STUDY Results: Depression increases cancer patients' risk of dying

dianetavegia
dianetavegia Member Posts: 1,942 Member
edited March 2014 in Colorectal Cancer #1
Article: Depression increases cancer patients' risk of dying


Depression increases cancer patients' risk of dying Click to read more

Depression can affect a cancer patient’s likelihood of survival. That is the finding of an analysis published in the November 15 issue of Cancer. The results highlight the need for systematic screening of psychological distress and subsequent treatments.

A number of studies have shown that individuals’ mental attitudes can impact their physical health. To determine the effects of depression on cancer patients’ disease progression and survival, graduate student Jillian Satin, MA, of the University of British Columbia in Vancouver, Canada, and her colleagues analysed all of the studies to date they could identify related to the topic.

The researchers found 26 studies with a total of 9417 patients that examined the effects of depression on patients’ cancer progression and survival.

“We found an increased risk of death in patients who report more depressive symptoms than others and also in patients who have been diagnosed with a depressive disorder compared to patients who have not,” said Satin. In the combined studies, the death rates were up to 25 percent higher in patients experiencing depressive symptoms and 39 percent higher in patients diagnosed with major or minor depression.

The increased risks remained even after considering patients’ other clinical characteristics that might affect survival, indicating that depression may actually play a part in shortening survival. However, the authors say additional research must be conducted before any conclusions can be reached. The authors add that their analysis combined results across different tumour types, so future studies should look at the effects of depression on different kinds of cancer.

The investigators note that the actual risk of death associated with depression in cancer patients is still small, so patients should not feel that they must maintain a positive attitude to beat their disease. Nevertheless, the study indicates that it is important for physicians to regularly screen cancer patients for depression and to provide appropriate treatments.

The researchers did not find a clear association between depression and cancer progression, although only three studies were available for analysis.

Original Study
Depression as a predictor of disease progression and mortality in cancer patients

A Meta-Analysis
Jillian R. Satin, MA *, Wolfgang Linden, PhD, Melanie J. Phillips, BSc
Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada

Abstract

BACKGROUND:
Cancer patients and oncologists believe that psychological variables influence the course of cancer, but the evidence remains inconclusive. This meta-analysis assessed the extent to which depressive symptoms and major depressive disorder predict disease progression and mortality in cancer patients.

METHODS:
Using the MEDLINE, PsycINFO, CINAHL, and EMBASE online databases, the authors identified prospective studies that examined the association between depressive symptoms or major/minor depression and risk of disease progression or mortality in cancer patients. Two raters independently extracted effect sizes using a random effects model.

RESULTS:
Based on 3 available studies, depressive symptoms were not shown to significantly predict cancer progression (risk ratio [RR] unadjusted = 1.23; 95% confidence interval [CI], 0.85-1.77; P = .28). Based on data from 25 independent studies, mortality rates were up to 25% higher in patients experiencing depressive symptoms (RR unadjusted = 1.25; 95% CI, 1.12-1.40; P < .001), and up to 39% higher in patients diagnosed with major or minor depression (RR unadjusted = 1.39; 95% CI, 1.10-1.89; P = .03). In support of a causal interpretation of results, there was no evidence that adjusting for known clinical prognostic factors diminished the effect of depression on mortality in cancer patients.

CONCLUSIONS:
This meta-analysis presented reasonable evidence that depression predicts mortality, but not progression, in cancer patients. The associated risk was statistically significant but relatively small. The effect of depression remains after adjustment for clinical prognosticators, suggesting that depression may play a causal role. Recommendations were made for future research to more clearly examine the effect of depression on cancer outcomes. Cancer 2009. © 2009 American Cancer Society.

Comments

  • John23
    John23 Member Posts: 2,122 Member
    Views
    The line that got me laughing, was here:

    "the study indicates that it is important for physicians to regularly screen
    cancer patients for depression and to provide appropriate treatments"


    Oh boy, more reason to prescribe more drugs!

    When we're depressed, we don't eat well, and our digestive system
    doesn't work as it should.... in fact when they sense danger, all
    animals stop eating as much, and their defecation rate changes
    as their digestive systems slow down.

    If we stay in that state of high anxiety too long, our health will suffer
    due to our digestion problems.

    Taking antidepressants actually results in more problems, since
    they are toxic to our liver and kidneys; the organs that are responsible
    for helping every other organ do their job properly. Your brain still
    knows the danger, but it fails to provide the symptoms that are
    easily recognizable, while more serious problems manifest themselves.

    I doubt there's a cancer victim anywhere, that doesn't worry and
    become depressed; it's difficult to avoid.

    I try my best to remain aware that my cancer is ticking away,
    like a silent bomb. I try to remain aware that I am here only
    for a short while; that no-one lives forever, and I should accept
    leaving this earth, just as I had accepted being here in the first place.

    I try to look at death as an ending to my "book"; the finale'.

    I try to change my ways, and provide some insight to those
    around me, instead of the idle generic pseudo-comforting banter
    that becomes so patronizing to one that is suffering.

    I don't want someone to tell me how good I look, when they
    never said that when I didn't have cancer.

    I don't want to hear words from others, that tell me that I should
    be optimistic, and not talk about "not being around". It is so
    unfortunate, that they do not realize that it is important to me,
    that I face and adjust to the inevitable, just as they will have to
    eventually; just as every living thing must, eventually.

    For me, facing reality forces me to adjust to my situation. It helps
    me find comfort, that I am making plans; using my time to make
    my final steps easier for those around me.

    It is so sad, when I see other families and friends of a cancer victim
    attempt to hide from the facts. They seem so upset, as if they didn't
    know it was going to happen; that death was around the corner for
    their friend or loved one.

    They didn't take the time to adjust, and understand that any life that
    begins also ends, eventually. They were not prepared to accept it.

    Inward peace and comfort is required. You can't get that by
    taking anti-depressants or by drinking your final days away.

    You find it by doing your best to accept was is likely to come
    sooner than later. You hope it's later, just as a 99 year-old hopes
    to see another morning sunrise, but you also accept the fact that
    you likely won't.

    I'm happy to see the sun in the morning, and I hate to see the day end.

    But when it does, I hope I have prepared myself and others close
    to me well enough for that time; It only comes once, like birth.

    There is a calming effect to accepting what you can't change,
    that no "anti-depressant" could ever provide.



    Good health and an unexpected long life for all !
  • PGLGreg
    PGLGreg Member Posts: 731
    Treating depression.
    I am also skeptical about the conclusion that depression should be treated, for the more mundane reason that it doesn't really seem to follow from what the report found:

    the death rates were up to ... 39 percent higher in patients diagnosed with major or minor depression.

    This says nothing about these patients being untreated for depression. In fact, we might expect that since they were diagnosed with depression, they were being treated for it. Then, if the death rate was higher for patients being treated for depression than it was for patients merely exhibiting symptoms of depression (25%), that tells us, uh, ...
  • dianetavegia
    dianetavegia Member Posts: 1,942 Member
    PGLGreg said:

    Treating depression.
    I am also skeptical about the conclusion that depression should be treated, for the more mundane reason that it doesn't really seem to follow from what the report found:

    the death rates were up to ... 39 percent higher in patients diagnosed with major or minor depression.

    This says nothing about these patients being untreated for depression. In fact, we might expect that since they were diagnosed with depression, they were being treated for it. Then, if the death rate was higher for patients being treated for depression than it was for patients merely exhibiting symptoms of depression (25%), that tells us, uh, ...

    I'm not one to use meds....
    but did find this study interesting. I believe, and I'm going to get a lot of angry remarks about this most probably, that we should do our best to CHOOSE to be happy. I'm not talking about clinical depression caused by chemical imbalances, but depression caused by circumstances alone. I do not believe we should use meds to treat 'depression' caused by such things as dealing with cirucmstances. The circumstances will still be there when the meds end; i.e., a divorce or job loss.

    I choose to be happy.
  • johnsfo
    johnsfo Member Posts: 47
    John23 said:

    Views
    The line that got me laughing, was here:

    "the study indicates that it is important for physicians to regularly screen
    cancer patients for depression and to provide appropriate treatments"


    Oh boy, more reason to prescribe more drugs!

    When we're depressed, we don't eat well, and our digestive system
    doesn't work as it should.... in fact when they sense danger, all
    animals stop eating as much, and their defecation rate changes
    as their digestive systems slow down.

    If we stay in that state of high anxiety too long, our health will suffer
    due to our digestion problems.

    Taking antidepressants actually results in more problems, since
    they are toxic to our liver and kidneys; the organs that are responsible
    for helping every other organ do their job properly. Your brain still
    knows the danger, but it fails to provide the symptoms that are
    easily recognizable, while more serious problems manifest themselves.

    I doubt there's a cancer victim anywhere, that doesn't worry and
    become depressed; it's difficult to avoid.

    I try my best to remain aware that my cancer is ticking away,
    like a silent bomb. I try to remain aware that I am here only
    for a short while; that no-one lives forever, and I should accept
    leaving this earth, just as I had accepted being here in the first place.

    I try to look at death as an ending to my "book"; the finale'.

    I try to change my ways, and provide some insight to those
    around me, instead of the idle generic pseudo-comforting banter
    that becomes so patronizing to one that is suffering.

    I don't want someone to tell me how good I look, when they
    never said that when I didn't have cancer.

    I don't want to hear words from others, that tell me that I should
    be optimistic, and not talk about "not being around". It is so
    unfortunate, that they do not realize that it is important to me,
    that I face and adjust to the inevitable, just as they will have to
    eventually; just as every living thing must, eventually.

    For me, facing reality forces me to adjust to my situation. It helps
    me find comfort, that I am making plans; using my time to make
    my final steps easier for those around me.

    It is so sad, when I see other families and friends of a cancer victim
    attempt to hide from the facts. They seem so upset, as if they didn't
    know it was going to happen; that death was around the corner for
    their friend or loved one.

    They didn't take the time to adjust, and understand that any life that
    begins also ends, eventually. They were not prepared to accept it.

    Inward peace and comfort is required. You can't get that by
    taking anti-depressants or by drinking your final days away.

    You find it by doing your best to accept was is likely to come
    sooner than later. You hope it's later, just as a 99 year-old hopes
    to see another morning sunrise, but you also accept the fact that
    you likely won't.

    I'm happy to see the sun in the morning, and I hate to see the day end.

    But when it does, I hope I have prepared myself and others close
    to me well enough for that time; It only comes once, like birth.

    There is a calming effect to accepting what you can't change,
    that no "anti-depressant" could ever provide.



    Good health and an unexpected long life for all !

    living well
    Beautifully expressed, John. Thanks for posting this message. So much of your message resonates with my own experiences. I too find that accepting what I can't change (the ultimate course of the disease) helps me live my life well now -- and that's what I focus my attention on: living well.

    It is indeed hard to at once acknowledge that I am likely to die from the disease and to continue living each day with vitality and purposeful intention. That struggle is worth every bit of the difficulty, though. It helps me to live joyfully and creatively with the people and activities that are most important to me. How difficult it is to write and talk about death sometimes, almost as if it were taboo, and yet it is just what it is -- an integral part of living -- for everyone, but people with cancer have reason to be more accutely aware of it. Your post helps.

    Depression sometimes seems like a similarly difficult topic among the community of people who are affected by cancer. It isn't surprising that serious, clinical depression might lead to a higher mortality rate among cancer patients (meaning that cancer patients who live with unrelieved severe depression may die sooner than those who do not, I think), and yes, doctors need to be aware of it. But it does surprise me when cancer patients and those who live intimately with them seem to believe that acknowleding the possibility of death and the feelings of sadness that accompany that need to be avoided or remain unexpressed. I find that moments of extreme sadness, even an occasional dip into despondency, are an understandable and rational and emotionally healthy response. To me, such feelings seem like part of the "wholeness" of the experience, oddly enough, part of living well.

    John
  • coloCan
    coloCan Member Posts: 1,944 Member

    I'm not one to use meds....
    but did find this study interesting. I believe, and I'm going to get a lot of angry remarks about this most probably, that we should do our best to CHOOSE to be happy. I'm not talking about clinical depression caused by chemical imbalances, but depression caused by circumstances alone. I do not believe we should use meds to treat 'depression' caused by such things as dealing with cirucmstances. The circumstances will still be there when the meds end; i.e., a divorce or job loss.

    I choose to be happy.

    Meds can be a help....
    if you've ever been with someone who had been mentally and physically abused as a child and then from age 15 to 33 by a husband twice plus her age who was a monster-a master abuser who got away with it thru his military position when police,etc would show up (spousal abuse then was not dealt with as now). While my friend's liver is always tested as well as her blood,etc, she could not live without her meds....Others, like some of us cancer people might need psych meds for a while too.Just as everyone reacts to chemo differently, so do we react to life differently.Not suggesting use of antidepressants as a way of life but they can and do help people.....Steve
  • Shayenne
    Shayenne Member Posts: 2,342
    coloCan said:

    Meds can be a help....
    if you've ever been with someone who had been mentally and physically abused as a child and then from age 15 to 33 by a husband twice plus her age who was a monster-a master abuser who got away with it thru his military position when police,etc would show up (spousal abuse then was not dealt with as now). While my friend's liver is always tested as well as her blood,etc, she could not live without her meds....Others, like some of us cancer people might need psych meds for a while too.Just as everyone reacts to chemo differently, so do we react to life differently.Not suggesting use of antidepressants as a way of life but they can and do help people.....Steve

    I Also
    Agree with you all to choose to live happy, I do take Zoloft, which does take the edge off, and agree with Steve, some people do need these drugs to help. I probably don't need the Zoloft, only because it doesn't seem to change me or how I feel, it just takes an edge, or dark thoughts away, but I have learned to accept my disease, and go with the flow.

    I had my first play rehearsal today and had a blast seeing my theater family again, they couldn't get over how good I looked after all those operations I have had, and been in and out of the hospital, like I told them, "Life goes on, you just keep going" and I don't even think about cancer all the time now.

    I hardly talk about it to anyone really, I don't like to be down, because then I know I'm bringing other people down with me, and I don't want to do that, I don't want them being sad over me, I am happier now then I was months ago, and feel like I'm getting better everyday, stronger everyday, the more accepting I am of it. I feel really good, and hope everyone can get to this place that I am at. :)

    Hugsss!
    ~Donna
  • KATE58
    KATE58 Member Posts: 299
    Shayenne said:

    I Also
    Agree with you all to choose to live happy, I do take Zoloft, which does take the edge off, and agree with Steve, some people do need these drugs to help. I probably don't need the Zoloft, only because it doesn't seem to change me or how I feel, it just takes an edge, or dark thoughts away, but I have learned to accept my disease, and go with the flow.

    I had my first play rehearsal today and had a blast seeing my theater family again, they couldn't get over how good I looked after all those operations I have had, and been in and out of the hospital, like I told them, "Life goes on, you just keep going" and I don't even think about cancer all the time now.

    I hardly talk about it to anyone really, I don't like to be down, because then I know I'm bringing other people down with me, and I don't want to do that, I don't want them being sad over me, I am happier now then I was months ago, and feel like I'm getting better everyday, stronger everyday, the more accepting I am of it. I feel really good, and hope everyone can get to this place that I am at. :)

    Hugsss!
    ~Donna

    I have always believed there
    I have always believed there is no point in getting upset about that which you have no control.I am usually in a good mood,altho I do have an occasionl,'pity party'day I really believe a good attitude helps you live longer.
    I actually have days when cancer never crosses my mind.

    Also, I do not fear death,I fear nausea and intense pain,and not being able to do for myself,but I do not fear death.My faith is strong and when I finally go 'home' I'll be with GOD..untill then I will trust in him and his plan for me.

    And as Donna says,I never talk about my cancer outside of a small circle of friends,
    (Phil Ochs?)and rarely then.A lot of people do not even know I am sick.I feel like if I talk about it, it will bum everyone out.So,I am thankful for 'that small circle of friends' and for this forum where I can vent.In the words of Tiny Tim ; GOD BLESS US EVERYONE!1
  • KATE58
    KATE58 Member Posts: 299
    Shayenne said:

    I Also
    Agree with you all to choose to live happy, I do take Zoloft, which does take the edge off, and agree with Steve, some people do need these drugs to help. I probably don't need the Zoloft, only because it doesn't seem to change me or how I feel, it just takes an edge, or dark thoughts away, but I have learned to accept my disease, and go with the flow.

    I had my first play rehearsal today and had a blast seeing my theater family again, they couldn't get over how good I looked after all those operations I have had, and been in and out of the hospital, like I told them, "Life goes on, you just keep going" and I don't even think about cancer all the time now.

    I hardly talk about it to anyone really, I don't like to be down, because then I know I'm bringing other people down with me, and I don't want to do that, I don't want them being sad over me, I am happier now then I was months ago, and feel like I'm getting better everyday, stronger everyday, the more accepting I am of it. I feel really good, and hope everyone can get to this place that I am at. :)

    Hugsss!
    ~Donna

    I have always believed there
    I have always believed there is no point in getting upset about that which you have no control.I am usually in a good mood,altho I do have an occasionl,'pity party'day I really believe a good attitude helps you live longer.
    I actually have days when cancer never crosses my mind.

    Also, I do not fear death,I fear nausea and intense pain,and not being able to do for myself,but I do not fear death.My faith is strong and when I finally go 'home' I'll be with GOD..untill then I will trust in him and his plan for me.

    And as Donna says,I never talk about my cancer outside of a small circle of friends,
    (Phil Ochs?)and rarely then.A lot of people do not even know I am sick.I feel like if I talk about it, it will bum everyone out.So,I am thankful for 'that small circle of friends' and for this forum where I can vent.In the words of Tiny Tim ; GOD BLESS US EVERYONE!1
  • tootsie1
    tootsie1 Member Posts: 5,044 Member
    Thanks
    That was interesting reading. Thanks for sharing!

    I've been meaning to tell you that I LOVE your new picture. You look so pretty!

    *hugs*
    Gail
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    All this talk about depression...
    is depressing!
    Wow, where to start, what to say? I think the best way for me to put into words my thoughts on this is to compare it to a woman giving birth. There is no way that I can understand fully what a woman experiences during childbirth. Likewise, there is no way a person who is suffering from depression due to a cancer diagnosis can fully be understood unless you ARE that person. I think it's an interesting article Diane and it's obvious that it's better to choose to be happy but there are times that it's not as easy as "putting on a happy face" or making a choice. I'm not deciding between chocolate or vanilla ice cream (chocolate, hands down, no contest). I certainly do not believe that I chose to get depressed over a Stage IV CC Dx. I went 6-9 months w/o any meds at all and the stress of the heavy chemo, having to work, having young kids and wife, and the possible prognosis wasn't exactly the happiest time of my life. The longevity of my "journey" hasn't exactly helped matters either. THANKFULLY I hooked up with a great therapist and along with some medication I function fine (for me).

    We are all not in the same place in our cancer journey so this is like comparing apples with oranges. Someone who went through surgery, chemo, done with treatment may have a different outlook than someone who's had chemo, surgery, chemo, surgery, chemo, surgery (on and on...get it?) Or someone who has had their life change with an ostomy. Not to knock anyone but I don't see too many of the long haul people here talking about how they did not get some depression from this, it seems to be more of the people who had it, now it's gone. This doesn't make anyone any better than anyone else, it just is an example of the different circumstances we all face and how we choose to deal with them. And I'm sure the ones who have been in here for the long haul with no meds and think depression is bunk will chime in in due time.

    John, you brought up how the meds can be toxic to our livers and other organs. I won't dispute that. Living on Earth is toxic too. Can't really dispute that either. Living in a state of depression that I would not have been in if it were not for stage IV cancer is the hand I've been dealt, this is how I'm dealing with it. Greg, we've been down this road before. I know you don't think much of depression, I'm glad you don't suffer from it. Maybe it's a cultural thing? Diane, I know you have a little faith (HA) I mean a very strong faith, God Bless You, it works for you and I'm glad. There is a saying that goes something like "don't judge unless you walk in someone else's shoes". While we all may be on similar journeys, we are all on different types of boats and have different storms in our waters.

    I certainly don't feel like anyone is condemning anyone else for choosing to take antidepressants to help them get through this part of their lives, I know you're all smarter than that. But I'm not going to tell a woman how she should approach childbirth or that I really know what it's like to give birth. I don't, it's an area that I may think I know a lot about but I didn't experience it and that is what I am trying to convey here. That unless you are in my shoes, or many of the other who take meds but may be cautious to comment on it, I don't think you don't really get it.

    Now I'm going to have come chocolate ice cream even though it's 8:20 am and it's BAD for me!
    Because I choose to.
    phil
    :-)

    Overall an interesting article Diane. It's always better to choose to be happy and do good when we can.
    (nice new avatar too)
  • Shayenne
    Shayenne Member Posts: 2,342
    PhillieG said:

    All this talk about depression...
    is depressing!
    Wow, where to start, what to say? I think the best way for me to put into words my thoughts on this is to compare it to a woman giving birth. There is no way that I can understand fully what a woman experiences during childbirth. Likewise, there is no way a person who is suffering from depression due to a cancer diagnosis can fully be understood unless you ARE that person. I think it's an interesting article Diane and it's obvious that it's better to choose to be happy but there are times that it's not as easy as "putting on a happy face" or making a choice. I'm not deciding between chocolate or vanilla ice cream (chocolate, hands down, no contest). I certainly do not believe that I chose to get depressed over a Stage IV CC Dx. I went 6-9 months w/o any meds at all and the stress of the heavy chemo, having to work, having young kids and wife, and the possible prognosis wasn't exactly the happiest time of my life. The longevity of my "journey" hasn't exactly helped matters either. THANKFULLY I hooked up with a great therapist and along with some medication I function fine (for me).

    We are all not in the same place in our cancer journey so this is like comparing apples with oranges. Someone who went through surgery, chemo, done with treatment may have a different outlook than someone who's had chemo, surgery, chemo, surgery, chemo, surgery (on and on...get it?) Or someone who has had their life change with an ostomy. Not to knock anyone but I don't see too many of the long haul people here talking about how they did not get some depression from this, it seems to be more of the people who had it, now it's gone. This doesn't make anyone any better than anyone else, it just is an example of the different circumstances we all face and how we choose to deal with them. And I'm sure the ones who have been in here for the long haul with no meds and think depression is bunk will chime in in due time.

    John, you brought up how the meds can be toxic to our livers and other organs. I won't dispute that. Living on Earth is toxic too. Can't really dispute that either. Living in a state of depression that I would not have been in if it were not for stage IV cancer is the hand I've been dealt, this is how I'm dealing with it. Greg, we've been down this road before. I know you don't think much of depression, I'm glad you don't suffer from it. Maybe it's a cultural thing? Diane, I know you have a little faith (HA) I mean a very strong faith, God Bless You, it works for you and I'm glad. There is a saying that goes something like "don't judge unless you walk in someone else's shoes". While we all may be on similar journeys, we are all on different types of boats and have different storms in our waters.

    I certainly don't feel like anyone is condemning anyone else for choosing to take antidepressants to help them get through this part of their lives, I know you're all smarter than that. But I'm not going to tell a woman how she should approach childbirth or that I really know what it's like to give birth. I don't, it's an area that I may think I know a lot about but I didn't experience it and that is what I am trying to convey here. That unless you are in my shoes, or many of the other who take meds but may be cautious to comment on it, I don't think you don't really get it.

    Now I'm going to have come chocolate ice cream even though it's 8:20 am and it's BAD for me!
    Because I choose to.
    phil
    :-)

    Overall an interesting article Diane. It's always better to choose to be happy and do good when we can.
    (nice new avatar too)

    Yep....
    You said it better then I ever could Phil :)


    Hugsss!
    ~Donna
  • Aud
    Aud Member Posts: 479 Member
    Shayenne said:

    I Also
    Agree with you all to choose to live happy, I do take Zoloft, which does take the edge off, and agree with Steve, some people do need these drugs to help. I probably don't need the Zoloft, only because it doesn't seem to change me or how I feel, it just takes an edge, or dark thoughts away, but I have learned to accept my disease, and go with the flow.

    I had my first play rehearsal today and had a blast seeing my theater family again, they couldn't get over how good I looked after all those operations I have had, and been in and out of the hospital, like I told them, "Life goes on, you just keep going" and I don't even think about cancer all the time now.

    I hardly talk about it to anyone really, I don't like to be down, because then I know I'm bringing other people down with me, and I don't want to do that, I don't want them being sad over me, I am happier now then I was months ago, and feel like I'm getting better everyday, stronger everyday, the more accepting I am of it. I feel really good, and hope everyone can get to this place that I am at. :)

    Hugsss!
    ~Donna

    Glad to see you're back in
    Glad to see you're back in theater, Donna. I checked out the theater online from an earlier post of yours.
    sounds like a lot of fun.
    Audrey
  • KATE58
    KATE58 Member Posts: 299
    Shayenne said:

    Yep....
    You said it better then I ever could Phil :)


    Hugsss!
    ~Donna

    AMEN,PHIL!
    AMEN,PHIL!


    GOD BLESS,
    KATE
  • John23
    John23 Member Posts: 2,122 Member
    PhillieG said:

    All this talk about depression...
    is depressing!
    Wow, where to start, what to say? I think the best way for me to put into words my thoughts on this is to compare it to a woman giving birth. There is no way that I can understand fully what a woman experiences during childbirth. Likewise, there is no way a person who is suffering from depression due to a cancer diagnosis can fully be understood unless you ARE that person. I think it's an interesting article Diane and it's obvious that it's better to choose to be happy but there are times that it's not as easy as "putting on a happy face" or making a choice. I'm not deciding between chocolate or vanilla ice cream (chocolate, hands down, no contest). I certainly do not believe that I chose to get depressed over a Stage IV CC Dx. I went 6-9 months w/o any meds at all and the stress of the heavy chemo, having to work, having young kids and wife, and the possible prognosis wasn't exactly the happiest time of my life. The longevity of my "journey" hasn't exactly helped matters either. THANKFULLY I hooked up with a great therapist and along with some medication I function fine (for me).

    We are all not in the same place in our cancer journey so this is like comparing apples with oranges. Someone who went through surgery, chemo, done with treatment may have a different outlook than someone who's had chemo, surgery, chemo, surgery, chemo, surgery (on and on...get it?) Or someone who has had their life change with an ostomy. Not to knock anyone but I don't see too many of the long haul people here talking about how they did not get some depression from this, it seems to be more of the people who had it, now it's gone. This doesn't make anyone any better than anyone else, it just is an example of the different circumstances we all face and how we choose to deal with them. And I'm sure the ones who have been in here for the long haul with no meds and think depression is bunk will chime in in due time.

    John, you brought up how the meds can be toxic to our livers and other organs. I won't dispute that. Living on Earth is toxic too. Can't really dispute that either. Living in a state of depression that I would not have been in if it were not for stage IV cancer is the hand I've been dealt, this is how I'm dealing with it. Greg, we've been down this road before. I know you don't think much of depression, I'm glad you don't suffer from it. Maybe it's a cultural thing? Diane, I know you have a little faith (HA) I mean a very strong faith, God Bless You, it works for you and I'm glad. There is a saying that goes something like "don't judge unless you walk in someone else's shoes". While we all may be on similar journeys, we are all on different types of boats and have different storms in our waters.

    I certainly don't feel like anyone is condemning anyone else for choosing to take antidepressants to help them get through this part of their lives, I know you're all smarter than that. But I'm not going to tell a woman how she should approach childbirth or that I really know what it's like to give birth. I don't, it's an area that I may think I know a lot about but I didn't experience it and that is what I am trying to convey here. That unless you are in my shoes, or many of the other who take meds but may be cautious to comment on it, I don't think you don't really get it.

