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Fatigue or Depression?

HobbsDoggy
Posts: 165
Joined: Feb 2013

I am exactly two months from my last radiation and chemo. Neck cancer, neck dissection, unknown primary. I find I am still sleeping what I consider too much. About 8 to 9 hours at night (awake about 4 times to drink a little water), then two naps a day. Some days the naps last an hour or two sometimes 3 hours each. I do the usual stuff in the morning and take my shower, then seem tired right away. Every tempting to go back to bed. I don't know if I am really that tired or just depressed from all I have been though. Saw a doc for depression and she started me on meds about 2 weeks ago.

My question is are any of you still suffering from fatigue after two months out? I am 67 years old, had been very activie until the beast hit. I need to get active again.

Thanks

phrannie51's picture
phrannie51
Posts: 3853
Joined: Mar 2012

a lot longer than we imagined it would.  I finished chemo on Aug 28th...went back to work on Oct. 16th....and JUST started feeling more like myself somewhere in January.   I still get very weary by the end of the week, and the first day of my weekend it's not unusual for me to sleep 11 hours.  I haven't slept like that since I was a teenager.  Getting back to normal takes a long time....the book they gave me at the Onc's office and the one I got from my insurance company both say that it can take up to a year to recover from treatment.  You may or may not be depressed on top of that....but depression isn't the only reason you're still feeling very fatigued.

I'm 62....and was always super active....it's been hard not doing all the things in a day that I'd like to get done.

Billie67's picture
Billie67
Posts: 834
Joined: Jul 2012

Have you had any bloodwork since treatment ended? For about 3 months after treatment I was the same exact way! My dr also RXd some depression meds and did some bloodwork, making sure to test my thyroid. Good thing she did because my thyroid was pretty much not working at all anymore and that is probably about 80% of the reason I was so tired. The other 20% was most likey dire to rads and a tiny bit of anxiety/depression.
It took a few weeks to start feeling more rested and now (4 months later) I am starting to feel almost normal. It takes time for the thyroid meds to start working and for the dr to find the right dosage. They tend to start low and increase as needed based on what bloodwork says.
The depression meds take a while to kick in too.
Maybe in your case it's simply healing and a little depression but it's still important to keep up on that thyroid because we H&N people are at risk of thyroid problems due to rads.
Good luck :-)
Billie

D Lewis's picture
D Lewis
Posts: 1547
Joined: Jan 2010

I still have lingering fatigue, 2 1/2 years later.  I have bloodwork every 3 months, and the thyroid is still normal. Seem to be in a reasonably good mood most of the time, but it takes an effort for me to get up off my butt and be physical.  I'm trying to do 40-60 minutes a day of cardio workout, and I do feel a lot better afterward.  I just have to make myself do it.

Deb

HobbsDoggy
Posts: 165
Joined: Feb 2013

Thanks for both the above.  Gives me something to work on.  See the chemo doc Friday will ask him about all of this.  Can always depend you all of you to come through with great ideas. 

fishmanpa's picture
fishmanpa
Posts: 1134
Joined: Jan 2013

Hobbs,

I've yet to undergo treatment so I can't speak from the cancer standpoint however I can speak from a cardiac standpoint.

I had open heart surgery in November of 2007 (heart attack and triple bypass). The week before I suffered the heart attack I had hiked Old Rag Mountain here in the Shenandoah National Park. Old Rag is well known and a very challenging and unique hike (an all day, 8 hour affair). I was very active at that time. I would go to the gym 3-4 times a week and was always up in the mountains hiking , camping or fishing.

As you might imagine, a physical setback like open heart surgery had a profound impact on my psyche. I began to withdrawl, stopped going out, slept a lot, often times I would not leave my apartment the entire weekend when normally I'd be up and wetting a line at dawn.

Suffice it to say I was suffering from depression. Upon examination from my doctor and conformation from a therapist I was prescribed an anti depressant which I took for about 5 months. I can conclude, based on how invasive both open heart surgery and H&N cancer are, one can suffer similar symptoms and diagnosis.

