cancer, caregiver, caregiving, chemotherapy, depression, head/neck cancer, lung cancer, oral cancer, Post Traumatic Stress Disorder, psychology, psyschiatry, PTSD, radiation therapy, surgery, survivor, survivorship
(Neil Young reference)
Depression is a tough subject, and a dangerous one.
Allow me to present my credentials with respect to discussing this subject: I am not a therapist, although I have bred one :); I am not a medical professional, although I am married to one; I am not a psychologist although it was one of my majors in college until I realized that my psych professors were NUTS; and, on top of that, it seems like at least half of the people I’ve known for the last 10 or 15 years are taking something for something, which also does not qualify me to speak on the subject.
But a guy I talked to for a time suggested that I have been clinically depressed since I was six years old. It turns out that he has left the business and, I think, was nervous about my energy level from the start anyway, but still, he had a PhD and said that to me, about being six when I began to develop the disease, while his cohort, the psychiatrist, issued me anti-depressants and charged me for visits where he simply asked how I was. I would say, “I’m fine!” and he would write a script, and that was the end of that encounter that month. No wonder they get the big bucks!
The other guy, though, the PhD, he WAS interesting, and he seemed to be honing in on something. Sometimes, when I think about the dangers of cancer and radiation and chemotherapy and all of that, I shake my head when I think of him, and wonder if trying to figure out the mind is not the most dangerous thing of all.
He was a timid soul, you see, and our deal ended the day I showed up unannounced at his offices for some other purpose (probably to see my drug dealer, the psychiatrist) and, seeing him in the parking lot as I was leaving, I jumped out of my car to say hello. Seeing me, he freaked out, acting like he didn’t know me and running, actually running, into the building. I was depressed :). I thought we were friends, after a fashion.
But, this is about cancer and depression. Not about nuts :).
I have read some conflicting literature about the relationship between cancer and depression, about the relationship between chemotherapy and depression. And I have met people who are living proof that being a cancer survivor, being a chemotherapy survivor, leads not to depression.
I will leave the issue of chemotherapy alone here. I have had my share of chemotherapy and I’m having it again as I write this, but I am not qualified to state that it has something to do with depression. Okay, I’m not qualified to say that anything has anything to do with depression, but I will, anyway. Just not chemotherapy and here is why: I can’t figure out chemotherapy. (Actually, if you’ve read my thing here from beginning to now, you have pretty much realized that I do not have ANYTHING figured out. Still, it is fun to conjecture.)
I have been a caregiver, in the sense that my mom had breast cancer in the mid-70s and then, in the 90s, had ovarian cancer and eventually died of brain cancer that turned out to be the metastisis of BREAST CANCER rather than ovarian, which, when I learned this fact years later, blew me away. I always thought it was the ovarian.
I have been a caregiver in the sense that I was holding my mom’s hand as she lay pretty much comatose and gone on a gurney in the family den before I finally fell asleep, only to be wakened by my dad, in the early morning, on the floor next to my mom, (me, not my dad) to be told that she had died.
I have NOT been a caregiver in the way that my dad was, or in the way that my wife is and has been. I did little more than love my mother, in other words. While my dad did the real work and did it for an extended period of time, even shaving his head, as I reference somewhere above, not looking like a goofball at all, as I think about it with more care, but like a nobleman and a lover, which he certainly was and is, as it turns out.
I did little more than love my wife and ail (and wail and rail and try to bail), while she took care of me (without fail :)).
I bring all of this up because I have been a caregiver in those two senses, that I have loved those afflicted with cancer, and have loved a caregiver to one who has endured it as well, that my mother died of cancer, that my sister survived breast cancer and that I cared for both of them, that I loved them both (and love them still, the present tense most important in reference to my sister, who is doing just fine in terms of physical recovery from cancer), and that I continue to marvel at the strength and patience of my wife.
And I was depressed before I ever thought about cancer. Just to be honest. Which is hard to do when you are talking about your own mental health, there being a sort of sanctity of the mind, a barrier that we erect, most of us, against the outside world. Some very gifted writers and poets have broken the barrier, of course, and have relayed to us through their brilliance that depression is there, and that it should not be hidden behind the closed doors of our minds.
So I write on here in their spirit, and in their honor, and in response to a friend of mine who used to haunt this site who told me it was the right thing to do. I believe her.
As I said, there is conflicting literature about the relationship between depression and cancer. It is acknowledged, I think, that cancer HAS a relationship with depression. In my reading of late, the wonks like to say that you might experience a temporary depression as a result of this cancer thing. And there is some acknowledgement as well that chemotherapy, some of it, may cause depression somehow, although OncoMan denies it, as he denies that ANYTHING is caused by chemotherapy but healing.
Here is my take:
I don’t care who you are, if someone tells you that you are going to die, that is going to be fairly depressing. Being told you have cancer, in our society, and with our understanding of it, so much of the real knowledge hidden, of course, is reason enough to believe, upon the grand announcement, that you are going to die.
It is not, after all, as if you have been studying cancer your entire life (most of us, anyway). It can NEVER happen to us, can it? And so we do not know much about it when we are told, and what we do know is that some people happen to die from this stuff, and that even the rich and famous are not immune from that result.
Being told that you have cancer does not mean that you are going to die (being told that you are going to die does not mean that you are going to die, either, as I discovered). But the thought flashes through your mind. Before you hear anything else, if, indeed, you are sufficiently strong to HEAR anything else, you first think, Oh my God, I’m screwed!
