Depression & Chronic Illness
Generally, most people (I hope) understand that those of us with a chronic illness are particularly susceptible to mental health issues and depression. I don’t think I need to quote actual statistics on depression in people with a chronic illness. However, I will. According to the Cleveland Clinic:
An estimated one-third of individuals with a chronic illness or condition experience symptoms of depression.
https://my.clevelandclinic.org/health/articles/9288-chronic-illness-and-depression (emphasis added)
I have to say, I’m shocked it’s only one-third. I’d venture a guess this is only reported cases. It takes at least a month or two to get an appointment with my psychiatrist at Sloan Kettering’s Counseling Center. Also, the waiting room is constantly crowded. So, based upon my own experience I imagine in actuality the percentage is much higher.
Further, according to the Cleveland Clinic:
People who have chronic illnesses must adjust to both the illness and its treatment. The illness may affect a person’s mobility (ability to move) and independence, and change the way a person lives, sees him- or herself, and/or relates to others. These changes can be stressful and cause a certain amount of despair or sadness that is normal.
https://my.clevelandclinic.org/health/articles/9288-chronic-illness-and-depression
Well ain’t that the truth!!
Some examples of depression rates cited by the Cleveland Clinic:
- Heart attack: 40%-65%
- Coronary artery disease (without heart attack): 18%-20%
- Parkinson’s disease: 40%
- Multiple sclerosis: 40%
- Stroke: 10% to 27%
- Cancer: 25%
- Diabetes: 25%
My Personal Issues Opening Up & Coping With Anxiety/Depression
I’ve mostly dealt with anxiety, which I suppose is a form of depression. However, with the pandemic isolation I’ve sunk into cycles of definitive depression. I have sat in my apartment wondering what all my intense fighting to get back to my baseline has been for; what has all the pain I’ve overcome been worth; and, on and on it goes.
Recently, it got so bad that I began to ask, “What”s the point of living?” Thankfully, I had my husband and doctors to “talk me off the ledge”.
Agreeing To Seek Therapy
Initially, after I was diagnosed it took so much to even get me to that Counseling Center. Prior to my diagnosis, I had never seen a therapist, never mind a psychiatrist! I had a very old-school view on therapy. Frankly, I thought it was simply an American fad, especially in the NYC area. I’ve spoken to a lot of fellow cancer survivors who also immigrated to the States or who are 1st-generation Americans. Our families would NEVER seek therapy (despite many of them needing it). Therapy is so very taboo.
I trusted my amazing oncologist, who encouraged me to seek therapy. It took a lot of courage, but thankfully I did it.
Honestly, I did not “hit it off” with the therapist the Counseling Center assigned. However, I kept going to my sessions because I knew in the long-run simply talking about my emotions was helpful. Then, the discussion of seeing a psychiatrist came up. Immediately, I was dead-set against it. Again, I had that old-school mentality. I thought, “Only crazy people see a psychiatrist!” Oh, how wrong I was when I look back on it now.
Upon meeting my psychiatrist, I took an immediate liking to her. I felt she really listened and understood, much more than the psychologist. After a few sessions with her, I asked if I could utilize her as my therapist. She agreed! I’ve now been seeing her off-and-on for probably 5 years. Frankly, I don’t know what I’d do without her guidance and support.
Agreeing To Take Medication
Personally, another huge hurdle I had to overcome was agreeing to take Lexapro for my anxiety. I was dead-set against it. Again, this all relates back to that limited, old-school mindset surrounding mental health. Also, there was that stubborn part of my personality that thought, “I don’t need medication! I can do this on my own!“
My psychiatrist “convinced me” (she’s NOT one to push her patients, which is why I put that phrase in quotations) by explaining: “These medications are available for a reason – to help you. You won’t have to take it forever and we will start you on a low dose. If you tell me you no longer want to take it, we will wean you off. So, why don’t we just try it?”
Given that pep talk, I cautiously agreed.
It was not an easy decision, but with the support of all my doctors Boy, did that Lexapro immensely improve my mood. It took some time to adjust to it, like any medication. However, I am so thankful to my psychiatrist for “holding my hand” through the process.
Feeling Misunderstood and Dismissed
Depression and anxiety are hard enough to manage on their own. Adding a serious illness on top of that can feel like the world is totally closing in on you, or closing you out.
