Battling Two Illnesses: Depression and Cancer

            Battling one illness is tough.  It requires a lot of strength.  What happens when another illness enters the picture? That is what I am facing.  I have battled depression most of my life.  It has not been easy. Stigma makes it even harder because so many people do not believe it is a real illness. Trust me it is a real illness.  It is made even more difficult with the addition of a second illness.  

            Most of 2022 and all of 2023 have been difficult from the perspective of depression.  I have had a huge battle and a lot of treatment.  The depression took everything out of me.  As I was getting better, I was hit with the diagnosis of a serious physical illness.  I have stage 4 metastatic breast cancer.  It shocked me and triggered the depression to strengthen again.  So, now I am fighting both a mental illness and a physical illness.  I am lucky that my mental health team and my oncology team are amazing.  

            So, what does my fight look like.  First, the battle creates noise in my head.  I have become used to the voice of depression.  It brings me down, sees the world through a negative lens.  The voice of depression tells me I want to die.  Cancer’s voice jumps in and tells me I am afraid of dying.  The contradictory thoughts fight.  The cancer questions everything.  “Why do I have cancer?”, “Why does chemo make me so sick?”, “Am I going to die?”, and “Why wasn’t the cancer caught earlier?”  The depression answers back with its negativity.  It is very loud inside my head.  

            Both depression and cancer cause me to cry.  I have fought depression for so long.  At times I fear I do not have the strength to fight cancer, too.  That drags my mood down.  I struggle to fight.

            I have learned that the depression is wrong thanks to my mental health team.  I want to live.  It is weird to have so recently been suicidal and now be fighting to live.  To live I need to fight depression and cancer with all the strength I can muster. 

            When the chemotherapy leaves me too weak to do anything except lie in bed, I think too much.  The depression and the cancer argue.  My head is their battleground.  At times I become numb.  Sometimes I need someone to talk to.  Other times I need to allow my illnesses communicate despite their bickering.  The noise is part of the battle.  I do not like it, but I understand I have to go through this to heal.  

            Some days writing helps.  Writing allows me to process my thoughts. I can have a conversation about my illnesses with the pages of my journal.  Sometimes I share my writing with others.  That sharing is healing for me.

            Depression and cancer each have their own pains and suffering.  Together they add up.  They feed off each other.  When the chemo leaves me nauseous, the depression tells me I am not strong enough to fight.  When I feel weak, the depression reminds me I am battling an illness that can kill me.  When the depression is in control the chemo side effects gain a stronger grip upon me.  Cancer wants to be heard, too. Depression and cancer each have a voice. 

            Living with two illnesses is very difficult.  I do not wish it upon anyone.  I am going to keep fighting.  The depression has been with me close to four decades and I am still fighting.  I plan to fight cancer the same way.  At times I will struggle, but I have an amazing support system surrounding me.  When I get through this, I am going to advocate to build more support systems for others in need.  Having depression and cancer sucks, but I am determined that some good will come out of it. 

            

A Little More Gratitude and a Cancer Poem

            Last week I shared all the people I am grateful for in my life.  Today I want to share a few things I am grateful for and then leave you with a poem I wrote this past weekend.

            First, I am grateful for TMS (transcranial magnetic stimulation).  There have been two posts on this blog about TMS.  It has made such a difference in my battle with depression.  I don’t know where I would be without TMS.  It is a treatment that works for me, and I know will be a part of my life.

            I am also grateful for chemotherapy.  How can I not be grateful for something that is keeping me alive?  It may seem a little strange to be thankful for something that makes me feel like crap each week, but it is doing its job.  It is killing my cancer.  As sick as I feel I am grateful that the medical knowledge is available to treat my cancer and that I have a chance to survive.

            Another thing I am grateful for is the ability to write and experience the healing power of writing.  For as long as I can remember, writing has been a part of my life.  I would be interested in knowing how many poems I have written in my life.  Writing is a healing tool.  I am grateful that I can express my thoughts and emotions in writing.  I am grateful that I have this blog to share those thoughts and emotions with all of you.  My books are another source of gratitude for me.  Each one has brought me healing and allowed me to share my story with others.  

