Why Breast Cancer is Better Than Depression

Originally Written and Republished by: Nancy Alterman

The day after my first chemotherapy treatment, I had an epiphany and was overcome with relief. I was going to be sick and not feel ashamed. Tears filled my eyes as I realized how different this was going to be from what happened eight years earlier when I developed a major clinical depression. Back then, I was very sick and deeply ashamed.  

The awareness that having breast cancer is a better experience than having depression occurred to me before all my treatments were even completed. I thought to myself, could I possibly be rushing to a conclusion? I wondered, what would people think about my preference for cancer over depression?  It sounded a little bizarre even to me.

Regardless of how it sounds, there actually are a few truths about the two experiences that are undeniable.  

There are truly 7 quite simple truths:

I will not suffer in silence and alone with breast cancer. People have been eager to help me at every turn. I have many offers for cooking meals, driving, management of home affairs etc…There are dozens of others who have been down this road and are willing to help me again and again. It has been wonderful to have their guidance and support. When I suffered from depression, I felt more alone and confused than I ever had before. My boyfriend at the time knew I was suffering and he himself was in therapy for low mood and depression, but could not offer me support and guidance as he was very functional and could not relate to my situation. When I was sick with depression, I spent every day hoping that the next morning I would wake up and be myself again.  I had no idea what I needed to do to get well. I had been to my family doctor but he never suggested a specialist and only could offer me medication.  I was lost.  I could not function.  I got behind in paying my bills because I couldn’t think straight enough to organize my papers and write checks. Every day routine things were a hardship. There was little understanding from others until I got desperate and was on the verge of quitting. I was involved with a weight loss support group and they could see that I was going down, but could only offer encouraging words.  There was no clear guidance available to my friends, my family and me as to exactly how to help me.
 

I will not feel ashamed about having breast cancer.  Being so sick with anxiety and depression was a foreign experience for me because I was, in general, a happy person. Most people viewed me as strong and quite capable, which I was. But still, I just happen to have worried myself sick when there were concerns about my daughter’s behavior in high school.  At first when I was depressed and later when I survived a suicide attempt, I believed that I had let down my loved ones. Well-meaning friends told me never to do that to them again, as if my sickness was an option for me. No one understood what had happened to me and I felt judged.  While I was sick, I feared that I might never be myself again.  I had become trapped inside a very sick body as I experienced “leaden paralyzes”, insomnia, difficulty swallowing and wanted to free myself from the body that had come to imprison me. There was tangible relief in sight. I no longer could recognize myself.  I was flat in my speech and presentation.  I had become so small inside, I could barely find me anymore, and every day I was stuck dragging around this already dead weight called my body. What made my shame feel even worse; I was forced to appear in court because I had tried to end my life.  I had misused prescription medication for other than it was intended and I was being prosecuted.  With Breast Cancer, I will never be given a summons because I am sick.


My cancer will not threaten my professional occupation as my ability to perform my duties will not be questioned.  Depression lives in the brain.  It is only natural to wonder if I would be well enough to perform my duties adequately. However, given that I attempted suicide, I was advised not to tell my employer as it would reflect poorly on my record and leave me vulnerable to potentially losing my job. I had to keep it a secret. I returned to work and did not talk about the cause for my sudden absence until many years later. With a cancer diagnosis, there is no need to keep my health status private or a secret. It has already been established at work that this is a non-issue. I have been reassured that I can take off as much time as I need to deal with the cancer treatments and the process of healing. My fellow colleagues and co-workers have been very understanding and have provided me with flexibility and ongoing concern in supporting my continuing to work while receiving the variety of cancer treatments required.


