Loss of Identity and Mental Health

I wanted to do a post today to acknowledge the fact it is World Cancer Day! This post is going to be a little bit different as it is not really about my treatment. Every post I have done so far has been more about diagnosis and the physical treatment of my Breast Cancer. This post is going to focus more on the psychological impact that a cancer diagnosis has had on me and how I have managed that.

So before I get into how cancer has effected my mental health I will write a bit about how my mental health was pre-cancer.

Before Cancer

From a fairly young age I have been a person who has suffered on and off with my mental health. At a young age my main issue was that I suffered somewhat from Depression and I was excruciatingly shy and therefore found it very hard to interact with people which led to a bit of Social Phobia. As I got older I suffered less with Depression and more with Anxiety. I am a perfectionist big time and expect perfection in the things I try to do in my life. I can and have put myself under enormous amounts of pressure in the past to achieve things and find it hard to cope with any kind of failure or criticism.

From September 2014 to May 2017 I started to undertake a college course which consisted of attending college for one full day a week. I then worked 39 hours over the other 4 weekdays. In 2015, I was made Supervisor within my job which came with a lot of extra responsibilities! I also started going out with my current boyfriend who lived in Kilkenny at the time. So I was extremely busy with college, work and travelling to and from Kilkenny at weekends. I also had periods of serious stress during those three years where I wondered what the hell I was trying to do!

Diagnosis and Treatment

Obviously, diagnosis was a huge shock for me. I spent that day in a bit of a day dream and when I went to sleep that night I hoped I would wake up and it would all be a dream. Clearly that didn't happen and so I spent a lot of time trying to inform myself on what exactly I was dealing with. Initially I was smart in where I looked for information, I read a lot of Irish Cancer Society booklets, I bought a book about Triple Negative Breast Cancer and I stayed off the more casual unreliable websites for fear of what I might find.

For about the first two weeks after diagnosis I was very emotional and my mood was all over the place but once I accepted my diagnosis I became very positive about what I was about to go through. I have to say generally throughout TC treatment I remained very positive and I didn't feel overly anxious about having cancer. I started to see a Psycho-Oncologist and decided I would continue to see them throughout treatment because I had a feeling that the positivity I was feeling would not last forever!

While on TC I read a lot about AC. I knew that the A in AC was Adriamycin and I knew that drug was strong and that it could cause damage to the heart and sterility. I joined support groups on Face book and read lots of peoples experiences of AC. I read to the point I scared the crap out of myself. As TC was coming to an end and I knew I would be starting AC soon, I started to get very nervous. I had my first infusion of AC on the 22nd January and driving in to the hospital that day I was scared of what this drug was going to do to me. I have only had one infusion so far and it was definitely harder than TC. I was a lot more nauseous, tired, weak and I had a few days where I felt like I was in a daydream and found it hard to concentrate or even be around people. This brain fog type feeling lasted about three days and those three days I was extremely anxious. I spent those three days thinking and over thinking about my future, possibility of recurrences and possibility of infertility. I have to say I would take nausea, tiredness or any other side effect over feeling that way again. I have a feeling that this was caused by the fact I was taking steroids for 4 days and then I stopped taking them and I must have crashed in some way which caused the brain fog and anxiety. I have my second infusion tomorrow and I will be talking to my Oncologist about this so hopefully it wont happen again.

What I also noticed about this cycle of treatment is that because it is a stronger regime there is more downtime between treatments. Because of this there was more time where I wasn't up to leaving the house and I wasn't up to doing much inside the house either. Therefore, there is a lot more time to think and feel sorry for yourself and obviously this is going to have a negative effect on your mood!

I had an appointment with my Psycho-Oncologist on Friday and within a few minutes of meeting her she was able to tell from my body language and the way I was speaking that I was anxious. I didn't necessarily feel anxious but when she got me to stop talking and spend some time focusing on areas of my body I realised that I was tensing certain areas to the point they were painful due to the fact I was anxious. She stopped me a number of times throughout our session and again got me to locate the area of tension and helped me to relax. I had had a number of sessions with this psychologist in the past but this was the first one where my anxiety was obvious to her. I don't know exactly why this is but I had a feeling all along that it would eventually rear its head.

So, what do I do to help with anxiety?

I find that the best thing I can do to prevent myself over thinking and becoming anxious generally is to distract myself by doing something I enjoy;

• Getting out; doesn't matter what to do but feeling like I've achieved at least one thing everyday makes me feel somewhat productive.
• Going for a walk; I try to go for a walk as often as I can. Sometimes I find the most basic walk tiring but getting out in the fresh air helps crazy amounts!
• Knitting; knitting has become my obsession. I always enjoyed it but since I have been off work I have discovered I have an insane passion for it. I find it distracts me and calms my mind and I love creating things and gifting them to the people in my life.
• Spending time with friends and family; I have an amazing support system of people around me. If it wasn't for them I think I would have gone crazy from boredom by now but they keep me occupied and I probably don't thank them enough for that - Thanks guys!
• Having Baths; baths are incredible for helping you to relax. I fill it right up to the top and add in Epsom salts and bubble bath. I pick an album and just relax and listen to the music.
• Mindful Breathing; I try my best to incorporate this into everyday. It helps me to relax and focus on the present moment, even if its just for a few minutes.

Loss of Identity

I don't know if every cancer patient goes through moments where they feel like they've lost their identity but I definitely have had those moments. When a person goes from such a busy lifestyle to being unwell and having a huge amount of time on their hands they don't only lose a part of their identity but also a piece of their self worth. I complained so much about college, work and everyday things before being diagnosed. I would give anything now to be in the situation I spent so much time complaining about! I think perspective is everything though and I know that when I do get back to my normal everyday life it will never be the same again, I will be a much calmer person with a whole new perspective on life and I really look forward to that!

The other side of feeling like you've lost your identity is your self image. My self image has changed so much since I was diagnosed on the 15th of September. I had just lost almost 4 stone so I was the slimmest I had been in years. I have gained back some of this weight, which is to be expected and I try not to dwell on this too much. Being bald doesn't bother me hugely either anymore. There are times when I catch a glimpse of myself in the mirror and feel very unhappy about what I see looking back at me but I know all of this is temporary and I remind myself that this too shall pass.

In about two months time I will be having surgery, I don't know what type yet and how invasive it will be. At the moment I don't feel too concerned about it but I'm sure when all is said and done there will be an adaption period for me to learn to accept the change there will be to my body.

I plan on getting a tattoo when I finish up treatment. I haven't decided where or what of yet but I want to do it to remind myself of this time in my life where I was stronger than I ever thought I could be. Being faced with something as scary as cancer makes you reach inside yourself and find coping mechanisms that you didn't know you had, well at least for me it has. This whole experience has given me a new appreciation for life and I find myself crying over beauty as well as pain now which I never did before!