After cancer – depression

http://well.blogs.nytimes.com/2009/09/29/after-cancer-treatment-waiting-for-the-sadness-to-lift/

September 29, 2009, 10:40 am

After Cancer, Ambushed by Depression

By DANA JENNINGS

I’m depressed.

I’m recovering well from an aggressive case of prostate cancer, I haven’t had any treatment in months, and all of my physical signposts of health are pointing in the right direction.

Still, I’m depressed.

And I’ve been ambushed by it. After more than a year of diagnosis, treatment and waiting, it’s almost as if, finally and unexpectedly, my psyche heaved a sigh and gave itself permission to implode.

I’m not alone in this cancer-caused depression. As many as 25 percent of cancer patients develop depression, according to the American Cancer Society. That’s contrasted with about 7 percent of the general population.

This isn’t about sadness or melancholy. It’s more profound than that. Broadly, I have a keen sense of being oppressed, as if I were trapped, wrapped up in some thick fog coming in off the North Atlantic.

To be more specific, I’m exhausted, unfocused and tap my left foot a lot in agitation. I don’t much want to go anywhere — especially anyplace that’s crowded — and some days I can’t even bear the thought of picking up the phone or changing a light bulb. All of this is often topped off by an aspirin-proof headache.

The fatigue frustrates me most. When I envision myself it’s as a body in motion, walking or running, not foundering in bed. On one recent day, I slept till 10 in the morning — getting 11 hours of sleep — then took a nap from noon to 2. And I was still tired.

I’ve had occasional depression over the years, but nothing as dogged as this. When I first learned that I had prostate cancer, I wondered about depression. But after the shock of the diagnosis wore off, I was sharp and clear-headed. I wasn’t depressed as I went through treatment — surgery, radiation and hormone therapy. I was buoyed by a kind of illness-induced adrenaline.

The bone-smoldering fatigue arrived in late spring/early summer, and intensified as summer deepened. I thought that I might be depressed, but resisted the diagnosis, didn’t want to countenance the idea that I could be depressed after all of my treatment.

I stubbornly chalked the fatigue up to the lingering aftereffects of radiation and my fluctuating levels of testosterone. But I was wrong.

I am seeing a psychiatrist who specializes in cancer patients, and have started a course of medication. My doctor assures me that depression isn’t unusual among those who are on the far side of treatment.

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.

Cancer pushes lots of difficult buttons. It lays bare our basic vulnerability and underlines the uncertainty of this life. And prostate cancer attacks our culture’s ideal of manhood. The steely-eyed Marlboro Man isn’t expected to worry about incontinence and erectile dysfunction.

Cancer feels bleaker than other diseases. Even though my health keeps improving, and there’s a good chance that I’m cancer free, I still feel stalked, as if the cancer were perched on my shoulder like some unrepentant imp.

It’s harder to write about the weight of depression than it is to write about prostate cancer and its physical indignities. Cancer is clear biological bad luck. But depression, no matter how much we know about it, makes part of me feel as if it’s somehow my fault, that I’m guilty of something that I can’t quite articulate.

This has also been a difficult post to write because during my dark waltz with cancer I’ve depended on my natural optimism and my sense of humor to help see me through. But depression blunts those traits.

In the end, though, I believe in and trust in the healing power of the stories that we tell each other. And I wouldn’t be truthful to you or myself if I ignored the fact that I’m depressed … even as I wait for a brisk wind billowing out of the north that’ll blow this fog of mine away.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>