When I lived in San Francisco, nobody batted an eyelash at dropping into casual conversation mention of a trip to their therapist. “Oh, I had a really great breakthrough at my therapy session yesterday” was on conversational par with telling someone “I tried a fantastic new recipe for kale smoothies.”
But San Francisco is not the rest of the country. (In fact when I moved to Chicago, I realized that San Francisco is sort of its own country.) Out here in the rest of the world, therapy is often seen as a luxury item or something that crazy people do. There can be a lot of resistance, embarrassment, and silence about seeing a therapist. So where is the middle ground for chronically ill patients who are struggling with the stress of their disease and need some help?
I am dedicating this post to a young adult cancer patient who I have become extremely close with over the past three years. She has been through the wringer with cancer and endless chemotherapy. She is in a funk and it’s totally understandable. 25% of all cancer patients suffer from depression, and the rate is even higher for young adults. But, my friend lives in the deep south where nobody talks about seeing a therapist. In our last conversation, I got the sense that the idea of going to therapy made her feel like a freak. Her oncologist has suggested it many times; I thought it might sit better if she heard the experiences of other patients who are trying to manage their own emotional ups and downs with cancer and chronic illnesses.
Give her your therapy 101: Have you ever seen a therapist because of depression, stress, or anxiety related to your illness? What did you talk about? Was it useful or not? How is it different than talking to a friend or your partner? What other ways have you coped with depression?
“Everything Changes is, without doubt, the most forthright, emotionally sophisticated, and plain-old valuable book of its kind I've seen.”
September 18th, 2009 at 2:24 PM
I did not see a therapist most likely because I have a degree in counseling myself and I had a wonderful support group. I was however extremely emotional and at times depressed during my treatment for thyroid cancer. Nothing can cause depression like being extremely hypothyroid for weeks and isolated from your family. I’d strongly encourage your friend to see a counselor or at the very least to try to join a cancer support group. I will consider taking a mild antidepressant when I need to go “hypo” again! There is no reason to be ashamed for needing extra help and support when you are faced with life and death situations and decisions and life altering disease!
September 18th, 2009 at 2:31 PM
Not a freak; not a freak at all. Cancer is rough and uncharted territory. Your family and friends who are not survivors themselves can’t really help as much as they’d wish. The things you’re going through are unique to cancer patients.
Even if they are survivors who can “get it”, you can’t really share or vent to your parents or spouse about your darkest thoughts and deepest fears without freaking them out, which doesn’t do either of you any good. But finding comfort and good advice on how to process things so they don’t build up to depression is essential! Depression isn’t just suffering. Studies show it actually can cut your survival chances. http://bit.ly/nC5A9
Depression can be caused by illness & treatment. It’s not that you aren’t strong enough. Deciding to take action about something IS being strong. It’s not as important to do something on your own as it is to just get it done if you think it needs doing. Taking action is the strong part, especially if you’re depressed which makes it harder to do anything. I never felt more slug-like or paralyzed then when I was depressed.
If therapy or antidepressants to kick start a mood recovery is scary, then make it less black and white. Try it for a limited trial period. Say, I will try therapy for 6 weeks to see how I feel about it. If I don’t like it, I try something else. It’s not an addiction or something that will take over your life. It’s all entirely within your control.
Three things helped me cope with the onslaught of cancer woes & worries:
* A cancer buddy/mentor or two, seems you’ve got one in Kairol but how about another too so you wont feel you’re burdening anyone (but don’t worry, you’re not. You can be a mentor someday & “pay it back” that way.)
*An online support group — can participate even if you don’t feel up to going anywhere or you’re far away.
* A therapist who’s been up close and personal with cancer. Your hospital should have a list of therapists with cancer specialties.
And know you are not alone!
Good thoughts and wishes for a cancer sister!
September 18th, 2009 at 3:18 PM
With all the pain and stress of a cancer diagnosis, how could you NOT be depressed!? I was in chronic pain after my BMT, and suicidal for weeks. Luckily, I was no stranger to therapy (thanks to my Jewish mother) when I got cancer, so it felt normal to go to someone to talk about the mental health aspects of my condition. Though it might not seem natural or something you would have done under “normal” circumstances, you should find, with a good therapist, that just having that 45 minutes to talk about your feelings alone, and having someone justify them is worth taking that awkward first step.
