Depression after Breast Reconstruction

You’ve been through a lot. You had to deal with the shock of your diagnosis and the fact that your life was forever changed. You endured the barrage of doctors’ appointments, tests, scans, surgeries, and various other assaults on your body. You were so busy, so focused, that at times it helped distract you from the deeper fear that this thing in your body wanted to kill you.

You were a warrior. People said they could never be as brave as you. And even though hearing this got to be a little annoying sometimes (as if you volunteered to get cancer and deserved some kind of a medal), you did take pride in being able to charge right through all your treatments (most of the time, anyway) and even joke with the medical staff.

Now that’s all behind you, and it seems like you should be happy or even ecstatic. There are many other women who’ve been diagnosed with breast cancer who weren’t nearly as fortunate in their outcomes as you’ve been. It makes you feel guilty when you think about it. Not just guilty that you’re alive and they may not be, but guilty that you’re not out celebrating life, living in the moment, appreciating the world you’re still here to enjoy. Instead, you have all you can do to get out of bed in the morning. You can’t summon up the energy or enthusiasm to do the things that used to make you happy before cancer. You feel hopeless, useless. You’re thinking, What’s wrong with me? Why can’t I get a grip? But as hard as you try, you can’t.

It’s not at all uncommon for breast cancer survivors to experience these dark thoughts and feelings. But don’t make the problem worse by beating yourself up. You have plenty of valid reasons for not feeling like yourself, including the effects of all those treatments on your body chemistry — the chemo, maybe tamoxifen or surgery-induced menopause, all the anesthesia. And to top it off, you’ve been laid up for weeks or months. Your body is still in the healing mode, and your immune system has been taxed. That doesn’t leave much physical or mental energy for anything else, even though you’re sick of feeling sick!

What you’re feeling may be temporary, related to any or all of the above. Many of us have been through it. But be aware that even if you can point to many reasons for feeling as you do, it is possible that your body has gotten stuck there physiologically. And it might need some help getting unstuck.

If your symptoms go on too long and are interfering with getting on with your life, call your doctor. He/She will talk to you, run some tests, try to figure out what might be causing the problem. It may be possible that you’re suffering from “major depression.” This is different than just “the blues.” It’s about brain chemistry, and it might not be something you can just snap yourself out of, any more than cancer was. Why continue to suffer, if it’s not necessary? It is well-established by research that combining medication with therapy yields the fastest results and best prognosis when dealing with actual major depression.

You will see that some of the symptoms listed below could be associated with having cancer treatment or “chemo brain.” Causes and effects are complicated. But don’t rely on self-diagnosis. Talk to your doctor.

According to the American Psychiatric Association, having five or more of these symptoms for two weeks or more (including the first or second ones listed) can indicate major depression:

• Depressed mood most of the day, nearly every day, such as feeling sad, empty or tearful

• Diminished interest or feeling no pleasure in all — or almost all — activities most of the day, nearly every day

• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite nearly every day • Insomnia or

increased desire to sleep nearly every day

• Either restlessness or slowed behavior that can be observed by others

• Fatigue or loss of energy nearly every day

• Feelings of worthlessness, or excessive or inappropriate guilt nearly every day

• Trouble making decisions, trouble thinking or concentrating nearly every day

• Recurrent thoughts of death or suicide, or a suicide attempt

If you don’t have major depression, it still might help to have a professional to talk to about the traumatic life experience you’ve just lived through. Or maybe it’s time to join one of those breast cancer support groups you previously ruled out. Whatever the cause, you can get through this dark time, just like everything else you’ve gotten through. You deserve to be happy. One day soon, you’ll wake up and notice the sun shining again.