Since I’ve been mostly very positive and outwardly strong throughout my “cancer chaos”, people are not accustomed to seeing me depressed. Now that I’ve been expressing these types of emotions to those around me, I’ve been feeling even more depressed. Mostly, I feel extremely misunderstood and dismissed when the reactions I get include:
- “You just need to stop thinking so negatively”
- “Focus on the positives”
- “Just change your mind set”
- “Just let things go that upset you”
- “Well, just look at what Jane Doe is going through” – insert whoever’s name for “Jane Doe”
- “We like to talk about funny and light-hearted issues. We don’t like talking about negative things”
- “We all have problems in our lives”
- “Sorry to hear that”
NONE OF THESE REACTIONS ARE HELPFUL!
You wouldn’t tell someone with asthma, “Just try and breathe better.” I imagine I am not alone in receiving such reactions… So, why are these the reactions people get when they express a mental health issue?
First, it’s not easy to open-up about feeling such immense anxiety and depression. Additionally, it’s not something I can simply snap my fingers at, and the feelings magically disappear. Yes, it’s important to focus on the positives and to try and change your mind set. However, it’s not exactly that simple especially with the plethora of medical problems I deal with day after day.
I wrote a bit about this in my Post on the book “Untamed” by Glennon Doyle: https://braincancerbabe.com/2020/05/25/untamed/
Clinical Tips For Coping With Chronic Illness
Again, citing to the Cleveland Clinic:
Depression, disability, and chronic illness form a vicious circle. Chronic illness can bring on bouts of depression, which, in turn, can lead to a rundown physical condition that interferes with successful treatment of the chronic condition. The following are some tips to help you better cope with a chronic illness:
1. Learn how to live with the physical effects of the illness.
2. Learn how to deal with the treatments.
3. Make sure there is clear communication with your doctors.
4. Try to maintain emotional balance to cope with negative feelings.
5. Try to maintain confidence and a positive self-image.
6. Get help as soon as symptoms of depression appear.
https://my.clevelandclinic.org/health/articles/9288-chronic-illness-and-depression
In my personal opinion, these “tips” are not very helpful apart from the suggestion to seek out “help” and to communicate your feelings with your doctors. When I read these “tips” what I hear is “Deal with it!” Now, I am not a mental health professional, and those at the Cleveland Clinic are likely much more intelligent. However, from a patient perspective these seem very clinical and quite dismissive considering how incredibly difficult it is to deal with anxiety/depression on top of a serious illness.
Tips for People Living With a Mental Illness/Condition From Those Who Have Been There
I imagine there are tons of helpful tips in dealing with mental health issues out there. However, personally I found this Blog Post particularly helpful. https://reflectionsfromaredhead.com/tips-for-people-living-with-a-mental-illness/
The author of this Blog is JANINE RIPPER, a mental health advocate. Throughout her Blog, she shares her “mental health ‘journey’, as well as resources, advice and tips about self-care, wellness and how to survive being an adult!” Ugh! Adulting! In my humble opinion, it sucks.
Similar to what I detailed above, JANINE received advice about her mental health that added to her “feelings of angst and self-loathing.” So, she put together this excellent Post, which is:
a collection of tips from people who have been there, live with a mental illness and those who have made it through to the other side. These tips are also for people who are supporting others.
https://reflectionsfromaredhead.com/tips-for-people-living-with-a-mental-illness/
If you are struggling with your mental health, again I am NOT a mental health expert, nor a doctor. Thus, I cannot and do not offer medical advice. Nonetheless, I think it is crucial to seek out an expert. Sadly, Yes, our society does still stigmatize mental health issues. However, your physical, emotional and mental health are all connected. If your leg was broken, you’d go to the E.R., at least I hope! The same goes for your mental health. If you are feeling depressed, anxious, or worse, go to a therapist or psychiatrist.
Of course, I recommend reading the tips on JANINE’s Post too. There’s some fantastic advice there!
I’ve been living with depression almost as long as I’ve been alive, but my health issues came later, largely as a result of my long lasting relationship with my depression.
Another great, detailed, and informative post though. There’s certainly nothing wrong with taking medication if it’s going to help you with your quality of life