September 18th, 2009 at 3:55 PM
I went to a counselor to talk about the what if every decision I was making was completely wrong. I talked about how no matter what kind of support I had - it was my journey, alone, my life, my risk. I talked about the things people did to “help” me that I really hated. I talked about how disastrously changed my body would be - even if I beat the cancer, I would have more to mourn… lots of things I could not say to friends and family…
September 18th, 2009 at 4:00 PM
I’m in the deep south, too, and saw a therapist for about a year after being diagnosed with MS. My body was out of control and my brain (anxiety) started to follow. I found a wonderful woman whom I call my validator, instead of therapist. She was always 100% on my side and a wonderful listener. She had the added benefit of being able to hook me up with other great specialists, like a totally non-scary dentist. She has been the most important member of my health care team, doing more for me than any of my doctors. If you friend is in Atlanta, I can recommend a great one.
September 18th, 2009 at 4:06 PM
This is a good one for me to answer right now. At the moment I have permanent tears sitting in my eyes. All day it’s been that way. I’m sad. I am so sick of this cancer/chemo crap. Been going at it for 4.5 years. Constant chemo. I just want to be normal again. I want hair. I want to meet someone who doesn’t care about cancer and likes me for who I am. I want to cry, I want to scream. Both of which I did today. The only time I saw a therapist was a couple weeks ago. He was at M.D. Andersons and he highly recommended I get a local therapist. I haven’t looked into it yet but I have plans to. I do take effexor to manage it but sometimes it seeps through. I hope she does ok!
September 18th, 2009 at 4:09 PM
I spent 7 years in therapy and 4 of those years were before my cancer diagnosis. I initially went to therapy out of difficulty dealing with having grown up with an alcoholic father and then becoming a widow at 25. I actually felt glad that I was already there when I got cancer.
I do remember feeling embarrassed initially and my mom tried to guilt me out of going probably out of fear I would spend my time on the couch blaming all of my problems on her. Which of course I did not.
It was really good to have someone objective to talk to. I was able to tell her things I wouldn’t even tell my closest friends. And I learned alot about how to handle my panic attacks, and depression. I stopped going 2 years ago, not sure why and sometimes I think about going back.
September 18th, 2009 at 4:37 PM
Every cancer survivor I know is on anti-depressants.
That said, I did not find a counselor to be all that helpful. I had to find my own way through the fogbank. It wasn’t easy and it wasn’t quick.
This may be my most relevant post on the subject:
http://donnatrussell.com/2008/08/23/its-cancer-now-what/
Take care. :)
Donna Trussell
Stage III ovarian, dx 2001
September 18th, 2009 at 5:28 PM
Hey there friend of Kairol’s hang in there. I live in the South, North Carolina to be specific, and when I finished treatment I started to fall apart. Finally I got my shit together and found a therapist, and a good match for me; a woman who was also a cancer survivor. I was diagnosed with mixed depression/anxiety. Once I got myself under control I made my husband go see a therapist for a while as well. I think we tend to forget that our significant other has had their world rocked nearly as hard as we have.
I also found support from the Young Survivors Coalition which was a good match for me. I could talk to people from my home and get feedback from people who had already been down the road. Once you find out you’re not alone you feel less crazy.
Finally, believe it or not, blogging keeps me sane. I started the blog when I was in therapy and my therapist really thinks that it is as responsible for my improvement as anything else.
If a therapist isn’t for you find a minister or an old teacher, or another survivor that you can scream and cry and vent with. It really will help. Good Luck! - Kate
September 18th, 2009 at 5:59 PM
Hello,
A therapist should be chosen carefully. Don’t be afraid to try them on. I went through three before I found my supporter. My supporter will NEVER judge me, will NEVER say “Oh everything will be fine” or MY favorite ” So and So had that. It’s nothing”. PLEASE. Also surgery is not a ‘piece of cake’ there was no cake involved. A good person who CANNOT UNDER LAW divulge what you say… is priceless. You can hate if you need to, be angry without being judged, change your mind six times over one idea in a half hour, wonder if you even HAVE a mind, forget aword mid sentence or mid-word and not be worried. You will laugh eventually. You will. I promise. The biggest laugh will be some bizarre thing that happens in treatment or some whacked joke only CANCER people get. Dark humor has it’s place. Please find someone to trust completely and then let that person be led by your needs. You have love with you, even when yoiu don’t think so. You have your CA family~~~US.
