Coping With Depression During Breast Cancer: Expert Insights

Coping With Depression During Breast Cancer: Expert Insights

hi in this video i’ll be interviewing rosie ingebritzen a clinical oncology social worker we’ll be talking about depression what is depression how do you know if you have it and what are your options for getting support for your mental health during your cancer journey [Music] hi rosie thanks for being with me today so let’s talk about depression depression is something we hear a lot about but people might wonder how do they know if they have depression and how common is it during a cancer treatment cancer journey how do people figure out if they have it and what steps should they take to get help so thanks for asking about depression it’s it’s such an important topic when we’re talking about cancer and it’s incredibly common to experience depression while you’re experiencing cancer or while a loved one is um so it’s actually you asked how common it is um about so about one in three people diagnosed with cancer will experience depression anxiety or both um so it’s a pretty staggering number um and they do often present with mixed symptoms and we’re going to be doing another video on anxiety and cancer as well um so in terms of um in terms of depression um you asked sort of how to recognize you know that that you might be experiencing it um and it’s really tricky when you’re also dealing with cancer because um a lot of the symptoms of depression are are actually symptoms of cancer and it’s treatment as well so things like sleeping too much or too little um feeling fatigued um feeling uh having appetite changes so weight loss in addition to weight loss or weight gain so i’m mentioning some of the ones that actually really frequently overlap with cancer treatment that can be hard to parse out some of the other ones though would be things like feeling a flat affect so kind of feeling like you know you’re not having any highs or really any lows others with depression present more a lot of lows you know feeling really really sad really down all the time some folks might even experience suicidal thoughts um and so i should say anytime i’m talking about depression or mental health i always want to put in right at the beginning there is such a thing as a mental health emergency so if you are ever experiencing suicidal thoughts thinking of harming yourself or someone else call 9-1-1 or go straight to the emergency room or tell a loved one who is in the room with you who knows about you know a safety plan um so that’s a really important piece that i always think i just want to get right out there at the beginning but you know thinking thinking about death is is part of the cancer experience it’s also part of depression um there’s a ton of overlap so i think some people they picture depression just being sad all the time right um but it’s a lot more than that it’s feeling slowed down it’s feeling um like i said can be feeling flat um like you you know like you don’t have much emotion at all um so there’s you know there’s a lot of different criteria for depression um and for major depressive disorder which is the the actual diagnosis that we’re usually talking about when we talk about depression you would need to have a number of these symptoms over a prolonged period of time so if you are feeling some of these symptoms of depression or you think you might be the only way you can know for sure is to be evaluated by a medical or mental health professional so that’s really really important but know that it is common um and i think one of the most frequent ways that i hear from folks who it turns out maybe they are experiencing some depression anxiety or other mental illness is when they say i just don’t feel like myself you know i don’t feel like me um and and that can be a real kind of red flag um another thing is you know if you feel like you don’t want to leave the house or even get out of bed that’s a pretty common early sign of depression you know if you just feel like you want to sleep all the time or can’t really motivate yourself to do a whole lot but again it’s so tricky because if you’re feeling crummy and you’re in chemo you know maybe you don’t want to get out of bed and that’s like really reasonable right so um so it’s complicated and that’s why it’s so important to talk to your medical team about it if you even have an inkling suspicion that that you might be even experiencing a few of these symptoms so what happens if somebody does say i think i’m depressed to the clinician they reach out to their oncologist their radiation oncologist their surgeon and the doctor or nurse pa says oh everybody feels this way during chemo or of course you’re sad how how do you then navigate that where you’re actually reaching out for help and you kind of get the you kind of get squished down or invalidated even that’s a good question um gosh i hope that’s not happening too often um because that can be so hard if you reach out for help and someone says i don’t think you need help um so you know there’s a few different things you can do um if you talk to your oncologist and for any reason they’re dismissive about it um the first thing i would say is advocate for yourself actually and just say you know actually i think this is really serious um here are the ways that it’s impacting my life it’s i don’t think it’s just the treatment and i really think i need help if for any reason you know i hope that you have a medical team that you trust um if if for any reason that you don’t feel like they’re listening or you know if you need to talk to somebody else about it your primary