Depression post-treatment
I am about a year post-chemo. I handled everything well from the bi-lateral mastectomies to the chemotherapy to the reconstruction. Then, shortly after I started Tamoxifen, this deep depression crept into my life. I was really struggling. I wanted to exercise and eat healthy and meditate, do what I could to manage it on my own, but I lacked the motivation. I had just started to feel better when my Mom passed away a few weeks ago. Needless to say, I took several steps backwards. After just recently reacting to a situation with a very skewed perspective and intense negativity towards myself, I talked to my therapist and went on an antidepressant. I am left struggling with feelings of failure, wishing I had the strength to "fix" things on my own.
Comments
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Dear Ij4618, Sorry you are in this club none of us wanted to join. But you have done everything you can to protect yourself, and are very early stage. Tamoxifen can definitely cause or increase depression, but hopefully the medication will level that out for you. Hang in there and talk to your doctor about all concerns you have. HUGS
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Thanks, pupmom. Even though I have been told many times that one year post-cancer still qualifies as "fresh", I can't help but feel I should be "over it" by now. And, to be honest, my strong emotional response, which came AFTER treatment ended, was a surprise to me.
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I was anxious for about 2 years, but time does heal. I rarely think about cancer any more. Getting more depressed AFTER treatment really is a thing. During treatment you have a goal to focus on, but once that is over, it feels like you're just hanging there, with no direction. And that's when you're likely to focus on the underlying fear.
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lj4618, as pupmom said, depression post treatment is a real thing. I compare it to PTSD. A cancer diagnosis is traumatizing. It is life threatening. During diagnosis and treatment you are in fight mode. After you come through some pretty awful treatments, survive it all, and then have a good prognosis...your mind and emotions begin to process it all. Trying to get back to living is a very difficult task. It takes time. I am coming up on my first cancer-versary...I don’t know how I feel about it. I certainly don’t feel celebratory...but I am thinking back to this time last year, between Thanksgiving and Christmas when cancer rocked my world.
It is good that you are on anti-depressants. It is really helpful if you have a psychiatrist monitoring your meds. Especially taking Tamoxifin...there are very specific anti-depressants that work with Tamoxifin. Don’t give up on the antidepressants. Work with your doctor and communicate how you are doing. Sometimes adjustments in dosage makes all the difference.
I am so sorry to hear that you just lost your Mom. That is huge! Her passing is going to compound your grief. Be good to yourself. Take time for yourself and don’t be afraid to say “no” to people and things that zap your energy and drain you emotionally. It will get better...it takes time.
Thinking of you and sending (((hugs)))💜
Bella2013
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Thank you, pupmom. I appreciate the encouragement and support.
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Thank you, bella2013. I am on Effexor. My Dr. was sure to research which medication would not interact with Tamoxifen. I appreciate your kind words and support. It's hard to imagine that things could get better because my mood is so low, but I'm trying to be hopeful.
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lj4618, this is my second cancer diagnosis and I can tell you that cancer and cancer tx is very rough on a person emotionally and physically. While we are in active tx, we are in survival mode. The treatments are grueling , invasive, and often painful. Plus, we struggle with a sense of "aloneness" that only being around other cancer survivors alleviates. Once we are done with active treatment, all of the flurry of activity suddenly stops. All of the emotions that we were not able to process while in survivor mode now have to be processed. Medical PTSD is really common amongst survivors and I suspect it is under reported. Be as kind to yourself as you would be to someone else in these circumstances. Be super kind to yourself, you've earned it. I'm so sorry that you lost your mom while trying to heal from your ordeal.
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I'm not sure how old you are, but losing my mom was the hardest thing that ever happened to me. These are big things and the idea that we should carry on like before - that's not normal.
That said, the nature of depression is that it tells you things won't ever feel different. That feeling is part of the depression. It's ok to feel it, but try not to completely believe it either. Feelings aren't facts. (I read that phrase somewhere and I love it).
I am left struggling with feelings of failure, wishing I had the strength to "fix" things on my own.
I know this feeling well. I think it's another one we shouldn't trust. Strength seems like it's always a good thing, but I don't know if that's true. It's ok to not always be strong. I think it's probably healthier to not always be strong. You've been strong before, and you'll be strong again, and it's ok to not be strong just now.
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Thank you, DWiseley. I appreciate your support.
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i appreciate that, Salamandra. I just feel like I should be over it by now because it's been a year. It's either the cancer made me depressed or the Tamoxifen. I had more mood swings at first, with Tamoxifen. But then it gradually turned into a really low mood that hasn't gone away.
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I take a magnesium supplement called Natural Calm that really helped with Tamoxifen caused depression. I also swear by Vitamin D.