            So, I have a lot to be grateful for. Expressing my gratitude has helped me remain positive as I battle depression and cancer.  Don’t be surprised if you see gratitude pop up on my blog again in the future.  

            I also wanted to share a poem with you.  This poem is about the cancer, more specifically fighting cancer.  At times I get down because as much as I try to fight, I often just do not have the energy or stamina.  My body is weak from the fight.  When I start to feel down about needing so much rest, my Aunt Holly reminds me that even when I am resting, I am fighting.  As I thought about it made a lot of sense.  My body is in a fight for its life.  It needs time to heal.  That is what happens when I am resting.  So, even when I am resting, I am fighting.  That is where this poem came from.

 

Cancer Chose Me

 

Cancer chose me.

I did not choose cancer.

Cancer is ravaging my body.

Leaving me to fight.

At times I am weak, but still I fight.

Battling cancer takes all my strength.

 

Cancer chose me.

Its poison attacking my organs.

I fight back with a different poison, 

A poison meant to kill as it heals.  

My body is a battleground between cancer and chemo.

 

Cancer chose me.

Some days I must rest.

I cannot actively fight every day. 

Learning that it is okay to rest has been difficult,

But it is something I must accept.

 

Cancer chose me.

I did not choose cancer,

But I chose to fight back.

Meet the cancer head on

And fight for my life.

 

 

            Check back on Thursday.  I will be reflecting on how depression affects my fight. Depression can affect battles with any illness.  I will share my perspective. 

Grateful Despite Cancer and Depression

           The past year has been very different for me.  It has been a difficult year to say the least.  Still, I have a lot to be grateful for this year.  As Thanksgiving is upon us, I would like to reflect on what I have to be grateful for.  Illness cannot prevent my gratitude.

            2023 started with me in a deep depression.  It was a battle that lasted months and impacted my ability to function.  It was one of the worst periods of depression that I have had in my lifetime.  That being said, I am grateful for my mental health team.  Dr. K, Dr. S, and Stephanie got me through a very difficult time.  My primary care, Cristina, also helped.  I am grateful to all four of them.  I know that not everyone has a mental health care team that they can rely on in difficult times.  In my darkest times they are there, supporting me, helping me through suicidal thoughts.  This past year I have really needed them.  They continue to be by my side as I battle cancer.  Having a mental illness and a physical illness is not easy.  I need their support and healing touch.  So, as I think about what I am grateful for this year, these four people are right there. 

            In addition, to my mental health difficulties, I am now facing cancer.  I am grateful that Cristina made sure I had the tests needed to diagnosis my cancer.  I am grateful that she made sure I am receiving the best care for my cancer.  That brings me to my oncology team.  Dr. St is amazing.  She gives me hope that I can beat stage 4 metastatic breast cancer. In addition to Dr. St., C has been inspiring.  She is the nurse navigator that encourages me with her dancing and words of encouragement.  Jackie, the nurse practitioner, helps by ensuring that I am prepared for chemo.  I also appreciate all the chemo nurses who provide such tremendous care.  They make sure I am taken care of and that everything goes smoothly during chemo.  I have hope that I can beat cancer because of this great team.

            As I reflect on what I am grateful for I must recognize my family and friends.  First, my Aunt Holly has been by my side through all my cancer journey.  She also understands the mental health side of what I am going through.  I am grateful for her care and encouragement.  My cousin, Sara, has helped me with so much.  I am grateful to have her by my side on this journey.  I remember us as kids, and I feel lucky that she is still in my life.  My mom and brother have been helping me.  They check on me and send supportive words.  I didn’t realize how much they understood about what I am going through until a recent conversation with my brother.  It has changed my perspective.  I feel grateful that they want to be an integral part of my healing journey.  My Aunt C and Uncle D check on me and encourage me.  They are coming to help me next week.  My Uncle A always texts to check on me and encourage me. 

