Cancer, Mental Illness and Stigma
Robin Williams’ death and the social media response has inspired me to write about Cancer, Mental Illness and STIGMA.
I could relate to Mr Williams a little - I’ve had depression and anxiety since 1991. In public, I’ve always tried to maintain a “optimistic view” of my life even with Stage 4 cancer. I am somewhat true to that at my core. However, behind the scenes, I am an expert at negative thinking - AKA “cognitive distortions.” My family sometimes pay the price of a grumpy, anxious momma.
I’ve never reached the point I would harm myself. I always found a way out of my bleak mood. I reach out to as many resources as I can, am blessed with a supportive husband and family and take my meds religiously. I used to believe that suicide was selfish. Then I read this - please do:
I can very easily tell everyone about my cancer experiences. I can tell everyone I have asthma and get pneumonia often. I did tell everyone - in detail - about my recent inpatient experience with the stomach flu. I could watch my my right knee meniscectomy (surgery) on a screen and recount the story. I helped support people with concussions using my professional and personal experience.
But I can’t comfortably talk about my lifelong experience with depression and anxiety. Yes I may have talked about it in the context of my cancer story. But I’ve never been comfortable telling it as story of its own. Because of STIGMA. People just don’t talk about it. I never know who wants to hear about it. I don’t want it to come around and bite me in the butt or be the topic of gossip. I’m still not going to tell the whole story. I’m not ready to overcome the STIGMA.
Why do we skirt around mental health issues. We say “please don’t tell anyone.” We are hesitant to tell friends we need medication. We don’t “tell all” about our therapy sessions. It can be embarrassing to recognize someone coming out of your counsellor’s office. Yet we’ll talk about the latest healthy food or exercise trend. We will discuss colonics. We’ll compare injuries sustained biking. When we do talk about mental illness, we don’t go into detail. We stay in the shallow end with most friends and colleagues.
I’m sure that society’s “hush-hush” approach to mental illness has caused this. Not the people with mental illness. Working in psychosocial rehab, I learned that the telling of one’s story was one of the most empowering experiences. I am absolutely thrilled that Olympian Clara Hughes toured Canada by bike to reduce the STIGMA of mental illness and shared her story.
So lets Talk About IT
(Most stats are from Canada in 2012)
- depression affects 10%
- anxiety affects 8%
- 1/5 women will report depression at some point in their lives
- “cost” of over $50 billion a year
- 11 people commit suicide each day in Canada
- only 20% of those with mental illness receive appropriate services
Stigma
- only 50% will tell friends that they have a family member with mental illness
- 42% of are unsure if they would socialize with a friend with a mental illness
- 55% wouldn’t choose a spouse with mental illness
- 48% think mental illness is an excuse for bad behaviour
- 27% are afraid of being around someone with a serious mental illness
- 54% of people believe depression is a personal weakness
With stats like that you can see why we don’t want to talk about it.
However, mental illness is an ILLNESS - sometimes acute and sometimes chronic. It requires multifaceted, client-centred, team-based treatment including counselling, exercise, diet, stress management, CBT, mindfulness meditation, family support and education, vocational rehablitation and/or medication.
Suicide can sometimes be prevented with the right support and treatment. Sometimes it can’t - even the most supported person can feel so awful they chose to end their lives. I have worked with some people with severe depression and suicidal ideas who later developed an aggressive terminal cancer and were at peace with dying.
Perhaps if we could talk about it more often it wouldn’t be so dark and mystical and scary. Perhaps we could save some lives.
Cancer and Mental Illness
- 25- 42% incidence of depression in cancer patients
- 41% have clinically relevant anxiety; 50% in women and younger adults
- suicide rates seem similar to general population though the theory is that there is significantly increased risk
- Depression and Anxiety are factors in a person’s survival and to manage the consequences (body change) and side effects of treatment.
Cancer Caregiving and Depression and Anxiety
(from Korean studies)
- up to 82% of caregivers have depression
- up to 38% have anxiety
(Holy crap - there’s no way we even begin to address that)
OK that’s up to 8X the incidence in the general population. But how much of resources, research and talk about cancer is dedicated to mental health? Not 80% thats for sure.
Most cancer treatment centres offer counselling and psychology or psychiatry consults to people with cancer. There are experts but you may have to try a few to find the right one. Cancer programs often support family and caregivers also.
The main cancer websites also offer excellent resources. However when you are severely depressed or anxious it’s difficult to follow through and use these resources. I’d recommend a professional to help. Your support network needs to learn more about it too.
In my experience the post cancer depression/axiety was almost more difficult than the cancer treatment itself. Also it was more difficult than any previous episode of depression. It started like a Post Traumatic Stress Disorder (apparently common).Then it became pure depression and anxiety. Medications were slow to work and I needed quite the combination. I learned later that PTSD is difficult to treat with medication. I am grateful for the assistance of a wonderful BCCA psychiatrist with the patience of a saint.
I’ve written bits about the process I used to get through this difficult time; healing retreats, counselling, psychiatry and art therapy. It has taken a lifetime to find the best technique for me. I have found it with the Callanish Society. They helped me to start actively healing from cancer using music, art, movement, loving kindness, healthy food, medical advice and counselling. Almost magically, I also processed a lifetime of depression and anxiety. Mostly through art. I have spent many an hour learning Cognitive Behavioural Therapy and Mindfulness. I’ve tried a variety of talk therapies from Freudian to interpersonal to CBT. But nothing resonated like art.
So in the spirit of reducing STIGMA please start talking about IT. IT being mental health. It’s key to your overall health so make it a priority.
Here’s my favourite line from an aforementioned article:
“Reach out to survivors of suicide. Practice using the words "suicide" and "depression" so that they roll off the tongue as easily as "unicorns" and "bubble gum." “
*****AND PLEASE - IF YOU HAVE ANY RESOURCES OR STRATEGIES TO SHARE PLEASE ADD A COMMENT******
RESOURCES
For Cancer and Mental Health in BC, Canada
Also in BC:
And it’s sibling in the US:
Professionally mediated online/phone support in Canada:
References …
You are right. We do need to start talking about mental illness and mental health in general. I can't figure out why more attention isn't given to a patient's mental well-being following a cancer diagnosis. We're making progress, but there's a long way to go. Thanks for writing about it. You're making a difference.
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