    Now I'm going to have come chocolate ice cream even though it's 8:20 am and it's BAD for me!
    Because I choose to.
    phil
    :-)

    Overall an interesting article Diane. It's always better to choose to be happy and do good when we can.
    (nice new avatar too)

    Depression
    Phil -

    Please allow me to clarify something....

    In Traditional Chinese Medicine (and in China), there is absolutely
    no stigma attached to depression, anxiety, or any other symptom
    that western medicine classifies as "mental illness".

    And rightfully so, since what is called a "chemical imbalance in the brain"
    by western medicine, is actually a chemical imbalance of the body.

    The stigma of being "defective" mentally, or "mentally unstable", or
    having "mental health problems", is not even closely considered in TCM.

    The chemical imbalance is due to a deficiency of the Liver and/or
    Kidneys; they are not producing the chemicals that the system requires.

    Western medicine agrees that the "imbalance" of chemicals that
    that causes anxiety, anger, mood swings, depression, etc., are those
    that the liver produces.

    Oddly, all the anti-depressants carry a warning that they should not
    be used by anyone with a liver (or kidney) condition. Close monitoring
    is usually necessary with those drugs. The fact for that warning, is
    that those medications weigh heavily on the liver and kidneys.

    The resolve by TCM isn't by administering medications to compensate
    for the lack of, or overproduction of, chemicals needed for the brain
    to operate as it should. Instead acupuncture and/or herbal treatments
    to get the organs to produce the chemicals needed, are applied.

    To get to the point of my reply...

    I am -not- denouncing the use of anti-depressants, or those that
    feel the need for them. But an awareness should be had, that the
    medications will cause problems that will require more medications,
    and more of the same medication.

    (And yes, I have first-hand experience - all bad - with anti-depressants).

    It's terrible that so many people that are taking anti-depressants feel
    the need to defend their use of them (I did, my wife did). And it's
    solely due to the stigma attached to having uncontrollable mood problems.

    There should be no stigma attached, and absolutely no need to defend
    one's use of those medications. It's not "mental illness", it's a biological
    problem for which there is a remedy.

    Being depressed due to the effects of chemotherapy, the chemicals
    that are damaging the liver functions, and the radiation that can change
    our chemistry, is also an issue. But that too, is not truly resolved by
    taking more medications that will further the load on the liver.

    But... As far as being depressed by the real thought of dying? That is
    what it is all about... There is no way to solve that situation other than
    to accept that possibility fully, or take medications.

    Dying is difficult for anyone to comprehend; we all feel we will live forever
    regardless of claiming that we know we won't. We say the words, but we
    somehow manage to feel otherwise. We buy things and order items
    that we will enjoy for years to come, even though the odds are great
    that we might be gone before the warrantee runs out. Odd, isn't it?

    When we truly accept the inevitable; when we fully comprehend that
    death is just another part of having lived, we find ourselves moving
    along through life more smoothly.

    Regardless of anyone's prognosis, no doctor is a prophet; no doctor
    can see into the future and know for sure that the cancer will result
    in early demise. Likewise, no doctor can tell that you will not die
    sooner than later.

    Any assumption that one of us has a more advanced cancer than
    another, is moot, at best, as is the thought that we are not at the
    "same place". We may like to think that we are not in the same place,
    or catagory; that our cancer condition is worse (or better) than another's,
    but that simply isn't true with cancer. Every one of us that has been
    diagnosed as having cancer, will worry about it incessantly,
    stage one, or four.

    When we accept the odds; when we accept our dying as a fact,
    we can plan for it; it will not be a surprise. We will instead find
    ourselves happier and more at peace with each day that we
    are alive.

    Each day will be looked at as a gift; a new beginning, instead of
    another day closer to the end.

    Each day becomes a happy event, instead of a continuance of
    a depressed state of worry. You don't worry about what you
    know is going to happen, you plan for it; around it.

    Understand: It's not an acceptance of our untimely demise,
    it is merely the real acceptance that no-one lives forever;
    that everyone dies, and that we too, will also die.

    You would be amazed at how much more at ease, and how much
    less you would feel depressed about an inevitable situation, when
    you face it head-on, and accept it as inevitable; eventually inevitable.

    Again, it isn't "giving up", it's planning around it.


    In the meantime, have a great day!

    Seriously... We came here, and we're going to leave here.
    It's hard to accept, but it's 100% better when we do.


    Good health, and the very best of years and years ahead!
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    John23 said:

    Depression
    Phil -

    Please allow me to clarify something....

    In Traditional Chinese Medicine (and in China), there is absolutely
    no stigma attached to depression, anxiety, or any other symptom
    that western medicine classifies as "mental illness".

    And rightfully so, since what is called a "chemical imbalance in the brain"
    by western medicine, is actually a chemical imbalance of the body.

    The stigma of being "defective" mentally, or "mentally unstable", or
    having "mental health problems", is not even closely considered in TCM.

    The chemical imbalance is due to a deficiency of the Liver and/or
    Kidneys; they are not producing the chemicals that the system requires.

    Western medicine agrees that the "imbalance" of chemicals that
    that causes anxiety, anger, mood swings, depression, etc., are those
    that the liver produces.

    Oddly, all the anti-depressants carry a warning that they should not
    be used by anyone with a liver (or kidney) condition. Close monitoring
    is usually necessary with those drugs. The fact for that warning, is
    that those medications weigh heavily on the liver and kidneys.

    The resolve by TCM isn't by administering medications to compensate
    for the lack of, or overproduction of, chemicals needed for the brain
    to operate as it should. Instead acupuncture and/or herbal treatments
    to get the organs to produce the chemicals needed, are applied.