Hang on. (((((((((((((((hug)))))))))))))))) for when you want one. ASK people for those too!
Just call me Auntie Ellie, everyone else does.
September 18th, 2009 at 6:00 PM
Thyroid CA Papillary
September 18th, 2009 at 7:03 PM
I think you would be more of a freak if you were not depressed! Hang in there!
September 18th, 2009 at 9:09 PM
Hey ya’ll,
I will be on chemo for life. While I am grateful for what the chemo does to keep me alive, the side effects suck and I no longer have the life I had hoped. No matter how rational we are, thankful we are, and hopeful we are — depression can creep into our cancer adventure. It’s just like any other ‘side effect’ so treat it as such.
When I lived in New York, folks talked about therapy openly. But in Texas it’s still taboo to a certain extent. Financial issues also keep lots of folks from getting therapy. And don’t forget the time sacrifice when we are already tired, sick and still trying to work and be human from time to time.
Evenso, please encourage all cancer patients to be kind to themselves and have some ‘me’ time to give voice to the fears, worries, hopes and dreams that all exist in the middle of the cancer storm.
For folks like me who will live all the rest of our lives ‘in the storm’ it’s not likely we can avoid a bit of depression from time to time. It comes and goes just like the nausea or swelling! A few therapy visits, or a single support group/online conversation won’t “fix” depression, but I am not sure there is a quick fix. Just like growing older, we need to allow ourselves time to adjust, and time to deal with ALL the emotions surrounding cancer.
Embrace your wild side and scream in the car when you are alone. Go for a long walk-if you can. Keep trying therapists and ideas until you find one that works for YOU. It’s important you get the right mix of support, friends, and professional help. No one can tell you exactly what will work.
Honor yourself and address the depression-so you can enjoy every moment possible.
We are with you in spirit girl. You are NOT alone.
September 18th, 2009 at 10:17 PM
I didn’t go to single therapy sessions until just recently - while I was on chemo I went to The Wellness Community for weekly group therapy - the best thing I did for my mental state. Since then, I’ve been through the wringer, and the need for me to talk with someone unbiased and not emotionally attached to the experience and me was essential to allowing me to work through the variety of emotions the past 9 months have brought me. So, yes, I see a therapist - gladly, proudly, and have no problem talking about it.
September 18th, 2009 at 10:53 PM
First of all, I did go to therapy for a few months and it really helped. Second of all, I now go to a “women with cancer” support group that helps as much - meets once a week and is a great pick me up. Third of all, I don’t understand how anyone can go through what we go through and NOT get depressed. And then to not feel like you can talk about it just makes it 100 times worse. I don’t talk about it to my family. And I’m not depressed all of the time, or even most of it. Some days I’m really happy to be here and be alive and be with my family. But let’s face it, no one can live like that all the time. So when reality hits, who better to talk to about it than other cancer survivors. They’ve been there, they know what you are talking about, and they don’t think you are crazy.
Also, many of the treatments people with cancer undergo can cause or exacerbate depression - pain killers, anesthetics, radiation, chemo, etc. So if nothing else, you have medical reasons to be depressed.
My Dad was always the “pull yourself up by your boot straps and get on with life” type. But you know what? Sometimes you just can’t reach those damn boot straps by yourself. And if you can, sometimes you don’t have the strength. Give yourself a break and ask for help. It doesn’t mean you are weak. It means you are a person who is having a hard time and needs a little help….
September 19th, 2009 at 11:36 AM
I see a therapist — and like Cathy, I’d been in therapy for four years prior to my cancer dx. My neurosurgeon made seeing a therapist a condition of approving me to return to work after intracerebral hemorrhage, because depression is a #1 problem for post-stroke survivors.
