The Art as Therapy: "My Battle with Depression"
Delilah O'Haynes speaks from Her Heart
August 01, 2007"My Battle with Depression" is an excerpt from the upcoming book, Walk Free From Fear of Cancer, by Delilah O'Haynes:
I felt the first onset of my depression within a month of my first chemotherapy treatment, and I informed my doctor at the end of October, just before my second treatment.
Miss Personality curtly stated, "Well, I suspect you're just a depressive type person anyway," and left the exam room.
At the time, my depression was mild, and I assumed it was just a result of losing my hair. Since my oncologist obviously didn't think it was serious, I told myself I would rise above it.
I still had one more chemotherapy treatment to take and student exams to get through, so I told myself that, once everything was over, I would be all right. Early that year, I had applied for a sabbatical for spring semester, and I assumed a more relaxed schedule would give me time for rest. Rest was probably what I needed, I told myself.
Christmas brought a snowstorm that forced me indoors, alone. I stayed in bed for two days, simply because I could not seem to do anything. Even getting up to fix myself something to eat was an overwhelming task, and I probably would not have eaten anything had I not had to get up to feed Roxie. I told myself that I was staying in bed because I had a slight cold and needed bed rest. I also assumed that my sadness was partly due to the weather. I hate snowstorms because my rape occurred during a blizzard, trapping me with my attacker. My father was buried on a bitter, snowy day, and my mother died during a three-day snowstorm.
All the same, I felt that something was terribly wrong in the core of my body. Seconds seemed to last for hours, and I didn't think that Christmas would ever end so that I could get out and be around people again. I watched Christmas movies on television, praying that the next movie would hold my interest so that I could get past another two hours.
The worst part was that I could not feel the presence of the Spirit. All my joy was gone. My future looked so bleak during those two days that I decided I no longer wanted to live. I felt as if I were falling into a dark and bottomless pit.
For the first time in my life, I fully understood the Psalms in which David describes his distress to God, likening it to a pit. "Unto thee will I cry, O Lord my rock; be not silent to me: lest, if thou be silent to me, I become like them that go down into the pit."
I had always known that many of David's descriptions were metaphorical, but I had never truly understood the depth of his despair. I now felt in my soul what he meant when he wrote, "I am poured out like water, and all my bones are out of joint: my heart is like wax; it is melted in the midst of my bowels. My strength is dried up," my tongue cleaves "to my jaws;" and you have "brought me into the dust of death."
The only prayer I was able to offer was one of David's: "Hear my voice, Lord! What good am I to you if I go down to the pit? Have mercy on me, Lord, and help me."
Providentially, the right people came to my aid. On the day after the Christmas holiday, I called the people who had been most helpful to me, my oncology nurses. I didn't know what was wrong with me, but I knew I was sick. And I knew I would not get help by calling my doctor. Debbie, one of the RNs, answered the phone instead of the usual receptionist. Debbie had been through clinical depression and knew immediately what I was suffering. She called my doctor and demanded she give me medication.
"Look, lady!" she told Miss Personality, "this woman is in serious trouble and needs help now!"
Then she set up a phone conversation for me with the hospital's mental health coordinator, who explained to me my options. Basically, I needed to either check myself into the mental health ward or stay with family until the medication took effect — which would be at least two weeks. Because I had thoughts of ending my life, I could not be left alone.
I've since learned that ideas of suicide during cancer treatments are quite common. One Christian cancer patient told me she knew that killing herself would be wrong, so she prayed that God would take her. The only thing that kept me from ending my life at that time was the constant reminder of my friends and loved ones — they would be devastated and would never understand. They would be angry with me for giving up, having no idea what cancer treatments do to people. I was just cognizant enough to agree with Kirk Douglas, who told a television reporter that suicide is a selfish act.
"Depression and the Cancer Patient"
There are actually several reasons for the kind of depression that comes with cancer treatments. First of all, chemotherapy drugs change brain chemistry, rearranging the delicate balance that keeps us sane and alive. Both these drugs and radiation kill fast-growing cells, such as cancer and hair cells. They also alter the very structure of other cells, causing them to mutate, which is the reason that chemotherapy can cause other cancers years down the road.
Your brain chemistry may never be the same after chemotherapy, just like someone who has "fried" his brain with illegal drugs. Some of those drugs "drain the brain of serotonin," according to Trinka Porrata, internationally recognized drug consultant and retired narcotics detective supervisor for the Los Angeles Police Department. It is reasonable to assume that certain chemotherapy drugs do the same.
