TNBC and Me: The importance of mental health

As a social worker I am all too familiar with how taboo mental health is in America. I was surprised to find that as a cancer patient mental health was rarely discussed, and [that] after being declared “cancer free” it felt even more unmentionable. As a 26-year-old diagnosed with triple-negative breast cancer, I was encouraged to seek therapy during treatment, but never felt the need to.  I was too busy getting married, working, and building a new life with my husband. Cancer felt like a major bummer, but not something that would haunt me once I was done with treatment. While I understood why mental health services were encouraged while I was in treatment, I really wish there had been more emphasis on the importance of mental health after treatment. No one prepared me for the whiplash when it was over; I could never have imagined the way my life would change again when I was on the other side of things. 

It wasn’t until things stopped spinning and the dust settled that I was able to look around and see the carnage for the first time. Things had been happening so fast that I didn’t realize the toll my illness had taken on so many parts of my life. I felt like I was suddenly surrounded by fragments of relationships that couldn’t withstand the pressures of a serious illness, a steady stream of medical bills, and a huge sense of emptiness. The humor I had used to cope with cancer thus far seemed to be sucked out of everything, and I struggled to find the positivity in anything. The impact of it all didn’t register until I had heard the words “no evidence of disease.”

It was pretty soon after being declared NED that I began to spiral. I felt like I had lost the identity of who I was before cancer and I wasn’t sure how to organize my feelings in a way that made sense to me. My emotions made me feel very unstable which presented in mood swings. I wanted to shield everyone, so I began to shut everyone out. My blog, where I had once gone to write puns about cancer, began to feel foreign because I had nothing happy to say.  I stopped hanging out with friends, returning phone calls, opening up to my husband, and going to work. I was embarrassed at how quick I was to cry and how quickly the slightest inconvenience could set me off. Things continued to get worse and finally came to a head when a co-worker passed away from breast cancer. I questioned why she was taken before me and why I was spared at all. This was all accompanied by sleepless nights, panic attacks, and bouts of nausea if I thought about anything related to treatment.

What do I do now? I didn’t recognize the person in the mirror and I didn’t recognize the person everyone kept telling me I was: “You’re a warrior,” a “fighter,” “you’re brave, resilient, and so strong.” How was I supposed to admit to these people, and admit to myself, that there were days I wished I hadn’t made it? Days when I saw my fellow cancer fighting friends picked off one by one and days when I could do nothing more than wait anxiously for the other shoe to drop? I felt like the most selfish human being on the planet.

As someone who concentrated on mental and physical health in graduate school and actually worked in a hospital with oncology patients, I was ashamed that I had never once considered that the impact of an illness only got worse once the illness was gone. I never realized that telling people that are suffering how strong they are can sometimes make them feel too weak to ask for help. I never told my patients that it’s OK to feel hopeless because I was too busy telling them how lucky they were to have survived. Struggling to admit to yourself and others that you’re unhappy after surviving an illness was harder, to, me than fighting the illness itself. If given the choice I would have gone through chemo ten times over rather than relive the first year after cancer.

A good rule of thumb is that when negative behaviors or emotions begin to affect your daily life, it’s time to get help. With the support of my loved ones I finally admitted to myself that I needed help and I sought out a local therapist. I was diagnosed with post-traumatic stress disorder (PTSD) and it felt like the diagnosis made everything fall into place. It was the reason I had nightmares, the reason I had hypertension and nausea when I walked into a doctor’s office, the reason for the mood swings and the anxiety. I chose to pursue a type of therapeutic treatment specifically for PTSD, and let me tell you, it was HARD. Without getting into the details of the treatment, I had to choose a couple of the most triggering memories and replay them over and over, until I began to be desensitized to them. Within three sessions over half of my side effects had completely disappeared. These memories that once held me hostage are now times I can look back on with confidence and appreciation. 

Just as everyone does not respond to treatment the same, not everyone heals the same. Some women claim they have epiphanies after cancer and never take anything for granted again. That’s not me. My cancer “battle” didn’t end the day I was declared NED. Cancer impacts me every single day whether it is an emotional trigger, a glimpse of my scarred body in the mirror, or the ongoing medical issues that I have to deal with.  If I could pass on any advice to people going through treatment or who have completed treatment, it would be this: Admitting you need help does not diminish the fact that you went through something incredibly hard and you survived. It does not make you weak, selfish, or unappreciative to suffer from survivor’s guilt, depression, anxiety, PTSD, or any other mental illness. Don’t try and hold it together for others, because eventually you will crack. If you are a parent, a spouse, a friend, or a coworker, remember that the best gift you can give to others is a whole and healthy you. Most importantly, give your mind the same love and patience you did your body when it was fighting hard for you, because your mind was fighting, too.

The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. If you or a loved one needs help, call 1-800-273-8255.

About 15 to 20 percent of all breast cancers are triple-negative. To learn more about this subtype, its treatments and how it impacts lifestyle, attend our conference, Sharing Wisdom, Sharing Strength September 28 – 30. To read more personal stories, visit TNBC and Me. 

The TNBC and Me blog series is supported by: