I didn’t know what depression was until I had my first cancer in 1996. Yes, I was a nervous person and yes I’d had the usual ups and downs of life but that aching, illogical, deep seated anxiety and depression that sits somewhere between your heart and your gut like a physical pain – I had never had that. Little did I know that it was lying in wait for me and cancer would deliver me into its arms.
A dire diagnosis of Stage 3C ovarian cancer in 1996 is what caused it – but only indirectly. My boys were still young and over the course of five months, I was told the cancer was widely spread and incurable. I put on the bravest face I could but I was in turmoil. Then, one fateful day when I was balancing precariously on the top of our seesawing trailer, sweeping leaves out, I heard the phone ring in the house. It was an ovarian cancer specialist from Auckland. He had reviewed my pathology and thought chemo might cure me.
He was right but of course it took a couple of years to have the chemo, to recover and for doctors to tell me that my type of ovarian cancer might not come back. Somehow, the emotional rollercoaster of the changing diagnosis and prognosis knocked the stuffing out of me and I ended up so depressed (long story) that I asked my GP to refer me to a psychiatrist. They agreed that I had an “obsessive personality with a depressive affect” and that I’d benefit from a serotonin reuptake inhibitor like Citalopram. After two weeks it worked like a dream. The deep anxiety and intrusive thoughts were almost completely gone and over the next few years when I went back to work I was more confident and more daring. Still a bit obsessive, a bit manic, but those deep dark pangs of anxiety and depression were no more. I developed a great enthusiasm for my job and hobbies.
That was 1999 and I had also been prescribed Zopiclone. I never got off either of those drugs for very long – and I needed both of them when cancer struck again in 2007. That began the recurrent head and neck cancer I’ve been facing on and off since then, albeit with seven good years cancer free from 2014 to 2021. I would get my Zopis down to half a tablet but I can only remember going off them for about a year. GPs would always prescribe Zopis to me because I had so many cancers and kept on surviving – in the scheme of things, Zopis weren’t a huge problem for me and I was careful.
Fast forward to 2021 and another quite big cancer and a two week hospital stay. I was going through hell on earth and I reckoned that if only I could sleep I could get through it. And to be honest, I was up there with Zopis at almost two a night before I entered the hospital. They were very kind and gave me the two, albeit reluctantly, and I slept through every night. That was like a blessing during a difficult time.
But now, another small cancer behind me, I’m struggling big time because of Zopis. If only I had tried harder during times when I was feeling okay! Duh! Earlier this year I was not sleeping well on two Zopis and was adding a ¼ of a pill to my nightly dose. I knew it was a problem and suspected that two was the maximum anyone could take. When I went to my GP he said, yes, two was the maximum and suggested a new antidepressant which when taken at night can help you sleep. Mirtazapine.
This has led to all my chickens coming home to roost. Yes, Mirtazapine has helped me reduce Zopis a little but it’s hopeless for mood enhancement. I’m now experiencing waves of depression and anxiety again. And for no good reason a lot of the time. (I’ve got a big dose of Imposter’s Syndrome too.) When I thought I might have a recurrence a few weeks ago the dread was heavier than it used to be. My joy and enthusiasm for life have been reduced. Enthusiasm has been my hallmark for years!
In my defense, it has taken nearly 30 years for me to reach this point. Some say that most of these drugs don’t work after a certain time period but it’s fair to say that Citalopram and Zopiclone kept the wolf from the door for me through six cancer diagnoses, three huge reconstruction surgeries and the seven year decline and death of my husband to Alzheimers some time ago.
Writing this down, I have come up with a plan. I’ll give Mirtazapine a couple more weeks. I’ll do what Arnold Schwarzenegger says in his documentary, “Don’t sit around asking yourself how you feel; keep busy, be constructive.” I’m going to spring clean my flat in advance, make myself a reading or listening programme and a walking plan and go back to the GP in late July. Scale down the Zopis. Write a gratitude journal. Use that free Balance app. Detox!
One of the most joyous days in my life so far was in that Rotorua backyard, climbing up on the trailer to sweep the leaves out, hearing the phone call, knowing it would be the specialist and then getting some of the best news I’d ever had. A reprieve. We love life when we are not depressed. We want to find out what happens next and I owe my existence to three or four expert surgeons including Seona Stubbs of Rotorua Hospital who removed my ovarian cancer so cleanly that chemo could stop it coming back.
I can do this. I’ll be back soon, all guns blazing …