All I can say is be cautious concerning the drugs. I had some severe side effects from (Zoloft). Digestion issues, sweats, shakes etc. I didn't "feel" a whole lot different but the people around me noticed a change. When I finally went off of it, the effects were disturbing. Sleeplessness, dizziness, a general feeling of disorientation etc. I realized how "drugged" I was. 

While I'm aware of the symtoms and have been treated in the past, I would hesitate greatly, even protest taking anti-depressants again. 

Seek opinions, do your research and proceed cautiusly. There are beneficial aspects of treating depression but one must weigh the positive/negative ratios before proceeding. 

"T"

 

 

 

HobbsDoggy
Posts: 165
Joined: Feb 2013

Interesting advice. My doc started me on the lowest dose and most generic antidepressant. She checked with me already and got every symptom I am having. She is very cautious, and clearly based on your experience with good reason. I have almost no doubt I have situational depression, who doesn’t would be my guess from what we all go though. I will monitor carefully.

I don't want to get home bound or even get close to giving up. Delicate balance. Side effects from the beast and from its treatment are more than just physical, at least for me.

Dr.Ed
Posts: 22
Joined: Jan 2013

I was still experiencing fatigue for about 7 monthsafter treatment and still get tired easily but it got better as the weeks went on. I also agree that you should get your thyroid checked because radiation can shut it down, and that willeasily cause fatigue. I'm glad I was given anti depressants I got pretty depressed for a while, then got off them when my recovery started to kick in. Celexa worked for me, but they also tried me on remeron because it could help sleep and appetite but it just wiped me out. You will probably know if the med is making you tired but just keep it in mind.

Dr.Ed
Posts: 22
Joined: Jan 2013

I was still experiencing fatigue for about 7 monthsafter treatment and still get tired easily but it got better as the weeks went on. I also agree that you should get your thyroid checked because radiation can shut it down, and that willeasily cause fatigue. I'm glad I was given anti depressants I got pretty depressed for a while, then got off them when my recovery started to kick in. Celexa worked for me, but they also tried me on remeron because it could help sleep and appetite but it just wiped me out. You will probably know if the med is making you tired but just keep it in mind.

phrannie51's picture
phrannie51
Posts: 3853
Joined: Mar 2012

...did I ever mention how bad my memory is?  A month ago the rad doc had me get a blood workup for thyroid, I'm losing it progessively, month by month.....he set me up with my Primary Dr., who in turn did another blood test....JUST LAST WEEK!!...LOL.  My throid is even worse than it was a month earlier, so he put me on thyroid meds....hopefully, I'll start feeling even better.

p

CivilMatt's picture
CivilMatt
Posts: 3094
Joined: May 2012

Hobbs,

 

At over 10 months out I can fall asleep at the drop of a hat.  I did not use to be this way and I am under thyroid watch (3 month monitoring).  So far the results are border line, but I aim to improve.

 

The funny thing is even though I feel tired I can go outside and get a lot done as long as I stay busy and have my water bottle.  I don’t feel sad or depressed at all and as long as life continues to improve.

 

I hear there is a real good wood cutting camp run by a guy named Tim in Idaho.  It is guaranteed to whip you into shape and this guy Tim is pretty funny.  Additionally, he cuts a huge discount for H&N members.

 

I got to catch some zzzzzzzzzzzzzzz,

 

Matt

longtermsurvivor's picture
longtermsurvivor
Posts: 1837
Joined: Mar 2010

most of us have felt this way.  Don't underestimate the  impact of deconditioning during these rather, ahem, rigorous treatments.  I dragged my saggy rear around almost a year with my first treatment back in the nineties.  Got better after getting back into a rigorous exercise program.  These last treatments, I've started back exercising the very moment treatments ended.  First walking and light  weights, then jogging and more weights.  I got myself whipped back into shape in a few months this last time, amazing how the tiredness passed.  Oh, and did someone mention thyroidWink

Skiffin16's picture
Skiffin16
Posts: 8104
Joined: Sep 2009

You guys/gals jumped right on this one...

Can be any or all of what was mentioned....

Fatigue from a body that has been blasted, burned, poisoned and abused...