Secondly, chemotherapy, radiation and hormonal therapy bring on complete and abrupt menopause, and a sharp decline in progesterone or testosterone can cause depression. For women, the PMS symptom known as "the blues" is caused by a drop in progesterone, creating "estrogen dominance" just before a menstrual cycle. Likewise, the condition of postpartum blues is caused by a sharp drop in progesterone after giving birth. Women with postpartum depression have been known to do "crazy" things that they otherwise would never have done. You can imagine, then, how much more depressed a woman might become if her progesterone levels suddenly dropped to zero. Lowered progesterone is probably one of the greatest contributing factors in clinical depression for pre-menopausal women undergoing chemotherapy, but, again, women are not always braced for this major change in their bodies. Since men also undergo hormonal changes with chemotherapy and cancer-drug therapy, they also stand a good chance of suffering from depression during or after treatments.
Third, other drugs administered during treatments, such as steroids given to lessen the effects of chemotherapy drugs, can bring on anxiety or panic attacks. The drug, Ativan, or a similar drug, is often given to calm patients' nervousness during treatments, but it can have a rebound effect that is much worse than the original anxiety and is highly addictive. I refused this drug before treatments because I know that it actually causes anxiety. The cumulative result of all the drugs administered during the course of treatments can shock the system, and certain individuals can have adverse reactions to the drugs.
In addition, according to my oncologist, certain types of cancer can actually cause clinical depression by altering brain chemicals.
Next, add up the physical stress of surgery, followed by chemotherapy, followed by radiation, followed by tests, followed by more drugs, followed by all the illnesses brought on by the treatments; and you have a recipe for depression. Most patients must undergo at least a year's worth of agony, which can tax the human body tremendously, not to mention the psyche. Cancer patients taking treatments often feel worthless, with no reason to go on. Even though I knew I would beat cancer and survive treatments, I still felt like an ugly, useless burden. And many patients, especially breast cancer patients, must also endure disfigurement and the loss of their hair in the process, which can increase self-loathing.
According to Dr. Mounzer, prolonged physical stress depletes the body of endorphins, the hormones produced by the brain to help us manage pain, so that we are no longer physically able to cope with everyday stress. More importantly, the hormone, cortisol, which is released by stress, literally "breaks down the body." Recently, researchers isolated another chemical that is released into the blood during stress, Interleukin-6, and which contributes to "heart disease, arthritis, osteoporosis, type-2 diabetes and certain cancers." Because this chemical can "linger" in the body for years, researchers now know "why chronic stress can actually kill people."(131)
Professor Jane Plant states, "One of the things you must realize from the outset is the heavy toll that surgery, anesthesia, radiation therapy, and chemotherapy will take on your body. Many people have to take breaks or give up treatments, especially chemotherapy courses, because they become too ill."(132)
Finally, we have the circumstances surrounding each individual's case that add to the psychological trauma of cancer, such as financial difficulty. Cancer treatments are expensive. My initial treatments cost in excess of $200,000, roughly the cost of a nice house. Plus, I spend an additional $10,000 each year after treatments for doctor visits and prescription drugs, in addition to what my insurance company pays. In addition, my monthly insurance premiums more than doubled after my cancer, and I was told that I could not get a cheaper policy until I was cancer-free for 10 years. Many cancer patients endure huge premium increases each year; insurance companies know that cancer patients will pay the extra charges because they cannot afford the alternative.
Keep in mind that I had the standard treatments at a local hospital. Even with the best medical coverage in the country, patients end up paying medical debts for many years or draining their savings accounts to cover the bills. My debt is much less than it would have been had I gone to the cancer treatment facility I first investigated, but it is still enough that, as I wrote this book, I had to sell my house and two-thirds of my personal belongings to be able to survive financially. At one point, I even thought I would have to give away my beloved Roxie, but I worked hard to try to find a way to keep her. As I finish this book, I live in a tiny, run-down old house. I have put up with holes in the screen door, a constant dampness problem, mold on the walls and carpet, and a commode that balks at flushing paper. Cancer treatments moved me from the middle class to the lower class.
Since tests and medications go on for many years beyond the initial treatments, there can seemingly be no end in sight to the cost or agony of cancer. Add to this the uncertainty of the future that comes with each blood test — many cancer patients can never consider themselves "cured" — and you have enough stress to strike down a Viking warrior!
Sample another excerpt from O'Haynes' new book,Walk Free From Fear of Cancer.
Sample poems from O'Haynes' collection.