            My friends have been great.  I want to mention them all here, but I am afraid I will leave someone out.  I’ll try.  Know that if I miss you, I still appreciate you.  Thank you, Pam, Shannon, Carol N, Sarah, Maria, Gus, Nancy, Jessica, Bernie, and Sharon.  I am grateful to the friends I went to school with over the years who have reached out.  It means a lot that even though we have been separated by time, you are still care.  Others have reached out including Sue, Robin, and Meg. Thank you to all of you.

            My colleagues have been wonderful.  I am touched by their generosity in helping me in my time of need.  I am grateful that so many of them reach out to me.  It means a lot. I appreciate my colleague, Robert, who sends me a gratitude list every morning.  It reminds me to be grateful.   Thank you to my former students who are wishing me well.  Your support means so much to me.  

            I know I have a battle with mental and physical illness.  It is not easy.  I have a lot of fighting left to do.  I am choosing to focus on the fact that I am lucky to have the ability and the opportunity to fight.  My battle is overwhelming, but my health care team, my family, my friends, my colleagues, and my former students give me the courage and strength to keep fighting.  I don’t know how my battle will end, but I am confident that I have wonderful people surrounding me in this battle.  For that I am grateful.  Cancer and depression chose me.  What they didn’t realize was they chose a fighter with a great support team.  I know it won’t be easy and some days are going to be hard.  At times I may want to give up.  That is okay.  It is part of the fight.  Good days and bad days will come together.  I will rely on my support team.  Each day I fight is another day to be grateful for.  So, thank you to everyone.  Please stay by my side and help me beat these illnesses.  

            I encourage everyone to reflect on what they are grateful for as Thanksgiving approaches.  It helps put life in perspective.  Even though I have to serious illnesses, I have a lot to be grateful for.  I have learned not to take life for granted.  Illness has given me that perspective. 

            I wish everyone a wonderful Thanksgiving.  I’ll be back next week.

 

            

Celebrating Nurse Practitioner Week

            Last month I recognized special physician’s assistants.  This week (November 12-18) is National Nurse Practitioner Week.  I’d like to recognize these amazing health care workers.  

            First, let’s learn a little about these professionals.  According to the American Association of Nurse Practitioners, nurse practitioners are “…clinicians who assess, diagnose and treat acute and chronic diseases, as well as counsel, coordinate care, and educate patients regarding illnesses.”  They “…undergo rigorous national certification, periodic peer review, clinical outcome evaluations, and adhere to a code for ethical practices.”

            Nurse practitioners treat patients in clinic and hospital settings.  They work with patients in a variety of health care fields including family practice, acute care, oncology, pediatric care, psychiatric/mental health care. These are just a few of the fields where nurse practitioners can be found.

            I was first introduced to the care of a nurse practitioner 20-25 years ago when I saw Tam.  She was incredible.  She took care of me with the knowledge of a doctor and the bedside manner of a nurse.  She took great care of me in the years that I saw her.  Tam was one of the first primary care providers to address my mental health.  I was very grateful for her care.  I am still in contact with Tam after all these years.  Occasionally I ask her for medical advice.  She has always been there.  I consider myself lucky to have been treated by Tam.

            Right now, there is an important nurse practitioner who is a part of my care team.  You have met her on this blog.  Stephanie is a psychiatric nurse practitioner who provides the TMS and ketamine treatment that have been so integral in my mental health care.  When I first started TMS a psychiatrist provided oversight of my treatment.  The second provider was Dr. Hutton, a leader in the field.  They were both great.  When Stephanie took over, I experienced the benefits of a nurse practitioner.  Stephanie ensures that I am comfortable with my treatment.  She has monitored the ups and downs I have experienced.  She connects with my psychiatrist, psychologist, and primary care.  In fact, she has been a leader in that connection.  When I talk to her about my mental health she listens intently and helps me make sense of what my depression and anxiety are doing to me.  Stephanie is there during the crises. She has helped me through suicidal thoughts and provided me with hope.  I feel comfortable with Stephanie and know that I can share any thoughts with her.  I appreciate Stephanie greatly.

