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Cancer and Depression

3 Jun

I’ve written about post-cancer depression here before. It creeps in like a bad flu and when it happens most people are surprised. Depressed? Not me. I’m a fighter, fighting against cancer. Nothing’s gonna get me, no, nothing at all.

The truth is, post-cancer depression is a lot more complex than that. There is a sense of great loss and also a sense of betrayal that the body and soul will not ever return to normal.

And of all the books, websites that I’ve read, nothing describes it as succinct as Dana Jennings, a writer for the New York Times. Gosh I wish I could write like him!

“Partly, I think, I’m grieving for the person I was before I learned I had cancer. Mortality is no longer abstract, and a certain innocence has been lost.

And while the physical trauma is past, the stress lingers and brings with it days washed in fine shades of gray. In the same way that radiation has a half-life, stress does, too. We all ache to be the heroes of our own tales, right? Well, I’m not feeling too heroic these days.” – Dana Jennings

After Cancer, Ambushed by Depression : Dana Jennings, The New York Times

Have a peaceful and joyful day ahead.

Sex and Intimacy after Cancer

15 Dec

One of the things I realised after treatment is that life does not return to normal. Well, some say that you’ll get used to the new normal  and then they go on to tell you what the possible new normal is. When it is expected, it could be well tolerated without much struggle. However, more often than not the new state surfaces out of the blue and it hits you like a “wham!”, and all you can think of is, “is that the new me now? and how long does that last?”

I came across this educational talk posted on the Livestrong blog about sex and intimacy after cancer. After treatment ended, I found myself not interested in engaging intimately with my partner. There are many reasons: don’t feel like it, not in the mood and pain. Coming to terms with the new self is a slow process and takes a great deal of communication. I remember being confused about the fear of intimacy and love – does that mean I’m not in love with him anymore? – and having to dissect what my emotions are before attempting to speak to my partner about it. I didn’t feel like a woman, more like a sexless person who has the technical functions of a female human being.

Speaking about it allows your partner to understand what you are going through. First of all it is a good thing for your partner to know that you are not rejecting him. Second of all, it reinforces the idea that you are still in the process of recovering and hence he knows what to expect – certainly not back to your pre-cancer normal. Best of all, if you can talk about it and laugh about it, it certainly helps with your relationship.

There are lots of information out there with coping with sex and intimacy after cancer. Here is the link to the livestrong video and it also comes with a handout which you can print out. This page at the National Cancer Institute also has information about how to cope with your sexual life after cancer. At the end of day, be patient and kind to yourself. Dealing cancer has been difficult and now you still have to deal with it?? WTF? I know, I feel that at times too. But moping around doesn’t really help. So focus on the positive and remember that life can sometimes throw you many curveballs, it is really up to you to make the best out of it. If in doubt, a loving hug to your dearly beloved or a relaxing massage never fails.

Your Inner Child

6 Dec

My session with the medical counsellor yesterday went up one higher level when we spoke about the fears, anxieties and negativity that comes after treatment.

I did not understand why after handling cancer treatment very well, I found it difficult to proceed in life, to live my dreams and future life with an optimism that is often seen in cancer survivors. One month ago, I realised that it could be menopausal symptoms which bordered on depression. Yesterday, my counsellor said it could be possible that the fears and anxieties were within me all along. Because I had a focus (to get treatment and get better), I have subconsciously pushed these feelings aside. And now it’s pay-back time.

After discussing my fears with her, it seems that there is an inner critic within me who is harsh and pretty much judges me according to all the mistakes that I’ve made. In fact, because of this judge, I have fears of failure because I fear that she will judge me. It all sounds a little psychotic, like I have different personalities within me but I honestly understand it as it is really true that I have such a judgemental voice in my head! We then went on to identify the different voices in my head, breaking down the inner conversations within my head. Then we proceeded to come up with things to tell those voices when they are at work. One of the things which we discovered was that I am often too hard on myself and I need to have a kind voice to myself.

I did a little research after I came home about “inner child” and came across this on the livestrong website. It is a little introduction on the concept of the inner child and is a good place to start, if you think you may have an inner child who has been suppressed.

5 Ways to beat the post-cancer treatment blues

15 Nov

What has 30 Rock got to do with breast cancer?

After reading books and searching online for ways to overcome the inevitable blues after cancer treatment, here’s my little list of suggestions which I have found to work:

1) Exercise daily, if not, as much as you can. Find an exercise that you enjoy and set aside time for that. For me, I found swimming a great way to beat the heat in Singapore and the arm stretching also helps to prevent lymphedema. The sensation of being underwater, accompanied by the sounds of water and my own breathing is an effective way to calm my mind from random thoughts.

2) Make plans. It is easy to get stuck with an disinterest with your daily activities. I was sketching a lot more during my treatment days and now I hardly have any interest to pick up a sketch pen. Try to plan small projects which are achievable to get yourself going, and soon you’ll be getting the hang of it.

3) Meet friends. Social withdrawal is a common symptom of the blues. For many months, I mistook my social withdrawal symptoms as a preference for solitude. Buried underneath unknowingly is often a fear and a lack of confidence to meet people, having to deal with them or their reactions if they knew you have cancer. To overcome this, try to arrange meetings with people you enjoy hanging out with.

