Treatment’s impact on mental health: Melissa Lopez Carroll

First comes hearing the diagnosis — breast cancer — and the emotions that stirs. Then there are the often grueling treatments, some lasting months, others for years or forever. It’s no wonder that people treated for breast cancer commonly experience depression, anxiety, or emotional distress.

That can happen at any age but younger women are more likely to be affected. Mental health side effects may continue for a long time. Some cancer centers now include mental health specialists on their teams, to support the emotional well-being of people in treatment.

Yet no health care provider, including her oncologist, told Melissa Lopez Carroll that she might experience anxiety or depression during treatment for stage II breast cancer. She developed both conditions but never spoke with her medical team about what she was feeling.

“I didn’t even think about it,” says Melissa, a teacher and mother of two young children who lives in Yonkers, New York. “In my mind, they were the doctors that were going to make me better from the cancer. It never dawned on me to bring up any mental health issues with them.”

Her breast surgeon gave her a pamphlet with information about a local cancer support organization. Much of the programming offered was held during hours “when I have nobody to watch my kids,” so she didn’t attend any sessions.

“I was blindsided by this diagnosis. I was living healthy,” she says. Diagnosed in 2018, she was 38 years old.

Melissa never went to a mental health therapist before breast cancer and didn’t seek such help during treatment. She wasn’t against the idea but, “it was hard to find time.” Her parents helped her with the children but she didn’t want to ask them to do so frequently. And then there was the cost of therapy. She became a single mom while being treated for breast cancer, so time and money were both in short supply.

“I did not seek therapy for my mental health challenges during treatment. Looking back now, I definitely should have,” she says. Melissa spoke with LBBC contributor Robin Warshaw about those difficulties.

Robin: Did you think you would work through treatment?

Melissa: I planned on going back to work. After my first chemotherapy treatment, I did go back. I didn't realize that the chemo was going to knock me out as much as it did. I was given what they call “Red Devil” (doxorubicin).

After the second chemo session, I had to call my husband from work and tell him, “I have to go home, I can't stay here. I’ve been crying the whole time.” I couldn't stand the noise. I was nauseous and dizzy and felt like I wanted to pass out.

I would get such bad anxiety when I would have to go for my chemo. I couldn't sleep thinking about it. It was like I couldn't breathe. I knew I would have to go back and get this done to me again. I would go to my dad and cry, “I just want to die.”

I know that sounds terrible and people might look at me and say, “What are you talking about because there are people who have died.” Right, but at that time I was feeling depressed. My marriage was also failing so that didn't help. I felt like a failure because I couldn't go to work.

Robin: In addition to your dad, did you tell anyone else how you were feeling?

Melissa: I only said it to my dad, not to anyone else. We’re really close and we are Christian. I felt like my dad is my safe place. I knew he’d help me through it and be positive. And not say, “You’re crazy for thinking that.”

Because I was so sick and my kids were so little (two and four years old), I was more depressed about my marriage in general but also the fact that I wasn't staying home. I stayed at somebody else's house because I didn't want my kids to see me so sick that way. I knew they wouldn't understand.

I stayed at my parents’ house the first week, at my sister's the second week, and at my aunt's house the third week, and then back at my parents’ house again. That didn't help my feeling depressed. I wanted to be with my babies. Every three weeks I was away from them for four or five days depending on how sick I was.

Robin: Did your depressed feelings continue?

Melissa: I always think I could do everything on my own. I’m too independent to ask for help. I felt bad eating their food, felt bad asking them to go to the store and get me something. I felt bad that my hair was coming out all over my sister’s couch. I just felt like a burden.

When I realized I couldn't work and the sickness was lasting longer and I just couldn't shake it off, that's when I started getting the depression and anxiety. It really hit me.

Robin: Did you talk to anyone on your medical team about how you were feeling?

Melissa: I spoke to my cancer buddy. We met when we happened to be sitting next to each other in the infusion room and chatting. Sometimes, when I was feeling depressed, he would say, “I'm going to pray for you.” We would watch fishing shows together on TV.

His daughter was around my age. He would get there before me, save me a seat, and say, “My girl’s gonna sit there.” He called me his girl. Towards the end, I didn’t always see him. He passed away last year.

Robin: Was there ever any discussion, with anyone, about seeing a therapist or counselor?

Melissa: At the end of March 2019, I decided to leave my husband. I finished chemo and moved out, living with my grandparents. I tried to stay positive. I didn’t want to wallow in the depression mode.

It was one of those days I couldn’t not cry in front of the kids. I called my sister and she suggested an organization called Support Connection. I immediately called, spoke to a wonderful woman, and talked for 45 minutes. I cried and she told me about a group in my area. I asked my parents and said I need help and I need to talk to somebody. So they said yes, they would watch the boys. I went to my first support group and it was amazing.

I'm still in the same support group now. I became friends with two other ladies there. It has really helped me a lot. We don’t just talk about our breast cancer journey. Hearing other people say the same things made me feel that I’m not crazy.

Robin: Did you think about seeking professional help for your mental health?

Melissa: I would just keep thinking I can’t do it because of time and money. We moved to my grandparents in the Bronx for 6 months and it was so hard. My kids went to school in Yonkers and I worked in the South Bronx. At that point their father and I were having minimal communication. There was so much on my plate, I barely had time to do a support group.

I'm actually in that cycle right now, because I started going to therapy in May. I'm gonna have to ask my therapist if there’s a way we can do telehealth. It's just too much. My dad is retired now, so my parents are living their best life and I feel bad asking them all the time to watch the kids.

I started seeing a therapist because I was looking for one for the kids. I contacted my sons’ insurer for an in-network recommendation for people close to where we are. I can see him at the same time, so it's been a little easier for me to not have to find a babysitter.

Robin: How are you doing now?

Melissa: I am not on antidepressants or any anxiety medicines and I have never been on any. I have been thinking about talking to my doctor regarding my anxiety. It seems to have gotten worse recently and I wanted to discuss maybe getting on medication to help me.

I think people look at me and feel like, “You should feel fine if the doctor told you that there's no evidence of disease and you're alive.” A lot of people don't realize that your mental health when you go through things like this is such a serious thing.

"And it doesn't matter what people say you should be feeling, you're gonna feel how you're gonna feel. I don't think a lot of people really understand that. Yes, I want to live, but there's so much else going on. You're going through such a mental battle at the same time."