            As a person with mental illness, I understand how important it is to have a mental health team.  Stephanie is an integral part of my team. I realize a lot of people don’t have a mental health team like I do.  I am aware that I am lucky.  I spent years without a team.  It is my hope that there will be more teams of mental health care providers to treat people with mental illness.  Psychiatric nurse practitioners are an important part of building those teams.  I hope someone reading this will decide to become a nurse practitioner after reading about them.  We need more nurse practitioners in the health care.

            Before I end this post, I’d like to give a shout out to another nurse practitioner.  Thank you, Jackie. She is the nurse practitioner who is a part of my oncology team.  Your care is appreciated.  

            If you see a nurse practitioner show your appreciation this week.  Show them your appreciation whenever you get the opportunity.  Encourage young people to consider a career as a nurse practitioner. Thank you to all the nurse practitioners serving patients. 

 

TMS: A Firsthand Account

    Recently, I shared a post by Stephanie Debnath, PMHNP-BC.  It provided a psychiatric nurse practitioner’s perspective and experience with transcranial magnetic stimulation (TMS).  Today I would like to share my experience as a patient.  

            My psychiatrist, Dr. S, first brought up the possibility of trying TMS in 2019.  I was struggling with depression.  Medication just did not help.  We discussed TMS and I was open to trying it.  

            When I first walked into SoCal TMS I did not know much about this treatment.  I had some basic information that Dr. S had shared with me.  I knew that she thought it could help me and I trusted that.  The SoCal TMS staff explained the treatment to me.  I filled out rating forms.  I completed all the necessary steps to get started.  Still, I didn’t know what to expect as we got started.  

            I was depressed.  I could not see my life outside of the darkness of depression.  I struggled with suicidal thoughts.   I was not sure anything could help me.  But Dr. S thought TMS was worth trying as did my psychologist Dr. K.  I was ready to give it a try.

            So, what is TMS like.  First, I sat in a large chair that reclined.  The psychiatrist and techs took measurements of my head.  They situated me in the chair and fitted a pad to the top of my head.  Soon I felt tapping.  It did not hurt.  There was a sort of rhythm to it.  They measured reactions to the magnetic taps in my hand. Quickly, they found the right settings and I was set for my first treatment.

            I attended treatment daily.  At first there were no noticeable changes, but the psychiatrist and techs encouraged me to be patient.  They said it would happen.  I just had to give it time.  Each session lasted about 45-50 minutes.   They were treating both my depression and anxiety.  

            After about three weeks I noticed my mood lifting. I felt lighter.  My thoughts were not as dark.  TMS was working.  I could feel the depression lifting.  I could not believe it.  I had never felt this type of lifting of my mood before.  Over the remainder of the treatment, my mood continued to improve.  I literally felt as if a weight had been lifted off me.  No medication had ever made me feel like this.  TMS was working.

            The psychiatrist explained to me that it was not a permanent change, but that I could expect to feel this way for several months.  He told me that the lifting of the depression lasts different lengths for different people. He promised me that when the depression came back, he would use TMS again to relieve it.  

            I could not believe how I felt.  I was not clouded in darkness.  For me it lasted several months.  When the symptoms of depression returned, Dr. S sent me back to SoCal TMS.  This time I was treated by Dr. Hutton, one of the leaders in TMS treatment and the head of SoCal TMS.  I learned a lot from him.  He set me up with treatment again.  My experience the second time was similar to the first time.  Again, around the third week, I felt the depression lifting.  By the end of treatment, I was feeling good.  

            TMS has been a godsend for me. I have lived with depression for almost four decades.  Noting had ever relieved it the way TMS does.  I do not understand all the science behind it, although Stephanie has explained a lot of it to me.  The one thing I do know is that TMS works.  