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I had a second opinion MO tell me that a cancer diagnosis tends to magnify any problems in your life. I believe that to be true. I'm sorry that you've had these feelings and now the loss of your mother
I've had some struggles over the years - feeling down, lack of energy kind of thing. I was tested for Thyroid problems, recommended B complex vitamins, etc. A few providers talked about drugs to help. I always felt like I didn't want to be on something all the time - afraid of how I'd feel, SE's, never stopping it.
At my one year anniversary from diagnosis, I was a mess. I think Tamoxifen added to that. I sought counseling, took up a nutrition and exercise class, tried a new job. I seemed to be doing somewhat better, but my marriage is a mess.
So here I am at two years - no more cancer therapy but lots of residual aches, pains, weird stuff. I'm so tired of not feeling good. I'm irritable, have problems concentrating, feel like there's no point in anything - it's all too much.
I talked to my PCP about this last week. He thinks I should take an antidepressant. I think I should, too. But I do get the "being strong" thing. And I feel like if I'm better with a drug then I guess everything that's wrong has really been my fault. But at this point - I guess I really don't care if I even feel like me anymore.
I do wonder if I should see a pychologist first, though. How important is an accurate diagnosis in mental health?
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I'm not a doctor but I'm personally pretty experienced with the mild to moderate depression/anxiety end of the mental health spectrum and its treatment, and since I'm open about it, I learn a lot second hand from friends' experiences as well.
My understanding is that once in a while diagnosis is both important and urgent - for example, if the issue is manic depression but only depression is identified, some regular antidepressants can actually make the mania part worse.
Sometimes it's important but not really urgent. For example, I'm pretty sure that depression was actually either masking or exacerbating my ADHD, which wasn't diagnosed until much later. I wish that it had been diagnosed earlier, so I could have gotten treatment for it. But in the mean time, the antidepressants did improve my quality of life and did not harm me.
A lot of the time, it's not really that important. A lot of mental health treatment for these things is trial and error - different people responding differently to different doses of drugs. A psychiatrist is that they will have deeper experience and knowledge of the drugs. But I think a regular GP can do a fine job of starting treatment for mild/moderate depression in most cases, and in many cases may be all that's needed. That is my nonprofessional two cents, which is probably worth about two cents
AFAIK, psychologists are more likely to do ongoing therapy and are sometimes used for diagnosing things like ADHD. They generally cannot prescribe medication. For most mental health specialization, one would see a psychiatrist.
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NotVeryBrave,
Not feeling like yourself is it, yes. And the fear you won't feel like yourself ever again. It's such a tough way to feel. "And I feel like if I'm better with a drug then I guess everything that's wrong has really been my fault." Wow. That helped me to see that that's how I had been feeling. But last night? I went to our family's annual caroling party. I was surrounded by friends and family who love me. I shared that I had started the antidepressant and I honetly was embarrassed and worried they would think less of me. You know what? They didn't. They were proud of me for taking charge and taking care of myself. Some even shared that they went on an antidepressant after their divorce, etc. I realized (also with the help of a friend) that the only person who is disappointed in myself is me. I just had cancer and my Mom just died. It's ok to not be ok! Life is a journey and this is just part of my journey. I have to let go of whether or not I have handled things well. I did the best I could. Taking the antidepressant shows I have more strength than I give myself credit for. I have to believe that I will look back on this in the coming years and be grateful that I made it through, grateful that I have more time on this earth to experience all its beauty, grateful that I took charge and went on an antidepressant to help me get through a very difficult time. You will be ok. You will get through this. We both will.
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Thank you for that. It's a tough place to be in. I think I just need to do something, try to get to a better place.
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I'm so sorry. I lost my mother 10 years ago and I cannot imagine coping with both at once.
I have been feeling similar feelings about having no motivation. I think it must be a pretty normal reaction to it all.
I'm about to try a support group recommended by the Nurse Navigator at the Cancer Center. I was looking forward to going and found out it was last week. I got my weeks mixed up.
I was diagnosed a year ago. It's taken me awhile to try and reach out and connect. I just didn't feel like it. It's still a struggle, but I think it will combat the negative thinking that I feel is zapping me.
