Last week was World Mental Health Day, and I wanted to write a bit about it because mental health is one of the least spoken about but most invasive aspects of cancer.
There are some obvious things like being numb/devastated/anxiety-ridden when you are first diagnosed. People get that, and it is widely understood. But I don't think most non-patients understand how much of a non-linear path the emotional and mental aspect of cancer is. The thing that struck me the most, and that seems to be common to many patients, is the depression that hits once treatment is over.
It seems natural to expect a patient to be happy, relieved and looking forward to the future once treatment is over and the cancer has gone. But in my experience, that isn't how it goes and from speaking to other patients, it's at that time that the wave of negative emotions seems to hit hard.
During the actual treatment, you're kept super busy with appointments, feeling ill, replying to people who are concerned about you, googling all you can and generally mustering up enough energy to put one foot in front of the other. There just isn't time or space to feel all the feels. But once treatment has ended, the appointments slow down and life is somehow expected to go back to normal, THAT is when it all hits. Because how do you go back to normal? How do you just bounce back, after what you've just been through? After facing your mortality, after your body has become disfigured, after you have lost some friends and others have stepped up magnificently, after you've missed out on things you were looking forward to, work, stopped being invited out (even though you're too tired to go but the lack of invite still hurts), after making and losing friends to cancer, either in real life or online, after having to tell your loved ones and feeling the horrific guilt that goes with it...how do you bounce back just like that? It's impossible. But people expect you to because hey, your treatment is over and the cancer is gone so you should be over the moon.
But that isn't your reality. You feel numb, depressed, flat, anxious about it coming back, guilty for feeling all that and confused as hell that you don't feel how you're supposed to. You plaster a smile on every time someone says "you must be so relieved it's over!" and say "yeah, so glad" whilst wanting to cry and shout "but it ISN'T over. Because what if it comes back? What if it spreads? Who is looking after me now?".
And that is part of the problem. After months of having a team of doctors and nurses looking after you and answering all your questions, all of a sudden you're on your own, cast adrift with nothing to hold onto. Sure, you have their number but you know you can't ring whenever you have a headache or a pain in your back. But it doesn't stop that little voice in your head from asking "is this pain cancer-related? How will I know? Is it back?". Being alone and expected to suddenly return to life post-cancer is almost as hard as cancer itself. If there's one thing I wished everybody knew about cancer, it is that it messes with your head tremendously. Even months after treatment has ended you can have days where you obsess about it, or burst into tears for no apparent reason. Life DOESN'T return to normal.
Sure, there is counselling available and I'd encourage everyone to take that up if they think it would help. Just contact Macmillan or ask your cancer nurse for more information. But tell your family and friends what's going on emotionally and mentally too. Let them know how hard it is for you. And if you are that friend or family member, understand that returning to life after treatment is really really difficult. Congratulate your loved one on finishing treatment but also ask them if they want to talk about it all. Because life after cancer will never be the same.
