Cancer and Depression

The death of lovable actor Robin Williams was both untimely and tragic, and shocking to so many. Most all of us probably have memories of movies that Robin Williams played a role in that we were quite fond of, and the impression left upon us by both the actor and the man. Just looking through his extensive list of movies and roles on, "Good Morning, Vietnam", "Mrs. Doubtfire", "Good Will Hunting", "What Dreams May Come", "Patch Adams", and the voice of the Genie in "Aladdin", are the ones that ring a bell with me. How many movies have you seen where Robin Williams starred, and you knew that only he could have pulled off that role?  What a great man and a great actor, probably one of the best in Hollywood, loved and adored by many millions of fans. His passing is a great loss, and to learn that he had been battling a very deep depression and that his death was an apparent suicide just made it hurt that much more. Although Mr. Williams was not known to be fighting cancer of any sort, depression is something that commonly finds its way to cancer fighters and survivors, and sadly neither of these topics are strangers to me.

Robin Williams, 1951-2014

Robin Williams, 1951-2014

My best childhood friend ended up committing suicide in 10th grade. We had drifted apart somewhat after elementary school as teenagers, but it didn't make it hurt any less when he was gone. Another high school classmate ended up committing suicide during his freshman year of college, and a good friend also lost one of her sons to suicide while he was in college. I thankfully have never had suicidal thoughts or tendencies, but I know what a deep depression feels like and just how big and impossible of an emotional hole you can feel yourself trapped in. 

Depression is quite common among cancer patients and cancer survivors. According to various studies out there depression occurs in 15-25% of cancer patients, but I personally think that those numbers might be a bit low. Many of my TC support group peers who were diagnosed with testicular cancer at around the same time as me had also reported experiencing very depressive periods as I had been (lasting more than 3 weeks) during survivorship and surveillance, and particularly around 18 months out from our treatments. We were really struggling day-to-day with depressive symptoms, with the rigors of cancer surveillance seemingly having worn so many of us down as we closed in on the all-important 2 year cancer free milestone for non-seminoma.

There's an excellent online brochure on Cancer and Depression by the National Institute of Mental Health that's definitely worth a read for anybody facing cancer or who has someone in their lives who is. 

The signs of depression are:

  • Ongoing sadness, anxious, or empty feelings
  • Feeling hopeless
  • Feeling guilty, worthless, or helpless
  • Feeling irritable or restless
  • Loss of interest in activities or hobbies once enjoyable, including sex
  • Feeling tired all the time
  • Difficulty concentrating, remembering details, or making decisions
  • Difficulty falling asleep or staying asleep, a condition called insomnia, or sleeping all the time
  • Overeating or loss of appetite
  • Thoughts of death and suicide or suicide attempts
  • Ongoing aches and pains, headaches, cramps, or digestive problems that do not ease with treatment.

I really struggled mentally and emotionally during the last 6 months of my 2 year period of active surveillance from January through June of 2013, and could have checked the boxes on 8 or 9 of those 11 symptoms. I know what it feels like to be hanging on by the smallest of emotional threads. I know what it feels like to be right at the edge feeling like you're going to completely lose it all, and that the slightest misstep by you or anyone close to you could send you falling. This is more PTSD than depression, but I also unfortunately know what it's like to have voices in your head telling you terrifying things. And I know what it's like to have cancer flashbacks and experience fear from the past as if it's in the present.  I was tired of being afraid, I was tired of the mind games that cancer was playing with me, making me constantly fear for my life before and after every surveillance appointment, and I just wanted it to end. I was never suicidal, and if I was I would have immediately sought help, but I did want to be driven out to the countryside and left on the side of the road in the middle of nowhere. I was so spooked and afraid and felt my untimely demise was so imminent either from cancer or who knows what, that I didn't want my wife or my kids, or anybody that knew or cared about me to have to witness whatever was going to happen. I just wanted to be left alone, and wanted cancer to leave me alone too. 

And of course I was perfectly fine, physically speaking. I had a cancer recurrence scare that triggered a lot of awful things inside my head, but my cancer (knock on wood) never came back. My life was never in danger, but my mind was tricked into believing that it was. These are the dark and terrifying places that the mental health fallout from a cancer fight and the rigors of cancer survivorship can put you in. It's why it's so important to find and have the support that you need not just during your cancer fight, but well beyond it into surveillance and survivorship as well. Depression can hit cancer fighters and survivors at any time, including even more than a year out from treatments as it did with me and peers of mine. My wife has a been a great partner for me in life and pulled me through the worst. The smiling faces and energy of my kids, and the enthusiasm for life that my son in particular has, helped to keep me engaged and smiling. And as I wrote in my last blog post on Stuart Scott and facing cancer, so many wonderful friends, mentors, work colleagues, my boss, and even neighbors down the road that I had only just met helped to pull me along and keep me engaged at a critical time during my survivorship. It took a lot of soul-searching and a lot of rebuilding, but with time I finally learned what it was going to take for me to truly survive cancer, and I managed to overcome my cancer induced depression and related demons. 

If you're struggling with depression whether it's due to cancer or not, you need to know that help is out there and that you're never alone in either fight. Your family and friends are your first line of defense. You can also reach out to your primary care physician or your oncologist for local resources such as support groups and therapists. A cancer mentor, whether it's from a formal organization like Imerman's Angels or otherwise, is an invaluable resource as so many of us that have fought cancer have also had to learn how to deal with depressive episodes whether formally diagnosed with depression or not. Talk therapy is preferred, but anti-depressants can help and are common as well. Exercise can work wonders. I took up running, and although I'm not very good at it due to chemo-incuded peripheral neuropathy and a lot of muscle fatigue, it's always been a great way to get anxiety and bad feelings out when you can dump them into a workout. If you're to the point of having suicidal thoughts and don't have anyone to turn to, please do give the National Suicide Prevention Lifeline a call at 1-800-273-8255. Every single person I know is beautiful and unique in their own ways. We all have our calling in life, and have wonderful things to offer people and the world. Each and every death by suicide is tragic and a great loss. I still miss my grade school friend, I know a mother who still misses her son every single day, and I know millions are going to miss Robin Williams as well. I'm saddened that his demons managed to get the better of him, but at least they're not going to hurt him anymore.

Whether you're facing cancer, or depression, or are having suicidal thoughts, please know that you're never alone in facing any of them. Ever. Help is out there. Please don't make a terrible mistake. You're special and unique, and the world needs you.

God Bless you and Rest In Peace, Robin Williams. Thanks for all of the wonderful memories and laughs. You will be sorely missed.