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I am so glad I found you all. I had a cancer dx 1 year ago. After 2 surgeries & months of radiation I thought I had this cancer thing licked. Suddenly I became extremely anxious,depressed,lost my appetiate,energy & didn't seem able to even go to the store.You all have given me hope & I',m calling my Oncologist Monday & see if he will send me to a psychologist.I am taking amitripline & my medical doc. put me on Lexapro since this depression began 2 weeks ago. I am also taking Letrozole to keep the cancer from returning.Do you know anything about this drug? Thank you for your help...Dianne
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My heart aches for the posters on this thread as I was so there three years ago, two years post diagnosis. I was so busy proving how strong and healthy I had become physically, that I deprived myself of my former life. Everything became post cancer. My typical pleasures were taboo and I thought I had it all figured out until one day I woke up and could not get out of bed. I am a social worker who has specialized in suicide prevention, but did not recognize my slow but steady decline emotionally. With psychiatric intervention that involved antidepressants, I am myself again, but back to my previous life. I now enjoy wine while I cook healthy but delicious meals, I put back in 15 lbs and forgive myself when I do not workout. I am still healthier, but much more balanced. I believe that PTSD I bring over diagnosed at the moment. The actual diagnosis involves flash backs. I was simply severely depressed. Just as serious. But equally treatable. Please do not suffer with this. Seek treatment that suits your beliefs as we should not have to keep on suffering. Love to all of you
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- For 2.5 years I have had depression and anxiety. Dr. Have tried me on ( setraline, benzo that starts with c, , fetzima, effexor, seaquel, ativan, now lamical and proxac) my son went in to talk with psyc and he told him I have been anxious for most of my life so dr said I have ocd. Wants to try me on anaframil. I am so sick of trying the meds but I want to stop the terrible thoughts. I feel sick just thinking about it. I believe the bc wont come back cause it was small 1.3cm with the sentinal mode with 1.9mm. 24 clear. No chemo had radiation double mastectomy Has anyone had experience with this drug. He wants to help me get off the other drugs if it works. Please help you can send me a private message if you dont want to post online thank you Let us know if you still need help or other ideas. Y
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- For 2.5 years I have had depression and anxiety. Dr. Have tried me on ( setraline, benzo that starts with c, , fetzima, effexor, seaquel, ativan, now lamical and proxac) my son went in to talk with psyc and he told him I have been anxious for most of my life so dr said I have ocd. Wants to try me on anaframil. I am so sick of trying the meds but I want to stop the terrible thoughts. I feel sick just thinking about it. I believe the bc wont come back cause it was small 1.3cm with the sentinal mode with 1.9mm. 24 clear. No chemo had radiation double mastectomy Has anyone had experience with this drug. He wants to help me get off the other drugs if it works. Please help you can send me a private message if you dont want to post online thank you Let us know if you still need help or other ideas. Y
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I have completely held it together until today. I was diagnosed and had surgery just last November and finished radiation 3 weeks ago. Started Tamoxifen a week ago. Last Friday had a horrible appointment with family doctor. Acted like they didn't even care about my cancer. Then today they cut me off from my pain medication for herniated discs in my neck, that I've taken for years. Referred me to a pain clinic. I don't know why but I just completely lost it sitting in my car at lunch. Almost sobbing. Like today is the first day I am actually acknowledging what I've been through. Am going through. I'm scared, I'm angry, and I feel completely alone. I'm going through a divorce on top of it all. Just need to vent to somebody. If I had to take a step back and think about it, it's probably the Tamoxifen side effects. But it still very concerning that I haven't cried about any of it until today. And I can't stop crying. I have suffered from depression for years, and my psychiatrist said I am probably handling it so well, because I've been through just as much with my depression. It hardened me I guess. Where do I go from here? Who can I reach out to? Any suggestions would be greatly appreciated.
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Hey ladies:
Do any have oncology psychiatrists that you can get access to?
After my 2nd dx, I started having major panic attacks. They disabled me. I saw my MO who said the panic attacks were not from my 2nd dx because it was stage 1. But I insisted I needed help, so she sent me to the cancer centres oncology psychiatrist.
He said that he was not surprised I was having panic attacks and prescribed effexor XR. He told me I could continue to see him or go to my GP. I chose my GP. He said anytime I need to see him, just make an appointment.
At my appointment, he said that cancer patients are usually shocked, in a bit of denial at first. They go into a flight, fight or freeze mode during treatment due to the stress. They numb out, or get angry and fight, or refuse to admit the seriousness. After all the treatment is over, the cortisol and adrenaline is no longer so strong in the system, and the real terror and horror of the diagnosis and what they have been thru comes through. This causes anxiety and depression.
I know its been two years since my second diagnosis, and I no longer have panic attacks. I am depressed though. I am on Arimidex and I think this exasperates it, but I also know this second dx has flattened me and freaked me out. I think every day is very precious because I could be diagnosed with mets any second. Instead of motivating me though, it causes me to freeze. I am unmotivated. I have lost interest in my former BC self. I have gained tons of weight from eating emotionally.
Should I go back to the oncology psychiatrist? Just knowing I can is comfort. I am not going though because I am thinking my depression will eventually lift, just like the first time I was dx'd. I know its "normal" to go thru this so... Im good.
So... does anyone else have access to an oncology psychiatrist?
wallan
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Hey CarrieSt,
I'm so sorry. I feel like any one of the reasons alone - cancer, divorce, pain treatment denial, would be well justified to cry over. All of them at once... it's a lot, and you're completely justified emotionally responding however you are responding.
