IAt 35, I never thought I’d write “I’m suicidal” on an intake form at an oncologist’s office. I had never been seriously depressed or anxious in my life. But there I was, post double mastectomy and chemo, staring at this form, knowing I needed to be completely honest with my medical team. I was suicidal. And I genuinely wondered if anyone would care.
When you are diagnosed with cancer, everything else happening to your life gets put to the side so you can deal with your medical emergency, whether it’s an impending divorce, financial woes, or your mental health.
Especially your mental health.
Your mental state is a key factor in your quality of life, how you handle stress and trauma, and your willingness to survive things like cancer (and thrive afterward), yet it quickly gets swept to the side in the effort to save your life. If you’re already struggling with anxiety or depression, a diagnosis can put you into an emotional tailspin, making medication more challenging to manage, and upping the ante on your daily life struggles. Even if you had no history of mental health issues, a cancer diagnosis does not play nicely with your mind. You can’t just walk it off or pretend it didn’t happen.
What oncologists either don’t know, or simply forget, is that a cancer diagnosis is a shock to the system. It is mental trauma. We are beside ourselves with fear, anxiety, uncertainty, and dread. And each new appointment means a new round of information, which triggers the trauma all over again. Even hearing about someone else’s diagnosis triggers the trauma. Hell, my head is spinning just writing about it.
But for doctors, the only mission is to scorch the earth of you. Burn, cut, and poison, then leave you to deal with the aftermath of a mental, emotional, and physical post-apocalyptic wasteland.
This is the space between. Where we’ve been dumped on our asses into the land of You’re Cured, only to realize this is not a happy ending and there is much rebuilding to be done before things are back to even a semblance of “normal”. This is where many of us get stuck. This is where we realize no one prepared us to survive this emotional half-life. No one told us we would have to rebuild. No one gave us the technology. There is no instruction manual. Only the crumbling facade of our former life, much of which will have to be razed as we forge new roads into our future.
If you have been diagnosed with breast cancer, keep in mind that many cancer centers don’t have psychologist or psychiatrists. Your cancer team may never speak to your own mental health professional, if you have one, to loop them in or ask questions. You may never speak to anyone, or be referred to anyone, to discuss how you’re really doing. As patients, we must advocate for our treatment choices and options, as well as our mental health, at a time when both are challenging.
The common breast cancer narrative is that you’re a tough badass who can handle anything, even cancer, with a smile, and when you’re finished you live happily ever after and everyone is amazed at how strong you are. But that story falls flat when you’re living it and realize it’s a lie. 30% of us will die, and most will have lasting treatment side effects and mental health issues. But we’re trained by the narrative to suck it up, put on a happy face, and move on. To pretend, so everyone else is more comfortable and they don’t have to face the reality of life behind the pink ribbon.
I remember the oncologist looking at my intake form that said, “I’m suicidal,” and pausing. She asked if I was seeing a therapist and I said no. There were no further questions. Then she referred me to a psychiatrist. You might think that I would be mad she wouldn’t ask me the necessary questions like, “Do you have plans to kill yourself?” but I wasn’t. Instead, it got so little reaction that I was mortified I had even brought it up. I was ashamed for her to even make eye contact with me. It was like admitting that I wasn’t strong enough to handle cancer. Admitting I couldn’t do it right. That I needed help.
But afterward, I was angry. Angry that she didn’t ask why I was struggling. Angry that it didn’t even seem to matter. That suicidal thoughts belong to some other realm, and well, oncologists don’t treat that, so that information somehow isn’t relevant to saving your life. She’s not a bad oncologist (I do like her and still see her), just a typical one. I’ve heard the same story from many other cancer survivors. This issue seems to not matter much to those who are trying to save our lives. You’d think preventing suicide would count as part of all this life-saving, but it’s like it’s not even on the radar.
So, you have to save yourself.
The world needs you and you are meant to be here, right here, right now. The people you influence and inspire need your presence. You are worth it and you’re valuable.
If you need immediate help, call the national hotline (1-800-273-8255). Speak up about your mental health, regardless of whether it’s anxiety, PTSD, or severe depression. Make your situation known and talk about it until someone helps you. You must advocate for yourself, or ask for help from a loved one to advocate for you. If that person can go to appointments with you, they can bring up your mental health concerns and give them more weight and validity. If you don’t have a mental health professional, find one or ask for a referral. If you already have one, keep them posted on your medical situation and make more frequent appointments if you can afford it. Try online therapy resources like talkspace.com or betterhelp.com. Read up and have your support structure read up on coping mechanisms for grief, PTSD, depression, and anxiety. Join a cancer support group, whether it’s online or in person.
There are some things you can do right now to help yourself get grounded, deal with your emotions properly, and find some peace. I know these may sound cliche, but techniques like these helped save my life. Now, as a life coach for breast cancer survivors, I use these same techniques with my own clients to help them get free from their mental suffering.
Write – Get all your thoughts out on paper, so they get out of your head. Even if they’re dumb, or pointless, or a waste of time. Get it out.
Breathe – Close your eyes and take three deep breaths. Be in the present moment by taking deep breaths and wiggling your toes or trying to feel your earlobes. See if you can feel your heartbeat. Then see where you can feel your pulse points. Can you feel the insides of your hands? Name 5 things that are touching you. Feel the difference between you touching them and them touching you.
Feel the Feelings – What we resist, persists. When we resist our feelings, they stick around. They’re actually meant to flow through us, like waves. Allow your feelings to just be. Let them pass. It takes about 90 seconds, but feelings do pass. Thank them for their presence, even the icky ones. Let them wash through you without attaching meaning to them.
Add Joy – Think of the things that bring you the most joy. Imagine that thing, memory, or wish as fully and completely as possible. Explore that feeling of happiness. Memorize that feeling. Practice adding that feeling to your day, on purpose. It doesn’t matter if it’s real or not. Tell your brain to shut up and let you have this moment of pleasure. Give yourself permission to enjoy it without the pressure of things you “should’ be doing. Be fully present and immersed in that moment and savor it. Know you can have this feeling any time you want just by imagining it. Then start to add items that remind you of that feeling to your life.
Life after cancer requires grieving: sifting through the debris, clearing new paths through the rubble, and building new foundations. It’s not an easy task, but there is much richness in the process. Compassion, patience, and peace can grow in the soil of the debris. Slowly but steadily, they spread throughout the landscape, sowing seeds of wisdom along the path, growing long roots of strength and resilience, and blossoming into a beautiful new version of yourself.
Melanie Childers is an editor, code monkey, writer, breast cancer body coach, yoga instructor, and all-around badass. She is one of the founders of The Underbelly, an online magazine and community dedicated to illuminating the darker side of breast cancer.