care doctor is a good resource if you have one um so you know you can call your primary care doctor’s office they are equipped to help manage mental illness so you know that’s certainly a resource i would also look for perhaps a different member of your oncology care team so if you talk to one person and they’re dismissive that doesn’t mean that everybody will be there may be an oncology social worker in your cancer center i hope that there is so you can ask anyone on your medical team and say i’d like to speak to an oncology social worker so that’s someone like me they won’t be able to prescribe medication but they can definitely do an assessment make a diagnosis if there’s one that’s appropriate and help get you the care that you need so the most important thing is to continue to advocate for yourself with when you’re dealing with depression it can be so hard because really this is another symptom of depression really small tasks can feel just monumental um so if you don’t know that you’re going to be able to advocate for yourself another thing you can do is bring in a trusted member of your family care team you know a family member a friend um someone who’s close to you um and say hey i’m really struggling with this and i’m i’m not really getting anywhere so can you help me navigate this um and you may need to make sure that they’re on your medical paper where you know that they’ve you’ve signed off that they can you can share information with them um but uh having a patient having an advocate in your team is a really wise decision as well to get the care that you need it’s such a good point that people who are depressed have a hard time sort of overcoming that resistance to doing anything and i love your point about bringing in your family and a friend and other people who love you and they may actually be the ones to notice that you’re not yourself definitely yeah the next thing i wanted to ask you about is this idea of mental illness and how depression is sometimes stigmatized or even unfortunately something that people think you’re just not trying hard enough all of us know people who’ve been depressed who’ve struggled with that like just get up and make your bed and all those tips and tricks about improving your energy level and it can be hard to ask for help because of the way our society views depression and other mental health problems and i think it’s would be really helpful to hear you talk how do you talk with your clients and patients who want to be strong you know they’re they’re running the house there’s the strong woman or the strong person in the family and asking for help for something that a lot of people think is just i hate to say this but a weakness of character or lack of will how have you seen that happen and how how do you hold space for people going through that how do you counsel them yeah that’s such a good point and it is something that people really struggle with um really frequently you know i’m happy to say that i think some of the stigmas around mental illness are that that have been such a part of our society for generations are just starting now to sort of dissipate um so you know it’s kind of on all of us to destigmatize mental illness um and one of the most helpful things to others is to express to share you know what you’ve been through so if you’re a patient who’s dealing with mental illness if you can if you can find it in you to be open with that with the people around you you’re actually going to help make such a difference for people in the future so that’s one thing to say um but if it really does feel uncomfortable to you you’re not alone in that um you know i think it’s important to remember that some of these mental illness effects of cancer and its treatment um you know they’re not just in your head they’re biological experiences that are happening inside your body and inside of your brain and so um to to get a really good understanding of what’s actually happening in the body and in the brain when depression is is a part of life might help um to really understand sort of the medical side of it and that’s something that hopefully your social worker your doctor your np or pa or anyone on your medical team can help educate you on you know to really understand those biological processes of depression or anxiety or whatever it is that you’re dealing with um so that you can you can help kind of conceptualize it for yourself as part of the physical experience the physiological experience of having cancer um and you know when you talk to your loved ones it it’s probably gonna be uncomfortable at the beginning you know it probably is and if you’re somebody who has um who feels a lot of expectations and pressure in the family to be strong and to be you know maybe you’re uh i think you said like the you know the matriarch or the you know a leader in your family it can be really hard to admit that you’re struggling and that goes for the whole cancer experience right all of a sudden you need help roles are changing your adult children might be taking care of you or you know it’s it’s an uncomfortable experience but the more open and honest you can be about what you’re feeling and what you’re experiencing and what your medical team is telling you about those feelings and experiences the better off everyone will be in in helping to manage this and then just knowing that it’s normal to be uncomfortable about this stuff it’s not an easy thing to talk about it’s not an easy thing to live with um and so just giving yourself a lot of grace about you know yeah of course this is uncomfortable like depression is uncomfortable it’s it’s a