4) Eat wisely. A lot of the books that I have read point to food and nutrition as a tool to get better, emotionally as well as physically. As your body is healing itself now after the harsh regime of cancer treatment, try to stay away from foods that will kick you into mood swings. I stayed away from caffeine and sugar (only a tiny bit when I really want a snack) and substituted sweets with raisins, nuts and fruits. Those foods not only give you the nutrition that your body so badly needs, they also prevent you from getting a high, followed by an inevitable low.

5) Humour. As much as it sounds weird, it helps tremendously to laugh about something everyday. Try not to take yourself, or your situation too seriously and see the lighter side of things. When things go wrong, have a laugh… you’d be surprised by how you feel. Psychiatrists have often said that your actions determine your feelings (instead of your feelings determine your action). So to lighten up, smile to someone, tell a joke, remember funny stories. I kept a whopping 5 seasons of 30 Rock comedy in my MacBook and they’re always there whenever I need a pick-me-up.

Talk it out.

14 Nov

There is a wonderful source of help in the form of kind voices whose faces you don’t see… and they belong to the counsellors at the Singapore National Cancer Centre Helpline.

If you feel like speaking to someone but you just feel like your friends or family will not understand what you’re saying, the cancer helpline is a good source of support. Oncology nurse counsellors are on the other end of the phone and they are trained with speaking with cancer patients, whether if you are dealing with the anxieties of your diagnosis or the side effects of cancer treatment. Most of all, it is absolutely anonymous and you will not be pressured to reveal any personal details if you do not feel comfortable. I called to ask about the tightness of my right arm last week and the nurse was kind enough to mail over some illustration of physiotherapy exercises that could help.

To speak with a National Cancer Centre oncology nurse counsellor, you can call them between Monday to Friday, 8.30am to 5.30pm at (65) 6225 5655. Alternatively you can also reach them at cancerhelpline [at]nccs.com.sg

How to cope with depression after Breast Cancer

27 Oct

It is official – I may be slightly depressed now that my cancer treatment is over. “What?” Some of you might say – didn’t you just survive an illness and now you should be living your life to the fullest, i.e. Carpe Diem? It turns out that survivorship is almost as hard as going through the treatment. After the long ordeal of surgery, chemotherapy and radiation, I am hit with bouts of feeling empty, sad, confused – and the chemobrain and lack of focus does not help at all. I had thought that after treatment I would bounce back immediately to my old self again. Now, I hardly know if my old self is gone forever, or if this new self is going to stay for good.

One thing’s for sure, my slightly depressed self stems from a lack of estrogen due to an induced menopause from the chemotherapy. Boy, is that estrogen powerful! Besides having really dry skin (on my heels mostly), I am also experiencing hot flashes, moodiness and generally a sense of emptiness.

Here’s a good article which talks about depression after breast cancer, and in the comments section there are lots of women who have came forward and wrote about their experience. Also, here’s a good video which you can learn much about depression after BC.

“Excuse me, my thermostat’s not working”

25 Oct

While having breakfast with my good friend Yunyi today, I shared with her about my current situation as a cancer survivor. One year on, after the gruelling regime of surgery, chemotherapy and radiation, I am now at a point in life where I need to make certain important decisions which will have a huge impact on my life in the next few year, or possibly the rest of my life. Instead of feeling the “Carpe Diem” which I read quite a lot in cancer survivors’ stories, I am overwhelmed by fear and consumed with worry.

A counsellor whom I spoke with two weeks ago turned the light on my current medical condition. A combination of chemotherapy and Goserelin injections has pushed my body into a state of induced menopause. Besides the physical symptoms of hot flashes, fatigue, dry skin etc., one of the side effects which I did not expect to hit me full on the face, was the emotional upheaval with the lack of estrogen.

This lack of estrogen is such a pain in the ass. The crying, the despair, the negativity, the fear, the fuzzy brain… all these just because of a hormonal inbalance in my body? Knowing that makes me feel like honouring all women who have to go through menopause. Compounded with having to make a decision about relocation to a non-English speaking country where I have to start all over again, I am suffering from a paralysis.

The paralysis stems from a number of things; mostly from a changed self. Nobody from my healthcare told me about the emotional recovery I will need after cancer treatment. Small things now upset me, making me sob uncontrollably. Instead of feeling confident and a “I can do anything because I survived cancer” attitude, I feel more blue than usual, more pessimistic … hardly like myself at all. My counsellor told me that it is as if I have a pair of shades on all the time, that through my menopause shades, the world is three tones darker than it really is. It is as if the thermostat to my air-conditioning is faulty and does not respond correctly to the external temperature.

With that, how can I make any decisions about my life, or regarding my partner? I don’t trust the new me, I find it hard to understand what goes through my mind, my decisions. They are all tangled up in a ball with overwhelming emotions.

Yunyi suggested that I learn how to do a centering exercise where I learn how to breathe deeply and return my self to a “centering” position without being overwhelmed by emotions. Another thing she suggested is for me to write down reasons for my fears and courage pertaining to relocation. I have learnt that this estrogen deficiency tends to amplify whatever emotions I feel, so if I feel fear – it is probably three times more than what a normal person, or the normal me would feel. Yunyi’s suggestion is that maybe I should visit the reason of fear, so instead of being caught up in the intensity of fear, get to know and understand the seed of the fear.

I think that’s a good suggestion, at least before I see my next medical counsellor.