    To get to the point of my reply...

    I am -not- denouncing the use of anti-depressants, or those that
    feel the need for them. But an awareness should be had, that the
    medications will cause problems that will require more medications,
    and more of the same medication.

    (And yes, I have first-hand experience - all bad - with anti-depressants).

    It's terrible that so many people that are taking anti-depressants feel
    the need to defend their use of them (I did, my wife did). And it's
    solely due to the stigma attached to having uncontrollable mood problems.

    There should be no stigma attached, and absolutely no need to defend
    one's use of those medications. It's not "mental illness", it's a biological
    problem for which there is a remedy.

    Being depressed due to the effects of chemotherapy, the chemicals
    that are damaging the liver functions, and the radiation that can change
    our chemistry, is also an issue. But that too, is not truly resolved by
    taking more medications that will further the load on the liver.

    But... As far as being depressed by the real thought of dying? That is
    what it is all about... There is no way to solve that situation other than
    to accept that possibility fully, or take medications.

    Dying is difficult for anyone to comprehend; we all feel we will live forever
    regardless of claiming that we know we won't. We say the words, but we
    somehow manage to feel otherwise. We buy things and order items
    that we will enjoy for years to come, even though the odds are great
    that we might be gone before the warrantee runs out. Odd, isn't it?

    When we truly accept the inevitable; when we fully comprehend that
    death is just another part of having lived, we find ourselves moving
    along through life more smoothly.

    Regardless of anyone's prognosis, no doctor is a prophet; no doctor
    can see into the future and know for sure that the cancer will result
    in early demise. Likewise, no doctor can tell that you will not die
    sooner than later.

    Any assumption that one of us has a more advanced cancer than
    another, is moot, at best, as is the thought that we are not at the
    "same place". We may like to think that we are not in the same place,
    or catagory; that our cancer condition is worse (or better) than another's,
    but that simply isn't true with cancer. Every one of us that has been
    diagnosed as having cancer, will worry about it incessantly,
    stage one, or four.

    When we accept the odds; when we accept our dying as a fact,
    we can plan for it; it will not be a surprise. We will instead find
    ourselves happier and more at peace with each day that we
    are alive.

    Each day will be looked at as a gift; a new beginning, instead of
    another day closer to the end.

    Each day becomes a happy event, instead of a continuance of
    a depressed state of worry. You don't worry about what you
    know is going to happen, you plan for it; around it.

    Understand: It's not an acceptance of our untimely demise,
    it is merely the real acceptance that no-one lives forever;
    that everyone dies, and that we too, will also die.

    You would be amazed at how much more at ease, and how much
    less you would feel depressed about an inevitable situation, when
    you face it head-on, and accept it as inevitable; eventually inevitable.

    Again, it isn't "giving up", it's planning around it.


    In the meantime, have a great day!

    Seriously... We came here, and we're going to leave here.
    It's hard to accept, but it's 100% better when we do.


    Good health, and the very best of years and years ahead!

    TCB with TCM
    Hi John, I think there is an awful lot to be learned and gained from TCM. They've had an incredible understanding of the human body for centuries and also seem to treat the ailment, not the symptoms as WM (Western Medicine) all too often does. I happen to like their use of herbal remedies for controlling nausea (wink). There is also no doubt that often the "cure" in WM is always followed by 3 pages of fine print disclaimers warning against possible side effects that often sound worse than the "illness" they are prescribed for. John Lennon had a very good quote where he said "The basic thing nobody asks is why do people take drugs of any sort? Why do we have these accessories to normal living to live? I mean, is there something wrong with society that's making us so pressurized, that we cannot live without guarding ourselves against it?" Food for thought.

    But, one can explain all the chemical and biological reasons of what makes a person be alive and makes the tick, yet it doesn't (and can't) truly convey what it is like for each of us to be alive. That is unique to everyone. So I come back to my original point of my reply which is that we all have our own experiences with cancer and we react differently and deal with them as best we know how.

    Are there possibly better ways to handle the depression that I used to have before meds, probably there is. I did not feel that I have the luxury of time to investigate all of them. I went for the quick fix. My bad? I have not had any bad experiences with the medications, only good ones. I am in the position of being the breadwinner along with the insurance carrier blah, blah, blah so I could not take time off to explore alternative methods.

    I have to chuckle at the title of the study:
    "Article: Depression increases cancer patients' risk of dying"
    It could have also read:
    "Article: Cancer increases patient's risk of depression"

    I can't help but think:
    "Study finds that people who hit their thumb with a hammer yell OUCH!!!"
    No _ _ _ _?

    I do disagree with your statement below:
    "Any assumption that one of us has a more advanced cancer than
    another, is moot, at best, as is the thought that we are not at the
    "same place". We may like to think that we are not in the same place,
    or category; that our cancer condition is worse (or better) than another's,
    but that simply isn't true with cancer. Every one of us that has been
    diagnosed as having cancer, will worry about it incessantly,
    stage one, or four."

    If I had be dx with Stage I CC and did treatment with or without an operation and it was all over and done with I would have a different outlook on things and do not believe that I would be using medication. To me, it's like comparing a cut on the arm to an amputation of a limb. There is a difference to me, maybe not to you.

    John, it seems that much of your reply is focused on death and whether or not a person has come to terms with it. I don't think that is true, at least it's not for me. As far as death goes, I've always stated that we all have that in common so this, for me, isn't a question of dealing with my mortality and that did not bring on the depression for me. From the moment we are born we are on our journey through life and toward death. Facing death has no bearing on my taking medication. I've found that cancer comes with a mixed blessing. I appreciate every day more than I used to, I notice subtle beauty in things I would glance over.