            Now, I monitor my mood.  I know when it is time for TMS treatment.  I am confident TMS will help me.  So, I will return each time it is necessary.  Based on my experience, I would recommend TMS to others struggling with depression.  If you haven’t already read Stephanie Debnath’s post on this blog, Renewed and Recharged (TMS),  from October 20, I encourage you to read it.  You can also learn more about how TMS works in my memoir, Traveling the Healing Journey: Finding the Light in Mental Illness. Check out SoCal TMS’s website and social media for more information and to connect with them.  See links below.

            I am not a mental health professional, but I can speak from my own experience.  TMS works for me.  I know it works for others.  I believe in this treatment, and I encourage others to explore it for themselves.

 

Links:

 

Get more information from SoCal TMS:

https://socaltms.com/

 

Learn about TMS in my book:

https://www.barnesandnoble.com/w/traveling-the-healing-journey-gina-capobianco/1142298691?ean=9798218067380

 

https://www.amazon.com/Traveling-Healing-Journey-Finding-Illness/dp/B0BFW7MVG5/ref=sr_1_1?crid=1U96Z0EWXCQ8&keywords=gina+capobianco&qid=1698627517&sprefix=gina+capobia,aps,143&sr=8-1

 

            

                           

"Cancer Hasn’t Won"

           I wasn’t going to post today.  I have had a few really bad days.  I am just not feeling well.  Saturday was probably the worst day I have had in this cancer fight.  I am so grateful to have my Aunt Holly by my side to get me through this.

Saturday night I started to write a poem titled “Why?”.  It turned into a 3-page stream of consciousness about my fears and feelings.  I am not ready to share that yet.  I am not sure when I will be.  I cried as I wrote.  Sometime later that night, I wrote another poem, titled “Cancer Hasn’t Won”.  I actually don’t remember writing it, but it is in my journal and no one else had access to it.  I shared it with my friend, Sharon. When I told her that I didn’t remember writing it, she immediately said that it was the whisper.  She has mentioned the whisper before.  It is the voice telling me to fight.  A few weeks ago, I posted a poem about that whisper, “Whispers Above the Water”.  Sharon encouraged me to post “Cancer Hasn’t Won” today.  So, here it is.  Hopefully, on Thursday I will feel better and can write a longer post.

 

Cancer Hasn’t Won

 

Cancer hasn’t won,

Though I am feeling beaten.

Cancer hasn’t won,

Despite how drained I am.

Cancer hasn’t won,

Even though I feel like quitting.

Cancer hasn’t won,

Despite knocking me on my back.

Cancer hasn’t won.

I haven’t given up the fight.

Cancer hasn’t won.

There is a bit of strength left inside of me.

Cancer hasn’t won,

With my last bit of strength, I rise,

And show cancer it hasn’t won yet.

 

Dancing the Down Days Away

            It has been a rough week for me.  I was grateful to have a guest post earlier this week.  If you missed the post on TMS, “Renewed and Recharged” by Stephanie Debnath, please check it out.  

            Today’s post will be a poem because I am not up to writing a longer post.  The poem was inspired by a conversation with the nurse navigator, C, yesterday at chemo treatment.  She was telling me how down days are okay and are part of the battle with cancer.  I sensed she really understood what I was going through.  They were not just “feel good” words.  She has been in that same chemo chair and understands.  That makes a huge difference. Since the beginning she has been doing little dances to encourage me.  The dances let me know that I can get better and mean so much to me.  So, here is a poem for C.

 

Dancing the Down Days Away

 

Down days are a part of life.

Hope seems bleak.

My mood fades into darkness.

Down days are going to happen.

This is one thing I know.

On these days I must search for the rays of light.

Find the little dance that is inside of me.

I see the dance in others who have known down days.

Their dance brings a smile to my face,

Reminds me not all days are down.

So, I will do my best to dance on the down days,

Even if my rhythm is off and

I don’t hear the music.

My dance becomes one with countless others

Who have known these down days.

Together our steps allow us to see the light.

Dancing on the down days

Asserting hope among the darkness.

Dance, dance

Dance away the down days.