physically uncomfortable process to feel depressed and so um you know it’s normal to not want to talk about it all the time it’s it’s normal to struggle to be honest with your family um but just the more that you can push yourself to go there and get the help that you need the better your experience will be in the quicker you’ll start to feel like yourself again so you’ve mentioned a few times getting treatment for depression and obviously i always tell my patients i can’t take good care of you which is my job if you don’t give me information so that importance of the connection and conversation and being open and actually asking for help is part of what your medical team wants to do right so but when we talk about treatment are we talking about medications you know you’re already getting all this stuff in your body you’re getting radiation and surgery and there are a lot of people who don’t want to add more things into their body in terms of pills and i i know as a social worker that there are other things people can do instead of or in addition to medical treatment meaning medication can you go through some of those that you found helpful in the years that you’ve been taking care of people with cancer so when i say treatment for mental illness um and for depression i’m not i’m not actually just talking about medication a lot of people hear treatment and you maybe think like okay my treatment for my cancer it’s chemo it’s radiation it’s medical treatment right but treatment for depression is a much broader uh topic than that you know so medication is often a piece of it um i’ve worked with countless folks over the years who have been started on like a low dose antidepressant something like that when they’re when they’re going through treatment and um you know they’ve been nervous about it because there is sort of this stigma around medications that’s similar to the stigma around mental health um that we talked about previously um and you know the truth is that for a lot of those folks they start taking this medication they expect this you know to feel really different to maybe feel off and the truth is they find a few weeks later maybe six or eight weeks later they say oh you know i actually i feel like me i just kind of feel like i can tolerate this a little bit better and it’s like wow that’s wonderful right that’s what we want to see and that’s usually the response that people get um in in addition to medication though which which isn’t necessarily right for everyone we would always want to see someone getting additional support as well so um you know if you are prescribed say an antidepressant it’s likely that your provider is also going to recommend some individual counseling if that’s available to you that’s sometimes available through the oncology social worker in your cancer center that can be a really good resource or you may look for someone locally um there’s good ways to find a therapist would be to um to ask someone on your medical team um to call if you have a local community organization that focuses on cancer or mental illness that’s a good way to find a provider but so yeah talk therapy can be a huge asset to treating depression there are also other things that you can do that can improve that can help improve symptoms of depression so it’s it’s really hard when you’re when you’re depressed but gentle exercise is huge in helping to regulate some of those chemicals that are creating depressive symptoms so if you’re able to get up and go for a walk i know it’s even harder when you’re in treatment but if you are able to get yourself moving get some sunlight some fresh air those things can be really helpful joining a support group which we have another video about if you want to check that out um joining a support group can be a huge help especially one facilitated by a licensed mental health professional particularly if you if you do know that you’re dealing with a depression a diagnosis of depression um it you know it’s good to to talk to a professional and figure out whether that group is going to be a healthy fit for you and then things like journaling gratitude practice yoga and meditation i’m naming these things and they sound sort of like fluff or extra but the truth is that there’s everything i’ve named so far there’s really good research scientific evidence that shows that these things work in helping reduce symptoms of depression and other mental illness in people with cancer um so you know doing things to take care of yourself and remembering to to do things that make you feel like you so things that you enjoyed before that you’re still able to tolerate even when you’re dealing with symptoms of depression and with cancer treatment which can be really hard trying to find time and ways to to connect with those parts of yourself that you used to enjoy um will help bring you back to feeling like yourself but i also think it’s really important to say there’s there’s no sort of like magic bullet in dealing with depression um so you know if if you’re depressed and someone says oh go outside for a walk right that might feel like yeah okay this is bigger than that right so when i’m talking about these things that can help it’s really important to find the combination that works for you no one yoga class or one therapy session is going to be the solution to this problem but a combination of things that can help help get you back regulated can really make a huge difference but the most important thing you can do is ask for help when you need it this is so helpful to think about body soul mind the social aspects of depression and how important it is to be kind to