My Breast Cancer Story Part 15: The Mental Health Piece

Cancer is a physically demanding disease, but the mental health component should not be underestimated. From the testing to the diagnosis through the treatments and living a life post-active cancer, thoughts and emotions are in a tailspin.

Months ago I shared a post about how my faith was helping to get me through. I won’t rehash everything I said there, but I do believe that God works through people (like you!) and made a huge difference in how I was able to face what I was going through. When it comes to support, I also realized that I’m at an interesting phase of the sandwich generation, usually thought of as adults who feel the pressure of caring both for aging parents and young children. Instead in the case of my breast cancer timing, I had support from my healthy parents as well as my very independent tween/teen daughters, sending their efforts into the middle of the sandwich – me. (We did live the other side of the sandwich generation years ago when the girls were small and the health of my elderly in-laws was declining, so I know how that goes too.)

My daily readings from Jesus Calling: Morning and Evening and Amazing Grace helped set my frame of mind for the day (and continue to do so; there’s a full year of dated passaged in each book), and memoirs by breast cancer survivors (or books by experts with legit medical information) were also really valuable. Some examples:

• Robin Roberts – Everybody’s Got Something
• Amy Robach – Better: How I Let Go of Control
• Dr. Marla Shapiro – Life in the Balance: My Journey with Breast Cancer
• Joan Lunden – Had I Known: A Memoir of Survival
• Hoda Kotb – Hoda: How I Survived War Zones, Bad Hair, Cancer and Kathie Lee
• Gillian Deacon – Naked Imperfection: A Memoir
• Dr. Kristi Funk – Breasts, The Owner’s Manual: Every Woman’s Guide to Reducing Cancer Risk, Making Treatment Choices and Optimizing Outcomes

(Based on this list it would look like female journalists/TV personalities are over-represented in the breast cancer world, but I think they are just more likely to write books about it.)

For me, exercise has always been very helpful when it comes to my mood and energy levels, and I just walk on the treadmill; nothing too intense. I also believe eating well in moderation (my idea of “well” isn’t a high standard), staying hydrated, and getting enough sleep are so important, BUT when it comes to brain chemistry and people who suffer from depression and anxiety, treatment by a medical professional is necessary, and medication may be very helpful. Fresh air alone does not effectively treat clinical depression.

I am reminded of the time years ago when I pitched an article to an editor about morning sickness treatments, including the drug Diclectin (which I took throughout both of my pregnancies). Her reply: “I don’t think so. When I was pregnant I just kept crackers by the bed to have before I got up and that worked for me.” Okay, lady – then you did not have morning sickness like I had morning sickness.

I use the Type 1 diabetes analogy when parents I know are hesitant to medicate their kids for issues like anxiety and ADHD. If the doctor prescribed insulin for your child, would you say, “No thanks, we’re just going to try more sleep and meditation”? I have seen kids’ lives (and educations) turned completely around with medication – which of course is not right for everyone, and is for a doctor to recommend, not me. (Side note: I just finished reading The Addiction Inoculation: Raising Healthy Kids in a Culture of Dependence by Jessica Lahey – one of my favourite authors – and she shares some interesting information about untreated ADHD being a major risk factor for addiction. I’ll be doing a full review of her book soon.)

The day of my diagnosis my family doctor asked if I wanted a prescription for Lorazepam (Ativan), in case I had trouble sleeping. I gratefully accepted, and filled the prescription for 10 pills. Five months later, I’m down to three left in the bottle. I know I took one the night before surgery, one before my MRI, and another one evening when I hadn’t slept well for a few nights in a row and was desperate for sleep. In May, I will go for my first follow-up MRI to see how things look, and I’m saving one for that big event. (Partly because of the nerves but also to ease the claustrophobia in the machine.) I know there are a lot of women in my Facebook support groups who are taking medication to treat their mental health, both during and after cancer treatments, and I certainly understand why.

As a Lenten resolution, I tried daily meditation, thinking that would help me even further. While 20 minutes is often recommended, I aimed for a 5 minute session (better a short session that I might do than a long one that I wouldn’t.) It lasted consistently for a couple of weeks, but it’s just not my jam. It might be something to explore again once I’m back to work and my days feel busier, but I’ve been doing more than enough sitting by myself lately.

For me, writing was a vital part of my recovery. I kept some things to myself and have a journal filled with all sorts of notes (I’m not joking when I say there are thoughts of a future book) but not only were the blog and social media posts cathartic to write, but the process gave me a purpose. I really don’t think I was seeking attention (I’m actually very private in many ways) but I truly believed that my writing could help others – and the feedback I received reinforced that.