J. had never worked with a 44 y.o. stroke survivor. He did research on my dx, my symptoms, and ultimately worked with my docs to expand my dx. to ABI (Acquired Brain injury, which has side effects similar to TBI.) He was instrumental in getting me a baseline neuropsych evaluation, something that should have been done right after the stroke. Now my neuro uses that evaluation to gauge any changes (so far, so good.) We worked together to develope coping skills for my new brain, worked through all sorts of issues after the stroke, and evolved from weekly visits with telephone sessions in between to bi-weekly, then every 3 weeks. He even learned about my dog-showing and training so that he could give me suggestions about how to cope in that situation.
I was just about to move to once-a-month visits when I got sick. J. knew I was scared, but I never expected him to be as moved or as galvanized as he was when I told him I had Stage IV cancer.
First, he got a colonoscopy. ;) As is his style, he learned everything that he could find out about CRC, rectal cancer, my docs, everything he could get his hands on. He put me back on weekly visits (and although I’m now back to visits every 2-3 weeks, he puts me back on weekly visits whenever I’m clearly not coping or I ask for help.) He is the only one of my docs who handles all of the insurance issues by himself, and when I hit the max number of visits, he called the insurer and told them, “She’s dying and I’m going to treat her; how do we make this work?” They worked something out to trade in-patient therapy days (which I’ve never ever used) for 10 extra sessions, and that was that. J. is always there for me, even when I’m in recovery in NYC (we do phone sessions.) I did find a good counselor on the 15th floor at MSKCC this last time around, but I spoke to J. weekly, too.
Absolutely, you might need to ‘try out’ a couple therapists or even the idea of therapy until you find the counselor and venue (one on one, group, mentor or online) that works best for you. For me, in cancer it’s a combination — my personal counselor, several online groups, the CCA Buddy program (I had a buddy prior to liver resection, and I’ve been a buddy to newly-dx’d stage IVs ever since) and most recently a face-to-face recurrent survivors support group. Each fills a different need. But I agree, try it for a month and see if it helps. I fought personal counseling tooth and nail — but after a month of talking with J. I knew it was helping, even if it wasn’t always comfortable.
A couple things though — first, every cancer patient isn’t on anti-depressants (I can’t take them!) And taking a pill may help you get through the day, but it doesn’t let you work through and process what’s happening, which is something I firmly believe needs to happen for each of us in order for us to recover into some version of our whole selves. Talking to a counselor can be priceless — he doesn’t have to care (but does), doesn’t have to help (but does), doesn’t have to like what you say (and sometimes doesn’t, tells you so and jolts you back into humanity!)
Second, therapists and other health professionals OFTEN have their own therapists, so please don’t let your own counseling training and/or experience prevent you from finding a counselor. By the goddess, no one expects health care pros to be perfect…and working with people in trouble can be debilitatingly stressful. I used to tell my counselor that I didn’t know how he sat there all day listening to people like me. He told me he talks to his own professional counselor/mentor, regularly. It’s ok to need an impartial ear.
Third — wile money can be a barrier, I found my counselor through the Employee Assistance Program at work. The first 6 visits were free. Until I could set up an appointment with a counselor, the EAP program counselors (all ASCWs themselves) did sessions with me over the phone, for free. The support groups at my docs’ oncology practice and at MSKCC in NYC are free. Free help is out there, but you, the patient, have to take the first step.
September 19th, 2009 at 11:53 AM
like one of the above posts said, i think it’s more unusual if you don’t have an emotional reaction to the whole cancer experience. for me, when i was first diagnosed, just like I immediately sought out oncologists to try and protect my physical health, i immediately wanted to connect with a counselor to be proactive about my mental health. Ha, so before i even had much time to process anything, I wanted that counselor on hand, to be an impartial, outside person, I could vent to and get suggestions from on how to deal and not let the fear,etc take over. it may take time to find someone you like, but just like you might not like the first dr you meet, same thing with a counselor.
My recommendation, if you dont’ want to go somewhere or pay for a psych. What I did was call up Cancer Care, who has free individual phone counseling. Between that, and the local SW at my hospital, i never wound up needing to go anywhere else. Now that my treatment’s over I’m considering going to an outside person. But it was nice to not have to pay or go anywhere during the intense times.