Many reputable and nationally known health care providers and institutions are eagerly seeking me as a breast cancer customer. There are many highly respected care centers and physicians eager to secure my business and encouraging me to come to them for help. Also, there are routine screenings annually for breast cancer.  When I had depression, once my family learned how sick I was, finding resources and hospitals to help me were nearly impossible. My family had to do some extensive research to learn where to take me for help and still did not get the right guidance.  After receiving medical clearance and was well enough to go to a psychiatric facility, my family could not figure out which one was best. There were no commercials on television or radio spots announcing that they were the best place for helping patients after a suicide attempt.  The first institution once had a good reputation. However, it turned out to be horrible as it had declined in recent years. And the better one was poorly managed and ill equipped to truly help me. I later learned that inpatient psychiatric care is really only designed to keep someone under surveillance long enough to keep them from hurting themselves or harming someone else and not a place for “true” therapy and treatment. Before my attempt, my sister made many phone calls before she found a competent psychiatrist who had availability to see me.  None would take insurance and the first visit was $225 back in 2007.  The psychiatrist turned out to be mediocre in my opinion because she did not fully screen for suicide risk. I did not complete any questionnaire for that purpose nor did she ask me if I had considered it as an option. I did tell her I was trying not to harm myself but even that statement did not trigger further investigation as to my risk for an attempt.

My family physician truly did not know how to help me either. He did start me on an antidepressant but I never could stay on it long enough to make me feel any better.  Maybe if he was better trained, he would have recognized that I was struggling more with anxiety than depression since I came in there saying I was not sleeping through the night anymore and I was worried.  I believe if I had known to ask for anxiety medication or if he had used screening tools for depression and anxiety, I would not have gotten so horribly sick.   As a family doctor, he did not know enough to refer me to a specialist or a crisis unit for a more thorough evaluation. None of these experiences could ever happen with cancer.  Cancer screenings and referrals are routine, not so with mental health.


There is solid science and good public information about breast cancer. here are public service announcements, newspaper articles, and television programs, all warning people about various cancer threats.  Not so with mood disorders.  Family doctors often do not have clear guidance for diagnosing and treating mood disorders. They get most of their information from drug representatives. The science behind many of the medications is not well understood. There are not enough highly skilled psychiatrists and therapists aggressively treating depression and other mental illnesses. For example, most doctors don’t understand that there are serious consequences for worrying. No one ever told me I could worry myself sick.  I knew I was having trouble sleeping because I was worried. In my lifetime, I received no warnings letting me know I was engaging in dangerous and risky behavior that could make me disabled. I never suspected that compulsively thinking about something which we commonly call worry, could lead me to a breakdown. I had been warned not to go with a stranger, not to smoke, never to drink and drive, not to walk alone at night- all these activities could result in danger to me.  I did not know that worry could result in danger to me in that stress hormones and chemicals would be released, flood my body and render me dysfunctional. 


My pain and suffering with breast cancer is intermittent. My pain, immobility, agony and suffering with clinical depression were constant. There was no real reprieve from the disability from my depression. Never once did I get to feel like myself the entire time I was sick.  When I was depressed, I was much more helpless and impaired and could not manage day to day tasks very well at all, than this type and stage of cancer is for me. My physical discomfort and even my emotional suffering with knowing my health is at risk, comes and goes. My sadness fluctuates appropriately. With depression, every moment awake took an effort to be alive. I was stuck in the heaviness and could not break free.   

The survival rate is better for cancer than clinical depression. About 40,450 women in the U.S died in 2015 from breast cancer*, though death rates have been decreasing since 1989. Women under 50 have experienced larger decreases. These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness. Contrast these survival rates with those for mental illness. 90% of all people who die by suicide have a diagnosable mental illness prior to their death. In 2014, there were 42,773 suicide deaths.

*The American Cancer Society Cancer Facts & Figures 2014

After 4 courses of chemotherapy, (the first concoction I was allergic to and the 2nd one made me extremely sick requiring a course of antibiotics) and 35 radiation treatments with the last 10 directed only at the surgical site, which is called a ‘boost”, I am concluding that my cancer experience was less disturbing to me than my depression experience. Although I was physically weary quite often; some pain at times, almost daily had an upset stomach and frequently struggled to do everyday tasks, I never lost my sense of humor or my ability to spend good-natured time with my family or friends. I was capable of making decisions regarding my health care because I could absorb the information provided and often was motivated to research more. I was never physically immobile or unable to sleep. Everyone who knew me understood what was going on and what to expect.  My co-workers were respectful and considerate of my needs. With cancer, I knew I was going to be well again. Yes. Breast Cancer is a better experience than Major Clinical Depression.

 

This piece was originally published on Ms. Alterman's personal blog, "Becoming Wiser Through Breast Cancer and Other Things"

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