Depression can also play int that, and is easy to get into post Tx.

Thyroid, though a little early for you perhaps, but certainly a possibility.

Like Pat mentioned, exercise when you feel like it, don't over push it though, and let you body (not your mind) dictate your scedule.

When I was heavy into exercise (not just heavy like now)... I can count many times I just felt I couldn't do anymore running for example. As soon a I stopped within a minute or so, I was back to normal.... Psyched out my my brain telling me I was just tooo tired and hurting...

In racketball, I learned to always push myself a little harder and not to quit when attempting a shot. Soon it was amazing how much my wins and game picked up.

JG

 

George_Baltimore's picture
George_Baltimore
Posts: 303
Joined: Jun 2009

I forget whether in other posts, you said whether you were male or female.  I think male but I wouldn't stake any money on it.  If you are male, another thing it could be is low testosterone.  I've been on thyroid meds for a couple years now and still feel dead tired all the time.  Saw the low T commercials and asked my primary to check the blood level.  Bingo.  It was definitely low.  The fatigue coupled with my mood swings (crying sometimes at the drop of a hat) hopefully, will be things of the past soon.  I started applying Androgel yesterday so it's too early to tell right now.  From what I've read, low T is fairly common as age builds up on you.  If you are female, I assume the same would be true of estrogen.  Might be something else for you to check.  Good luck.

peggylulu's picture
peggylulu
Posts: 367
Joined: Dec 2012

Hobbsdoggy, I am 67 also and almost 4 months out from Radiation . I've lost 60 pounds and I know I'm not eating enough but I still get tired much quicker than I did before. Hope this helps. From everything I've read on this wonderful board it takes a long time to get past the effects of Radiation so hang in there and rest as much as you need to. They say rest helps you recover faster .

Peggy

phrannie51's picture
phrannie51
Posts: 3853
Joined: Mar 2012

At this stage of the game....and for many months after, what we're feeling can be attributed to SO many things....We've been thru the gamut emotionally, physically, mentally and spirtually.....Am I gaining weight because:  a) I'm supposed to; b) my throid; c) I'm eating more than a few can Ensure; d) my body isn't using the energy to try and keep up with the healing.  Am I tired because:  a) My body just went thru hell and it's trying to heal; b) my throid is screwed up; c) depressed.  Do things hurt because:  a) I'm still healing; b) because I have some side effects from the hell I just went thru;  c)  I'm getting old and I'd be hurting anyway.....

There are so many variables for everything we feel now....that the Dr.'s can only go by blood tests...."How are you feeling" with an answer that unless there's physical back up in some way....it's hard to know where it stems from.

p

boardwalkgirl
Posts: 263
Joined: Jun 2012

I am 6 months out of treatment and still am very tired most of the time. I went back to work October 1st and that was difficult to get thru the day but it has gradually gotten better. I feel like I am suffering from some depression now, which I try to talk myself out of every day. I have already had the thyroid checked and it came back ok. I think I am just so ready for spring to get here and maybe that will help with the depression. I can't seem to stop worrying about everything, I know I just need to be thankful for having a clear scan last time and for what I have, but I worry every day that it is going to come back. The tiredness will gradually get better but some days are just worse than others.

lorig01
Posts: 69
Joined: Jul 2012

I am 5 months out of treatment for tonsil cancer and I am surprised by the depression. I held up well during treatment and felt good enough to return to work several months ago but in the last month I have been hit by somewhat severe depression.  Like many here, my thyroid test was in the normal range.  I think my depression stems from the loss of joy in eating and the fear of a reoccurence which could mean death or disfugurement or loss of quality of life. I find myself resentful towards folks that can enjoy food and I am spending more time by myself.  The weather is beautiful here, (Houston), so I am going to get out and ride my bike and tomorrow I will  golf.  Being outside makes me feel better but I do get sad around the meal times.  I know that I am lucky that I can still eat by mouth by it is a chore and I no longer enjoy eating.   As time goes by this is really starting to drive me crazy.  I used to be a"foodie" and thought this would get better with time but it seems to get worse. Is anyone else experiencing this level of depression surrounding eating?

