Childhood Cancer

Childhood Cancer Survivors

Worry, Sadness, And Depression

Worry and sadness can be seen as two sides of the same coin. For many survivors, worry is fear related to losses that may occur in the future, while sadness is related to losses that occurred in the past. Both of these emotions are a normal part of anyone’s life but both can become troublesome for survivors. In the case of worry, survivors can become focused on fear of a relapse or fear of late effects. If the worry grows too large, it may compromise a survivor’s ability to seek appropriate healthcare. In essence, the survivor becomes afraid of knowing. Sometimes survivors become embarrassed or ashamed of their concerns about their health and body. After all, young adults aren’t generally worried about things such as cancer relapse or heart problems. Routine health concerns for survivors make them out of step with their peers, potentially causing negative self-directed feelings.

Some survivors worry that they are hypochondriacs—that they are overly concerned about their health. They become fearful that their doctors will view them as complainers or find their health worries crazy. This may interfere with getting good, thorough follow-up care. Survivors who feel extreme worry may benefit from seeking help from a professional. There are many ways to reduce worry and not allow it to overwhelm your life.

Depression is distinguished from the normal sadness about the real losses that can occur from treatment. Sadness can arise from temporary losses (e.g., loss of hair) or permanent losses (e.g., loss of fertility or mobility). Depression takes over normal sadness when a survivor is only able to focus on losses and can no longer find any pleasure in life. It may become crippling and prevent the survivor from seeking and getting appropriate care and from enjoying the positive aspects of life. Survivors struggling with depression should consider seeking help with a mental health professional.

When people are profoundly depressed, they may feel life is not worth living, or that they are not worthy of care and help. They often lack the energy to participate in activities that used to interest them and they may withdraw from important relationships and social interactions. These feelings make it especially hard for them to get the help they need, both physically and emotionally. No one should have to suffer alone through depression; it can be successfully treated with counseling and/or medications.

I have been diagnosed with and treated for both anxiety and depression. My anxiety and depression have been daily issues for me. In many ways they are bigger problems than my physical side effects have been, as they impact my everyday life more evidently. For example, my cardiac health doesn’t really affect how I interact with other people, but my anxiety can make it very hard for me to branch out and feel comfortable doing something different or making new friends. In that way, my anxiety and depression have been the hardest side effects for me to manage and control.

My family has been incredibly supportive and proactive about getting me help - I was seeing therapists within two years after ending treatment. I have gone to in-person therapists (including talk therapy, play therapy, and cognitive behavioral therapy) and I have seen psychologists and psychiatrists who have prescribed anti-anxiety and antidepressant medications. I’ve never done any support groups or online therapy.

 

During treatment, feelings of anxiety and depression were definitely present, but most of my focus and that of my family and care team was centered on getting better physically. It’s worth noting that when I was undergoing treatment, the emotional toll of cancer on long-term mental health was poorly understood. After treatment, I think I expected those emotions to go away, and viewed the anxiety/worry as just a temporary result of what was happening at the time, but this was far from the truth.

My undiagnosed anxiety and depression persisted and intensified when I got to high school. That’s when I made the decision to start seeking help regularly from a therapist. I was lucky to have friends that were very supportive, but in the beginning, it was very challenging to rationalize to my parents. Their generation feels a huge negative stigma around receiving therapy and medication for mental illness, and frankly the stigma was still quite strong at the time I sought help. They could not understand why an otherwise healthy and thriving teen girl would need to seek help in this way.

Now as a 26-year-old, I still regularly talk to my therapist and take prescribed medication for my anxiety and depression. Although a constant work-in-progress, I have made great improvements to my mental health and well-being. I now have the professional and personal support I need to continue this progress and to lean on if/when things get more severe. My parents, too, have made great strides in their respect and understanding of mental illness and are great supporters of the work I continue to do on my mental health.

 

Throughout my whole life I have struggled with anxiety and depression, both of which I feel have gotten harder to deal with since having cancer. I have put in a lot of hard work with different kinds of therapists to try and seek better ways to cope with anxiety and depression. Still, sometimes it’s hard to cope by yourself, and I often look to my friends as a support.

 

Both times transitioning out of treatment, I felt a huge sense of relief, especially with our second during COVID policies where my children couldn’t see each other the majority of a year. Each transition took about a year to begin to feel human again, have a sense of routine, normalcy as much as possible, and less full-blown anxiety. The second time I actually utilized anti-anxiety medication which helped a lot. It’s hard not to assume the worst in any scenario, but I really tried to focus on “normalcy” and not hover over the kids or keep them from risky play that is a normal part of childhood.

 

Now as a Mom, I have an intense amount of anxiety about my little boy. When he gets bruises and even when he had the little “toddler tummy” my mind went to directly to negative thinking. It’s a lot to deal with but it is bearable. What helps is talking about it with others that understand. Giving myself grace and allowing myself to feel the things I feel. And knowing that others that haven’t been there, won’t understand and that’s okay. It doesn’t mean I’m alone.