oneself and to continue to think of yourself as a whole person so i really appreciate the recommendations you’ve given one of the things that our people watching this video may wonder about is having access to mental health clinicians people who are you know like you people who are so kind and encourage self-compassionate knowledgeable like you are what if you live in a rural area what if you you know are paid so poorly uh that you can’t afford to have somebody highly skilled and there isn’t a volunteer organization you know these are pain points for people especially with you know the world is as it is we’re all hurting and and what is it like how would you advise somebody who’s on a wait list let’s say for mental health counseling treatment how do how do we respond to those incredible needs for help now yeah it’s it’s so tricky and you know it’s such a shame that these services that are just essential in my opinion can be so costly for folks and insurance it doesn’t always cover it um so one thing to do is to to find out you know if you do have insurance to find out what’s covered before you go in for any kind of therapy because it can it’s very expensive out of pocket or it can be um and so to find out you know to make sure you’re in network and make sure that what your the person you’re seeing is going to be covered is essential if you don’t have access in your area you know if they’re if you live far away from from any mental health professionals or if for any other reason you have kind of you know barriers to access there’s a few different things that you can do one would be to i keep saying talk to your oncology social worker obviously i’m biased because i’m an oncology social worker but if you do have one in your cancer center they often do actually provide short-term adjustment to illness counseling and that can be a huge resource um sometimes you know if you get into therapy you don’t always need to be there for a year every week right some people can get a whole lot out of four or six maybe eight sessions um so you know trying to find some short-term counseling is definitely better than nothing and a lot of times it’s all you need so so asking your oncology team is there someone in the cancer center who provides these services is huge um there are some online and phone-based resources as well so two that come to mind would be the cancer support community nationally provides has a help line that’s staffed by licensed counselors um so that if you go to cancersupportcommunity.org the the number for the help line is there i believe they also have a live chat and there is there’s also an organization called cancer care that i believe has a hotline that’s staffed by oncology or by professional counselors um so calling somewhere like that um the american cancer society is sort of a they have a um like a resource kind of clearinghouse type system in place so if you call them um you’ll talk to a trained uh resource navigator a cancer resource specialist i think they call them who can help point you in the right direction and find out what’s local to your community so um it’s a lot it can be a lot of legwork this is another reason to uh to bring in someone in your family or a you know a friend or chosen family member to help you with this um because it can be a lot of phone calls to make but chances are there’ll be something that you can find either on the phone online or you might be surprised to find something in your local community that’s available one other thing i would mention is you know a counselor for depression does not have to be specialized in cancer so if you don’t have say like a cancer support community or a gilda’s club or um or even an oncology social worker you might have something like um catholic social services or jewish family services or another community based organization that provides things like free counseling um so a lot of times folks just aren’t aware that those things are there because you probably never thought you know you’d find yourself needing them um so doing some some outreach in your own community and finding um you know finding those resources can just be a matter of connecting with the right person so it can take a little doing but there’s a lot more out there than you might realize it’s so important when people are depressed who you can feel so hopeless and what you just provided was a lot of hope a hope that not only is this treatable but that there really shouldn’t be barriers to accessing help for something that’s so important during such an important and challenging for many people time of their lives so thank you so much for that thanks for all the great information and and really useful tips and tricks and resources if this video has been helpful for you if you click like and subscribe that helps other people just like you find this video and don’t forget if you go to yerba.com you can get your personalized report and learn more about your treatment options and what to expect as you go through treatment

What is depression, what are the signs of it? What are the causes of depression during cancer? What are the best ways to cope with it? In this video, Dr. Jennifer Griggs interviews guest Rosie Ingebritson, LMSW about how to cope with depression during cancer.

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Resources for Mental Health:
https://www.cancersupportcommunity.org/
https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/emotional-mood-changes.html
Catholic Social Services (Websites Vary by Location)
Jewish Family Services (Websites Vary by Location)

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