phrannie51's picture
phrannie51
Posts: 3853
Joined: Mar 2012

thru treatment pretty much at the same time....I don't worry all the time, but it does come in waves and lasts for a couple of weeks...it seems just when I'm about to post something about it, it starts to fade, and I get a two week repreive from fretting so much about reoccurance.  What I notice as "different" now is I have to push myself to do the things I used to do with pleasure....it's like cancer has taken the shiney off of the things I used to love to do.  I keep thinking if I keep doing them, telling myself that I still like doing it, that maybe I'll self-talk myself into being the old me.  The old "take your body, and your mind will follow" kind of thing.  The line between depression and tired is so thin during recovery.

I'm not going to hesitate in getting on anti-depressents if spring doesn't lighten me up....a person doesn't have to be on them forever, but they help in getting over a hump in the road.  Let's make a deal.....if the end of winter comes, and we're still anxiety ridden and slumped we'll check in with our Dr.'s and ask for anti-depressents to push us threw the maze.....Deal??

p

Ingrid K's picture
Ingrid K
Posts: 811
Joined: Mar 2011

Depression can definitely cause some of the fatigue.   I caved pretty soon after my surgery, mainly due to the disfigurement that was involved.   I started out on a small dose of Effexor, and then after treatment ended and I was still complaining of fatigue, we upped the dosage on the Effexor and added the thyroid replacement meds.

I really didn't want to add the anti-depressant to my med list, but I figured after all the damage the radiation had done to my body, adding a little "upper" wasn't that big a deal.

I now have a bit of insomnia, but am not nearly as depressed or tired.

I recommend it to anyone who is on the fence.  Like Phrannie says, it helps to get over the hump and back to semi-normal.

Good luck !

 

 

 

boardwalkgirl
Posts: 263
Joined: Jun 2012

Phrannie, it is a deal. I am not very good about wanting to take meds but I don't want to be like this all the time either. We have planned a vacation in June taking all 3 of our grandchildren and 3 of their friends to Disney. It was a promise I made to them about 5 years ago and I am determined to do it. I talked my radiation oncologist in to waiting until we get back to do my next scan. He was ok with it, I am just worried something will show up on the scan and I am determined to do this trip. Hopefully Spring will bring both of us a new outlook and take away the worries and depression.

HobbsDoggy
Posts: 165
Joined: Feb 2013

Just a bit over two months out from my last rad and chemo I seem to have a bit of a set back as far as fatigue goes. The lack of progress and lack of taste, etc. does have me depressed some and trying to figure out what is just physical tiredness and what is depression is not too easy. Also I am in the Midwest and the cold season is upon us so may have that adding to the mix. The doc I saw yesterday said I am still early in recovery so don't panic yet, easy for him. Blood tests all came back normal. Again cannot tell you how much your messages mean to help me make it though all of this.

jlslee
Posts: 1
Joined: Apr 2013

Hello to all,

I know we are all in this together and that helps more than I ever thought it would.

I was diagnosed last July 2012. Had lumpectomy in August. Four rounds of chemo and neulasta from October through December 2013. 31 sessions of radiation in January and February 2013.  I know I should feel good that things are behind me, but I am so depressed every day.  I have not slept more than a couple of hours a night ever since diagnosis.  I am so scared all of the time.  I feel so alone even though my family has been wonderful.  I miss my children so much and my grandchildren even more.  My children are grown as are my grandchildren and do not live very close.  I miss the days when they were all little and needed mommy and nanny.  I cry most of the time without control.  I never said "why me" and I don't really feel sorry for myself, just so depressed I cannot handle it.  My husband has been wonderful also, but he works all day and I am alone except for occassional lunches with friends.

I don't have to tell any of you that chemo and radiation are very hard.  Even when you make it through, you feel like your head is in outer space not being able to concentrate.  I thought after treatment I would be good again.  I have had problems with my legs after treatment.  My upper thigh ached so badly day and night.  My legs don't seem to work like they used to.  My shoulders ache at night and I end up having to put ice on them, all hindering sleep that I might get.