It sounds like it's probably time for a new family doctor. But in the mean time, these are some possible suggestions:
- See if your cancer center has a psychiatric staff and if you can get an appointment with a doctor there
- See if your cancer center has social workers - even if they can't prescribe they can:
- be a great listening ear and supportive voice
- be great for helping you find other resources and supports, including connecting you to support groups, for everything from the divorce to the pain management to the mental health and cancer.
- Look on PsychologyToday for a therapist who takes your insurance and has experience/specialty in working with clients dealing with illness/cancer/disability
- Check if your work has some kind of Employee Assistance Plan that could offer you some short term support with a social worker or something else
- Lean on your friends. They *want* to be there for you.
- Keep posting here
I don't know much about pain management except that it's cruel what doctors are doing to patients nowadays. I'm so sorry you have to deal with that. -
Hey Wallan,
I starting seeing a psychiatrist at my cancer center when it became clear I'd have to come off of my Wellbutrin to go on Tamoxifen. It was also really great timing for helping support me with the anxiety both about work and leaving it and about going back to it.
Why not go check in with the psychiatrist, if it's covered by your insurance? Yep, I bet you are right that your depression will eventually lift, but maybe the visit will help it lift faster, or maybe he'll have some informative or comforting words or suggestions, and at least he'll get an update on your case so if things ever get worse later, he knows you a little better.
I'm thinking of also looking for a therapist who has experience with people dealing with cancer. My mental health now is good enough and I'm still so fatigued from the radiation that while I can manage work, I have minimal energy for anything else. So that's on the back burner for now.
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Thanks Salamandra.
I work too and find that it tires me out and I have no energy for anything else. I am sorry to hear you are facing this too.
I think my fatigue is part of my depression. I am on Effexor XR. Isn't that supposed to help with depression and anxiety? I know that my panic attacks disappeared after a time once I started it, so it does work. I really don't like taking the Effexor XR (150 mg per day) though because of the side effects. (weight gain, insomnia, low sex drive, headaches). I really don't want the psychiatrist to up the dose. LOL. I guess this stops me from making an appointment.
I do see a therapist - she is not a therapist for cancer patients though. She helps me face reality in my life in general. So this is good.
You may be right about the depression lifting faster if I talk to the oncology psychiatrist. He was the only one who validated my panic attacks. I will think about going to see him again.
wallan
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Please be aware of neurofeedback. There is a very simple one size fits all system called Neuroptimal. Google it. It works very rapidly... 12-15 sessions or so. You will feel a difference in 6-8 sessions. What it does is to "mirror" the activity of the right brain, through giving you auditory feedback in synch with the activity of the right (unconscious) brain. The right brain soon realizes it is being mirrored and it becomes aware of its own activities and modulates itself.
Depression is generally a right brain issue. It can be patterned thinking that is hard to break out of. Or it can escalate because you get mad at yourself for being down and it spirals.
I am an advocate for foster youth (a CASA) and I discovered NF through getting it for my very anxious, suicidally depressed foster youth. It was incredibly effective for her-- her depression remitted totally. I decided to try it to see for myself. I was not depressed, but it totally improved my patience, and my sleep. It will not do you any harm because it's your own brain opting to become more efficient as it becomes aware of its own activity.
Also, do not forget the practical steps to feeling better alongside medical steps: Up early and outside in the sunlight moving around. This can be a walk around the block, gardening, whatever. Exercise daily. Treat yourself gently. Make contact with loved ones and encouraging friends. Get into nature.
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Please do not underestimate the effects of Tamoxifen. Within a week of starting it, I had suicidal thoughts. What helped me was magnesium, vitamin D, counseling including a technique similar to what santabarbara described called EMDI (or something like that) that uses binomial beats to retrain your brain. It worked wonders for me. Hiking also helped when the weather permitted.
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I'm depressed lately too. It's out of character for me, so I am wondering if it's because I started an AI a month ago, or if I'm finally just emotionally collapsing now that I'm done with active treatment. I don't know how to live happily with the aftermath of all this cancer treatment. Sometimes I think I can live a good life in spite of everything, and other times I feel like my life is ruined now and that things will never be good again. My MO referred me to psych-oncology, but they called to tell me they don't take my insurance. Nice. I'm sure I can go elsewhere, but way to kick me when I'm down, right? Anyway, I'm just rambling now. I hope everyone feels better. Cancer is just about the worst...
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don't..... it's hard as hell. I started taking adderall. It's helped me quite a bit vs. herbs and all the other crap I tried so hard to do to help myself. It helps me with fatigue, and incidentally, mood. Though I still struggle to get things done or care about mundane things like cleaning the floor. But, it puts a little wind in my sails.
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You are all the best.
Good advice from you all. I am going to look into neurofeedback. It looks interesting.
wallan
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