Depression. It's a word that has come into our everyday language,
sometimes in ways which are not so helpful. We all feel sad, we all feel low,
but when someone experiences depression, these feelings persist for weeks and
months. Depression is not a sign of weakness. It's not something someone can
simply "snap out of."
Clinical depression affects people in different ways and takes many
forms, including feeling sad and unable to cope with everyday life, feelings of
pointlessness, desperation and in severe depression, suicidal thoughts. It can
cause physical symptoms like fatigue, pain, insomnia and loss of appetite too.
Depression can be a lifelong problem for some, with episodes being triggered by
stressful life events and experiences which are traumatic - like a diagnosis of
breast cancer. Depression can also come in cycles, seemingly without any
particular trigger.
We poured our hearts out, women with a primary breast cancer diagnosis
and women with secondary breast cancer, sharing some of our personal
experiences of depression. We described dark days with no zest for life, a
weariness that took away our motivation to carry on.
Many of us described becoming depressed once active treatment had ended;
the hospital appointments cease and, with them, the structure that kept us
going. Everyone around us expects us to be back to our old selves and it’s time
to go back to work or other routines. However, we feel shaken and lost, our
confidence shattered by the whole trauma of invasive surgery and treatment as
well as continuing to deal with longer term physical side effects. We may wish
to protect those around us and pretend we are back to normal, or we may be made
to feel we should have ‘moved on’ once the primary treatment has ceased. It’s
easy to see how depression can either creep up on us, or hit suddenly as the
enormity of what we've just been through hits home.
The debilitating effects of hormonal treatments taken by so many women,
or, early menopause symptoms, increase
the psychological demands we face, causing us to experience mood swings and
fatigue at a time when we are already psychologically vulnerable.
Women with secondary breast cancer face unique psychological challenges
- living with the knowledge that we cannot be cured, our treatment is ongoing
and our regular scans and checks cause great anxiety as the quest to halt
progression continues. We cherish every day, but we can also experience bouts
of deep depression as the relentless treatment regime punishes our bodies and
minds.
Depression can make us feel worthless, it can strip us of all joy in
living and make it difficult to accomplish everyday tasks. Fortunately help is
available. Many of us shared that we had found talking therapies such as
counselling, psychotherapy, Cognitive Behavioural Therapy and support groups
helpful. Exercise - in many forms - can also be helpful. Anti-depressants and
sleeping tablets have their place too.
Depression can mean we have to rest and take time away from work and
possibly family leading to isolation and contributing to feelings of
hopelessness. Some of us spoke about times in our lives when we felt we could
no longer carry on. We also described how something or someone prompted us to
reach out for help, to seek support from professionals, family and friends to
get better.
Naz explains that depression presents an evolutionary paradox to
scientists. Is depression a cry for help? Is it an attempt to conserve
resources? Does it represent an exhausted brain? Is it a consequence of chronic
anxiety? Is it a state of no hope, helplessness, and repeated failure? There is
no future to look forward to. Is it a chemical imbalance?
Depression, Naz told us, is all of these things, but mostly it signals
an exhausted brain, a brain so full of fear, anxiety and negative and traumatic
thoughts that no room remains for cognitive thinking and common sense is
replaced by irrational hopelessness. The neural pathways involved in goal
driven behaviour are no longer working efficiently, and there is a reason for
this. They can’t.
How Do We Cope?
For many of us, a first encounter with serious ill health or depression
taught us how to look after ourselves. We learn to spot signs of sinking into
depression and seek help to prevent it before it gets a stronghold. We learn to
practice extreme self-care, and to reach out to each other for support.
However desolate depression makes us feel, there is always a way back
up. Naz told us how we may learn to thrive following depression, as our
severely depleted brain resources slowly but surely return to normal. We can,
with the help of others, bring ourselves back from the brink by training our
brains to respond differently, by practicing cognitive focus. There may come a
time when we can use our depression to our advantage, beating it down with
determination and our will, our desire to overcome adversity and thrive again.