Don't know what to do.  Want to be "normal" again.  Want to stop being afraid it will come back.  I used to be lively now I feel old and feeble.  My hair is only 1/2 inch long even though I finished my chemo in December, four months ago.  Maybe I was expecting too much.

I love all of you and want also to help others in our situation but I cannot even help myself.  Does anyone have the answer??

Jan

debbiejeanne's picture
debbiejeanne
Posts: 2590
Joined: Jan 2010

jan, i'm so sorry you're so depressed.  i too suffer with depression.  i think that is the worst side effect of cancer.  you need to force yourself not to worry so much about it coming back.  i know that's easier said than done but you must make yourself stop.  instead, make yourself busy or go out with friends.  pray pray and pray.  prayer always helps.  i will be praying for you as well.

God bless,

debbiejeanne

peggylulu's picture
peggylulu
Posts: 367
Joined: Dec 2012

Jan , welcome to this board ! You've found the right place to be to get answers to any questions you might have . There are so many great people here that have a ton of good information ! I have taken zoloft for several years for depression and during treatments my Primary Family Doctor told me to double my Zoloft. I didn't even ask or mention depression and he thought I needed it so if you're not taking some thing for depression definatly ask one of your doctors for some medicine.

Best wishes for feeling better . Peggy

CivilMatt's picture
CivilMatt
Posts: 3094
Joined: May 2012

Jan,

 

Welcome to the H&N forum, I see you are a very qualified participant, sorry about that.

 

To get more response you may want to start a new thread, that way more members will chime in. 

 

From my perspective and I can sleep “right now” you do not sound like someone enjoying being “cancer free” or at least having some positive perspective on what has happened to you.  Not to diminish the life changing event which happened, it is just one chapter in your life’s story.

 

Matt

donfoo's picture
donfoo
Posts: 1332
Joined: Dec 2012

From what you describe, the cancer associated events likely triggered more than a depression "side effect" of the cancer treatments. Given the amount of time and the symptoms you are experiencing you need to see a psychiatrist, not some therapist. Even though MO, RO and others may be able to prescribe, you need to understand you likely have a new disorder and needed to be treated by specialists in this disorder. All your previous providers have no idea how to treat major depression, just as they have no idea how to treat cancer.  good luck and god speed to wellness. don

Roar's picture
Roar
Posts: 250
Joined: Mar 2013

My motto was let's get it done so I can get it behind me- problem is that it's not behind me. Yet- my doctor told me today there's no guarantees in this business. Stay positive- seek a professional to talk to if you think that will help.i always feel alone- I use to be a tough guy now I am a humble cancer survivor and every once in a while I find myself in the midst of a good cry. Be strong- you are loved - but life goes on-  YOU ARE NOT ALONE

Roar's picture
Roar
Posts: 250
Joined: Mar 2013

I finally found someone with the same diagnosis as me- unknown primary - my last treatment was early December - I still get fatigued - I worked through my entire treatment - it was ugly for the last 3 weeks- it was my goal to be able to eat a nice Christmas dinner with my familly- needles to say I didn't eat very well at our Christmas dinner- but I was there and plan on being there many times over. I can't go 100% at work every day or I burn out- so I go 75% sometimes less. When my body tells me to rest I rest. It seems I had a lot more bad days right after treatment than I have now- maybe 1 bad day a week- and on a bad day I don't want to do anything. I am 55 and I have always been active- a gym rat. I have not worked out at e gym since my surgery. I tried a few weeks ago and asked myself if I was crazy. S I will give it more time. I think there are times I have to fight off the depression as it is easy to feel sorry for yourself as it seems the gift that keeps giving is radiation and chemo. Just keep fighting - drag yourself out of the house and go for a walk- do anything except vegetate on the couch. Although once in a while you need that too. I was taking a lot of naps right after treatment- once I stopped the pain meds the napping gradually stopped. Ad believe it or not my problem was trying to go to sleep at night. It took a long time to get back on schedule- I still can't get up as early as I use to. So just hang in there and keep fighting . 

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