never be certain, it feels like the start of a depressive episode that never happens because I am able to fight it off with my medication and cognitive therapy techniques.

I have not had clinical depression in over 10 years but it has been a strong concern of mine that I would have a recurrence due to the stress of being a cancer patient. So I was really scared last week and although I talked to a few people about the fears I had about cancer recurrence, I told no one, not even my husband, about my fear of being depressed again. I felt isolated, lonely and guilty about being a very needy person. I was still able to work and behave with a semblance of normalcy when it was very important that I did so.

By Thursday night, I started feeling significantly less stressed. I had gotten the core of peace and serenity back even though I was still distressed. But I wasn’t entirely back to whatever “normal” is these days. My emotional states change so much more frequently and intensely than they used to and I understand why they do. I can live with the “normal crazy” of cancer treatment. I am still myself but in technicolor. When I am depressed I am not myself. There are some people who have persistent depression, which tends to be a steady, low level misery.

In contrast, when I’ve gotten depressed, it has been acute and more severe. I fell into a very scary, powerless, and hopeless chasm, into a world where I could act like myself for some periods of time but it was acting. And I didn’t feel like myself at all. The first time it happened, I kept thinking that if I just kept problem solving, it would go away. So I let my untreated depression go on for some time. The second time it happened, I recognized it within a week or two and thought, “Oh no, we’re not doing this again” and got myself back to see a psychologist and my internist within a week and my symptoms started subsiding very quickly, within a couple of weeks.

Now that I’m writing this, I am realizing that I handled that last episode pretty well. And I am also still seeing a psychologist every month, not to mention all of the healthy things I do that are good for both physical and mental health. Depression, you are not welcome, but if you come anyway, I can deal with you, too.

(Update: The results of the MRI showed “no evidence of disease” and that is my current breast cancer health status.)

Today, my brain feels pretty functional and I feel calm despite the fact that I still have a number of unknowns in my life including the results of my MRI from last Friday. I spent a good 2-3 weeks up until last Friday on a roller coaster of anxiety. I can’t remember if it was Wednesday or Thursday of last week but on one of those days I was a mess for a few hours. I was so worried about my MRI and the prospect of going through cancer treatment all over again. I have had plenty of sadness and fear. This was different than in times past. As I have written, I have felt storms of emotion at different times during the past 1 1/2 years. But at my core there was a sense of peace and calm.

How was my core different this time? In addition to the stress around the MRI being scheduled, then cancelled, then rescheduled (I hate that kind of stuff), about a week or two into that whole mess, my energy dipped precipitously. I was really really fatigued. Like everyone else, I have a low energy day every once in awhile. But I had several in a row. And the fatigue felt different to me, it was the kind that can pull me down into very sad places. This scared me. Anxiety followed by prolonged fatigue is how my depression has started in the past. And I have had periods of time, especially in the winter when I experience this fatigue and although I can never be certain, it feels like the start of a depressive episode that never happens because I am able to fight it off with my medication and cognitive therapy techniques.

I have not had clinical depression in over 10 years but it has been a strong concern of mine that I would have a recurrence due to the stress of being a cancer patient. So I was really scared last week and although I talked to a few people about the fears I had about cancer recurrence, I told no one, not even my husband, about my fear of being depressed again. I felt isolated, lonely and guilty about being a very needy person. I was still able to work and behave with a semblance of normalcy when it was very important that I did so.

By Thursday night, I started feeling significantly less stressed. I had gotten the core of peace and serenity back even though I was still distressed. But I wasn’t entirely back to whatever “normal” is these days. My emotional states change so much more frequently and intensely than they used to and I understand why they do. I can live with the “normal crazy” of cancer treatment. I am still myself but in technicolor. When I am depressed I am not myself. There are some people who have persistent depression, which tends to be a steady, low level misery.

In contrast, when I’ve gotten depressed, it has been acute and more severe. I fell into a very scary, powerless, and hopeless chasm, into a world where I could act like myself for some periods of time but it was acting. And I didn’t feel like myself at all. The first time it happened, I kept thinking that if I just kept problem solving, it would go away. So I let my untreated depression go on for some time. The second time it happened, I recognized it within a week or two and thought, “Oh no, we’re not doing this again” and got myself back to see a psychologist and my internist within a week and my symptoms started subsiding very quickly, within a couple of weeks.

Now that I’m writing this, I am realizing that I handled that last episode pretty well. And I am also still seeing a psychologist every month, not to mention all of the healthy things I do that are good for both physical and mental health. Depression, you are not welcome, but if you come anyway, I can deal with you, too.

I had my long awaited MRI this morning. The results should be available next week. In the meantime, I will concentrate on having the best weekend that I can.

But first I want to tell all of you something. As many of you know, MRI’s are enclosed and noisy. And the noises they make are like ones you might expect during an intergalactic war. Last time I used visual imagery to deal with it. I visualized Space Invaders-type old school video game images advancing down the screen with each rapid series of  “EEEEE! EEEE! EEEEE! EEEEE! EEEEE! EEEE! EH! EH! EH! EH! Chu chu chu chu chu chu.”

Today, I did something different. I thought about my new coping statement, “Never underestimate your team.” I visualized my friends and family. Yes, that means you, too. When I didn’t have a face to attach to you, I thought of the many words of comfort you have given me.

Thank you. I wish you much health and happiness.

Love,

Elizabeth

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