September 21st, 2009 at 8:20 AM
Where to begin? First of all, I think every treatment plan should include referrals to a therapists experienced with cancer patients. This is one of the most shattering, stressful and difficult experiences a person will ever face. People like me have sought out the help of a therapist for much less, after all. If anything, I’m disappointed that more cancer centers don’t do more to promote counseling services (either their own or referred to a third party) to patients. Cancer will affect everything in a patient’s life: relationships, mood, work, sexuality, the list goes on and on. Besides, as good and as supportive a family or friend network a patient might have (although not all of us have even that), they are not objective and, because they care about you, will have their own issues to grapple with. So a patient very much needs a dispassionate, qualified, helpful, and objective professional with whom to talk, not only during treatment but for some time after. I’ll close by speaking from personal experience: I’ve seen a therapist not because of my cancer per se but he has been very understanding about my cancer and has helped me to integrate my experience into the overarching issues I’m dealing with. Cancer is a lonely experience for so many of us, all the more reason to find a good professional who can help you work through all the very many issues it raises.
October 11th, 2009 at 6:00 PM
I saw the oncology counselor in the hospital a couple of times. She wasn’t especially helpful. (I think it intimidated her to learn that we actually had a class together in the counseling program — that’s what my masters is in, though that’s not what I do — which I think didn’t help. But having a counseling background doesn’t mean that counseling isn’t useful.)
But I am seeing a therapist now — not as a result of being a cancer survivor, though cancer comes up from time to time. I decided that with this, like with everything else in my life that isn’t quite mainstream, I was going to speak about it without shame or being intimidated when it came up, and if people judge me on it, so be it. I will be judged by others for anything and everything, and I will not censor myself to try to make myself appealing to people who are insecure enough to need to judge me.
But that’s just me ;)
October 12th, 2009 at 5:09 PM
I love that everybody’s comment are all over the map… kinda like living with cancer. I’m excited for my friend to read them. Keep’em coming.
January 2nd, 2011 at 10:52 PM
i too have a degree in counseling but that has nothing to do with whether or not i need a therapist. most people think i am going to therapy to talk about the fact that i had cancer and how scary that is, blah blah blah. thats not it at all. not yet anyway. im going because i moved to a new city in a new state 3 years ago, got married 6 months later, just had twin girls this past february, then bought a house and moved in july, and was diagnosed with thyroid cancer end of august when my girls were 7 months old. my life has totally spun out of control, and while cancer was the only “bad” thing that happened to me, i had no stability or privacy to fall back on after my treatment was over. i had no normal. not to mention the indescribable exhaustion of trying to raise twin babies while going through treatment(full of complications) and the slow torturous climb of post surgery synthroid dosing. so really im in therapy to figure out how to be a mom with cancer in a new city/state. you may not want to go, or know why you are really going, but if you know you aren’t ok, then force yourself to find someone you like, because that makes all the difference. it wont help you to rehash the details of your story to someone for the first few sessions-find someone who “gets it” and can start helping you from the start. someone who gets to know YOU, not your story or you with cancer.good luck
January 2nd, 2011 at 11:03 PM
Anonymous - Wow, you’ve had a quintuple whammy. It’s like all of the life factors common to young adult cancer patients were stuffed into one person - YOU! What a lot you’ve got going on. Please let me know if I can ever be a resource to you on the thyroid cancer front or elsewhere. There are a lot of great young adult cancer patients out there trying to figure out how to parent infants and toddlers. If you are looking to connect with any of them, just let me know. I’ll be glad to put you in touch. Hang in there! Kairol
February 7th, 2011 at 10:16 PM
having a therapist has been the one thing to get me through post treatment. i have been in therapy before and am a therapist myself. right now i am in therapy bc of how everyone else in my family dealt with my cancer (NOT WELL) while everyone thinks i must be so scared ohh bc i had CANCER and of course i have to deal with that. what i really want to say is “no, you blank-blank-blank, i have to now figure out how to deal with all of you in a post cancer world! yes of course i have to process and deal with how its affected me and changed my life and taken me away from my baby girls when i should have been playing with them and enjoying them. i can say things to my therapist i cant say to anyone else. everyone wants it to be over and almost as if it didnt happen and for me to be fine and normal, and i will be one day, but that’ll be when i am damn well ready. so my therapist is helping me get to that place.