Depression is one of the most difficult issues a patient that had been diagnosed with cancer has to face. I am a physician who had been diagnosed with throat cancer four years ago and am sharing my personal experiences as a cancer survivor and a clinician. You can read my story and read my book on my experiences as a patient with cancer at my Blog: http://dribrook.blogspot.com
I am doing so hoping that my perspectives will assist other individuals who had undergone similar experiences cope better with their situation and hopefully gain insight into their lives. It is also presented to health care professionals who care for patients with this illness in the hope that by gain insight into the patients’ world would be able to better assist them in their plight.
Coping with and overcoming depression is very important not only for the well being of the patient but may actually facilitate their recovery and may even increase their chance for longer survival and perhaps even ultimate cure. There is growing evidence in many scientific studies that there is connection between mind and body. Even though much of these connections are not yet understood it is well known by experienced practioners that individuals who are motivated to get better and exhibit a positive attitude recover faster from serious illnesses, live longer and sometimes survive immense odds.
There are so many reasons to become depressed after learning about cancer and living with it. It is a devastating illness to the patients and their families and medicine has not yet found a cure for most types of cancer. By the time cancer had been discovered it is too late for prevention and if the cancer had been discovered at an advanced stage the risk of dissemination and ultimate cure is significantly decreased.
Many emotions go through the patient’s mind after learning about the bad news. “Why me?” and “Can it be true?” After first becoming stunned by the news, feelings of denials, which are followed by anger, with ultimate acceptance of the new reality. It is believed that depression is a form of anger. Perhaps anger at the new devastating reality.
The patient has to face their ultimate mortality, sometimes for the first time of their life and have to deal with all the immediate and long term consequence consequences on them and their loved ones. Paradoxically feeling depressed after learning about the diagnosis allows the patient to accept the new reality. By not caring any more it is easier to live with the uncertain future. “I do not care any more what happens “feeling makes it easier for a while. However, this coping mechanism carries a heavy prize because it can actually interfere with getting appropriate medical and surgical care and can actually lead to rapid decline in the quality of life.
Hopefully a patient can find strength within themselves to fight the depression. In my case after I returned home from the extensive surgery I had to remove my cancer which included also the excision away of my vocal cords, I was overwhelmed by the daily tasks I had to perform and the new realities I had to accept. I was mourning the many losses I had experienced, which included my voice, my wellbeing, and the need to accept many permanent deficits such as not having a normal voice any more and having to speak using a weak and rusty voice generated by a prosthesis that connects my trachea and esophagus. I felt that I had to make an early choice between succumbing to the creeping depression and let it consume me or become proactive and fight back and return to life. I chose the latter because deep inside I had a very strong desire to get better and overcome my handicaps. I also realized that my struggle is not over and will be with me for a long time and that I will need to conquer the down hill slope again and again.
The driving force on many occasions to become proactive and resist depression is my wish to set an example for my children that one should not give in the face of adversity. I new that they may and unfortunately would also have to face difficult in the future and did not want to leave them the legacy that their father gave up and did not do his best to get back to his feet. This was and still is a driving force that I resort to whenever I feel down.
Support by family members and friends is very important. Feeling that ones’ continuous presence in the world and actual involvement in their lives is very helpful in reigniting the will to go on. The involvement and contribution to others lives can be invigorating. As a parent’ or grandparents’ one can draw strength and will to go on by seeing and enjoying the interaction and the impact one has on them.
What I found out to be helpful was to become re involved in activities I liked before and find a continuous purpose for my life. I started to return to the hospital to participate and teach in medical rounds and listen to medical lectures. What was most encouraging and rewarding was that my contributions impacted and improved individual patient care. I felt that I was making a difference again. This made me want to return to the hospital and teach even more. In the process of helping others, I was also helping myself.
I was also able to gradually return to many of my other routines. I started with simple challenges such as reading medical literature again, accepting invitation to review articles submitted to medical journals, learn how to take a shower without aspirating water, and even simply walking more. I gradually became able to ride a bicycle and even climb to the top of a mountain with my family. Even though I realized that the quality of my voice is not the same as before, one of my greatest comebacks was to be able to teach and lecture again with the help of a microphone. Each of these small steps made me feel better and stronger. I was discovering the world again, quite like an infant learning to walk.
Seeking the help of a mental health professional can be very helpful. I was fortunate to be assisted throughout my illness and recovery process by an excellent, compassionate and skillful social worker. We discussed various issues relating to my recovery process, as well as my anxieties and frustrations. Having a caring and competent physician and speech and language pathologist that can provide continous folowup. Their involvement can help deal with any emerging medical and speech problems are very important for the sense of well being.
I Brook MD