Am I “ready” to go back to work? Well, physically my skin is still peeling a bit, but I have no pain and I’m comfortable in a bra and regular clothing which was a big goal for me. I do get the odd twinge where my lymph nodes were removed and I think maybe I’m going to become one of those people whose body parts can predict the weather. (Breast feels funny? Pack an umbrella!) I am perhaps still a little more tired than I was pre-cancer (many nights Eva comes to my room for a remote “tuck in” at 9 since I’m already in bed by that time) so I will continue to prioritize sleep. I’m also still emotional at times (I had a random cry on Easter morning) which could be because of the drugs that I’m on for the next five years, or everything I’ve been through in general, or in that moment maybe just because Easter is different when kids are older and oh yeah, it’s COVID so I was housebound and couldn’t see extended family.

The fact that I have a partner at work is a huge factor in my return as well. She’ll be standing by if a Tamoxifen hot flash forces me to take a minute, and we share both the physical and mental work connected to our kindergarten class. (My love language is “acts of service” and the fact that she willingly runs our errands – like regular dollar store visits – is one of those little things that really eases the load.) I also feel so much better returning knowing that she has been there the whole time to maintain consistency, and the young man who replaced me as the teacher did a great job, so I’m expecting a smooth transition.

Once I set my return to work date, I decided a mental health checkup might be a good idea, to make sure I’ve processed what I need to emotionally at this point. My social worker has been excellent at helping me talk through my experience (virtually) and accept the grief and trauma that come with a cancer diagnosis and treatment, and we’ve also discussed practical items moving forward, like how to help ease my mental load at home as I return to work. (When I say “emotional labour” you moms all know what I mean. While at home for five months I took on some caretaking tasks that just won’t be sustainable when I spend my days out of the house like everyone else in the family, so it will be an adjustment for everyone).

As my medical leave was winding down, I took on my first post-cancer writing assignment to ease back in to professional work. It’s funny but I actually find things like writing articles and prepping for TV segments easier when I’m teaching because I know I can’t focus on them while I’m at school and can keep them out of mind. When I was home all day every day this particular project always seemed to be looming over my head – but also because it’s a really important and sensitive topic for educators and I was eager to get every word right. (I’ll share that soon too.)

I plan to very slowly add other pursuits back into my schedule, and prioritize ruthlessly. Some things I was doing before my diagnosis I just won’t be doing anymore.

When it comes to mental health, gratitude is great place to be, but you can’t take anyone else there. While it does help me at times to remember that my cancer could have been “worse”  (I didn’t have to lose a breast, I didn’t need chemo, there was minimal financial impact on our family, I have a great prognosis) you never want to point that out to someone else (i.e., “Well, at least you….”) because if someone is trusting you enough to share their situation with you (whether it’s in person or online) you don’t want to look like you’re negating or downplaying any of the awfulness they might be feeling. I mean yeah, it could have been worse for me but it could have been a whole lot freakin’ better if I never got cancer in the first place!

For me, there are also moments of guilt, especially when I hear of women with breast cancer who do not have a hopeful prognosis, or even when being on leave kept me from having to do online learning with my class back in January – that online teaching is HARD, y’all. (Can I get away with “y’all”? I was going for a Reese Witherspoon feel.)

I also found it harder to celebrate the end of cancer treatment and “live my best life” during COVID, because all of those “seize the day” bucket-list type items can’t be checked off now…or any time in the near future. I have a LOT of travel and some fun media things on my wish list, but they all have to wait. My husband suggested a piece of jewelry or other item to commemorate what I (we) have been through, but quite honestly I’d prefer a trip! Experiences over stuff…and there aren’t a whole lot of big experiences to be had right now.

As I move forward, I keep remembering what other breast cancer survivors have warned me about, which is that there will be people in my life who will no longer want to talk about it. It’s over! It’s never coming back! Be positive! Let’s move on! On GMA3 one day (I took in ALL the talk shows while on leave) host and survivor Amy Robach commented, “People always say, ‘So you survived, you’re done, right?’ But you’re never done.”

Based on the data, my cancer has a very low chance of recurring but low doesn’t mean no. I say a lot of positive things about how physically well I’m feeling, how I’m excited to move forward, get back to work, and live a long healthy life, but I can already relate to Amy’s comment: you’re never done. So if I feel like having a blue moment and lamenting my experience and future risks, I want someone to hear it and validate my feelings (without telling me about the person you know who died of breast cancer of course). On the other hand, if I feel like proclaiming that I beat this and I don’t think my cancer will ever come back, well then you can go ahead and chime in with your agreement. And that’s where I am right now. As the saying goes, “I can do hard things”…and I did.