If you are a caregiver, you think, instead, Oh my God, we’re screwed! Or, maybe, Oh my God, he/she is screwed! 🙂 Or maybe even, Oh my God! I hit the lottery with that insurance policy!
Whatever is on your mind at that moment, life has changed dramatically, and life will never be the same, regardless of what anyone says to the contrary. Life will never be the same. And that can be for better or worse, but it will never be the same.
Philosophically, of course, one could argue that every moment in your life is one that alters your life forever, and I agree, but let’s not go there now because I’m not up for that. The point is, there are momentous moments in your life, getting married, the birth of a child, the death of a loved one, a graduation, whatever, and being told you have cancer is absolutely one of those moments.
I would say that with the exception of the birth of a child, all of them can be depressing :). I mean, you get married, you have to be somewhat tentative, right? And watching a child graduate sort of dates you, doesn’t it, is rather a bittersweet moment.
But I digress. As usual.
Being told that you have cancer is a bummer, and there is no one out there that can argue otherwise. I venture to say that no one went dancing out of the doctor’s office singing that he or she had cancer. Arguably, being wed can be a happy experience :). Watching a child graduate may mean good things :). But being told you have cancer just doesn’t have any positives attached to it.
(Note that I said being TOLD you have cancer doesn’t have any positives attached to it. HAVING cancer, I am here to tell you, may actually have some positives attached to it, believe it or not. Okay, I don’t believe it either.)
Being depressed is a natural return on that deal. But as the medical folks will tell you, there is a difference between feeling depressed and being clinically depressed. Most of us, thankfully, will feel some depression, maybe even for awhile, but will then move on. Survivors and caregivers both.
Even so, temporary or the clinical deal, the docs seem to shrug it off. I advised my docs after the first event that a psychologist should be a part of his team. You see, he was well organized, and hand-selected every single person involved in my care. But there was no Head Doctor. When I told him that he should include one, he seemed to agree, and as I understand, he has now handpicked a social worker, but that is not the same thing.
Some of us need information about where to go for help with payment and food and drugs and all of that and I am not making shortshrift of that, for that is an important element in recovery — not worrying about that stuff — but I am talking about the personal mind of the personal survivor.
I am talking about me.
And I am saying that a Head Doctor would probably be a good thing.
Let’s start with the announcement. ‘You have cancer.’ How many people say, ‘Okay, cool. How am I doing otherwise?’
Not counting people who were drunk or stoned or otherwise outside of the realm of what we normally consider reality? (And I add this caveat because I WAS fairly outside the realm of what we normally consider reality, first time around, but only because I already had a feeling that the news would not be good.)
I can’t get past this. I apologize, I do, but I simply can’t get past this. I try and I try, but the truth is, this is such a devastating announcement that it defies words, and I cannot come up with adequate words to convey what it means. If you are a survivor, you know what I’m talking about. If you are a caregiver who was in the room when the announcement was made, you have an inkling at least of the power of the words. ‘You have cancer.”
It blows you away.
What I’m getting to is Post Traumatic Stress Disorder, but give me a minute or so.
After the announcement, you get to hang around and wait. And wait. And wait some more.
If you get surgery, then you are in a knife fight that you can not win. One, you are unconscious. Two, the other guy has a knife and you do not. Three, he is awake and has helpers and you are not awake and have no helpers. Four, you are in a knife fight that you can not win.
Talk about your PTSD!
If you get radiation, that is another story all together. I do not know what others have experienced. I had to wear a mask. I would rather lose a knife fight and DIE. Okay, not die, but come close to it. Instead of the mask. But even if you didn’t get the mask, how nice it is to know that you are being microwaved?
Has anyone had radiation without thinking of popcorn burning and blowing up in the microwave? Has anyone had radiation without thinking of burnt chicken legs? Dry soup? (I made that one up.) Explosions that you have to explain to mom? Egg art for example inside the machine?
Okay, I didn’t think of any of those things, but that was because I was wearing the mask and that sort of consumed my thinking entirely. I DID think of Poe, and of Dumas, assuming he wrote the story about the guy in the iron mask. I don’t keep up like I used to.
Some people talk to me about cooked lungs. Cooked lungs. And some people tell me their butts were fried. Fried butts! Am I getting across here? Of course this is depressing. Who wants to wear a mask? Who wants cooked lungs? Who wants fried butt? (Excluding certain hunter-gatherer types of folks I know.)
This is not a diversion from the topic…this stuff is perfectly understandable reasoning for depression. And yet, most cooked lung and fried butt folks I know are not depressed. So it is not just that. That is not enough.
There IS chemo. I said I wouldn’t talk about it, and I won’t, not in the scientific way. I will only say that if the chemicals don’t kill you (and that is what they are designed to nearly do, after all) hanging out with dying people will get you close.
I don’t mean to be cruel. I like dying people. Some of my best friends, it turns out now, are dying people. As a matter of fact, everyone I know is dying, but that joke gets old, doesn’t it? You know what I meant. Some of my friends are dying, and there is no better place to find such friends than in a Chemo Palace (okay, some of you may argue that going to a bar late at night will give you better odds, but I am not here to debate).
Chemo will depress you. Beyond the chemicals themselves, which are certain to do a job on you, there is the atmosphere in the Chemo Palace. But we’ve explored that. I need a rest. I am feeling rather manic at the moment :).