    I felt that there was this suggestion (and still feel it) that many of us who are taking medication to help us deal with the cancer are somehow doing more damage to ourselves or are making the "wrong" choice. I feel it's the lesser of the evils. Depression, left untreated is very dangerous to oneself too.

    So, here we are again...
    Be well
    -phil
    PS: I wish I had more time to write but I'm at work.
    I also think this discussion can go on and on and on...
  • dianetavegia
    dianetavegia Member Posts: 1,942 Member
    A very wise Stage IV woman said....
    QUOTE:

    I've spent a great deal of time in the last couple of weeks thinking about being 'positive' or 'happy'. There seems to be so much pressure for survivors to measure up or live a certain way. It seems that so many people right now are extraordinarily 'negative' right now about the economy, swine flu, the weather.... mostly everything. And yet, because I have canzer I need to be happy at all times because that's the only way to beat canzer....OK. It gets frustrating at times.

    That being said, I am expected to be happy all the time because I usually am. I laugh and have fun everyday, even when I don't feel well. It's just who I am. So it is also ok to NOT be that way because it's not who you are. Whatever gets you through the day. I don't feel that any time is wasted time. I make the most of each day by just living a normal, boring life! I schedule college visits for my son, make dinner, do laundry, feed the dogs. I watch trash tv sometimes - it doesn't add anything to my life really, but it makes me smile. How can I worry about my next scan or treatment when a wealthy NY housewife can't get the coordinating drapes? But I wasn't there the first 6 months of my diagnosis. It takes awhile to accept your new life. Any major diagnosis is life changing. Give yourself and your mother some time.

    I also don't pursue "happy". Happy can be elusive. I do pursue JOY. I can find joy in many small moments everyday. Watching my children turn into young adults, prom night, dinner with friends, playing with the dogs, spring flowers, rainy days, sunny days - there is joy to be found everywhere. Moments of joy beget moments of happiness. Having something to look forward to everyday makes a difference for me. Little things sometimes. When I'm really sick it is usually dinner time. Nope, can't always eat but my youngest son is 17 so dinner is the only time I'm assured we will all be together at one time. If I don’t feel up to sitting at the table they sit in the living room or even on my bed. We make it work because it is important. And it brings me joy. Going for a ride in the car and seeing the flowers bloom, a walk in my neighborhood, friends over for coffee. Little things seem to matter to me more these days than the big ones. Yes, we are planning a BIG vacation this summer, hoping for a wedding in the next year, etc. But what about today?

    Kimby

    END OF QUOTE
  • PhillieG
    PhillieG Member Posts: 4,866 Member

    A very wise Stage IV woman said....
    QUOTE:

    I've spent a great deal of time in the last couple of weeks thinking about being 'positive' or 'happy'. There seems to be so much pressure for survivors to measure up or live a certain way. It seems that so many people right now are extraordinarily 'negative' right now about the economy, swine flu, the weather.... mostly everything. And yet, because I have canzer I need to be happy at all times because that's the only way to beat canzer....OK. It gets frustrating at times.

    That being said, I am expected to be happy all the time because I usually am. I laugh and have fun everyday, even when I don't feel well. It's just who I am. So it is also ok to NOT be that way because it's not who you are. Whatever gets you through the day. I don't feel that any time is wasted time. I make the most of each day by just living a normal, boring life! I schedule college visits for my son, make dinner, do laundry, feed the dogs. I watch trash tv sometimes - it doesn't add anything to my life really, but it makes me smile. How can I worry about my next scan or treatment when a wealthy NY housewife can't get the coordinating drapes? But I wasn't there the first 6 months of my diagnosis. It takes awhile to accept your new life. Any major diagnosis is life changing. Give yourself and your mother some time.

    I also don't pursue "happy". Happy can be elusive. I do pursue JOY. I can find joy in many small moments everyday. Watching my children turn into young adults, prom night, dinner with friends, playing with the dogs, spring flowers, rainy days, sunny days - there is joy to be found everywhere. Moments of joy beget moments of happiness. Having something to look forward to everyday makes a difference for me. Little things sometimes. When I'm really sick it is usually dinner time. Nope, can't always eat but my youngest son is 17 so dinner is the only time I'm assured we will all be together at one time. If I don’t feel up to sitting at the table they sit in the living room or even on my bed. We make it work because it is important. And it brings me joy. Going for a ride in the car and seeing the flowers bloom, a walk in my neighborhood, friends over for coffee. Little things seem to matter to me more these days than the big ones. Yes, we are planning a BIG vacation this summer, hoping for a wedding in the next year, etc. But what about today?

    Kimby

    END OF QUOTE

    Great quote from a great Lady
    Parts of Kimby's quote reminds me a little of the book by Barbara Ehrenreich,
    "Bright-sided" and the pressure on people to be happy.
    Kimby possibly has the most positive and upbeat attitude of anyone I've "met" on this site. She has always been a great source of support for us all on this board.
    :-)

    Joy works great! En-joy each day and live it like it's your last.
    "One never knows, do one"
    F.Waller
  • Shayenne
    Shayenne Member Posts: 2,342
    PhillieG said:

    Great quote from a great Lady
    Parts of Kimby's quote reminds me a little of the book by Barbara Ehrenreich,
    "Bright-sided" and the pressure on people to be happy.
    Kimby possibly has the most positive and upbeat attitude of anyone I've "met" on this site. She has always been a great source of support for us all on this board.
    :-)

    Joy works great! En-joy each day and live it like it's your last.
    "One never knows, do one"
    F.Waller

    Amen!
    Beautifully said! That's the way I live, take it one day at a time,

    "Dream as if you'll live forever, Live as if you'll die today!" from James Dean, which is one of my favorites.

    Hugsss!
    ~Donna