Episode 04.Depression: 7 Stages of Grief

A warning this episode features a brief discussion of suicidal ideation. Please consider this when accounting for how and when you'll listen. I'm Caitlin Rouse and I'm Kevin Adams and we're going through it. Hello podcast listeners. I'm Caitlin Rouse and he is Kevin Adams. Welcome back to Going Through it. This is a podcast dedicated to how we both are navigating a very chaotic year together. We are talking about cancer diagnosis, cancer treatments, surgeries and now new parenthood. Come back, welcome back. This week we are talking about depression. As you probably heard on the top of this episode, this is already going to be a heavy one. The depression stage for me was very real and very raw. Choosingtherapycom defines depression as quote depression stems from internalized or repressed anger. In this stage, it occurs when time has passed for the ramifications of a significant loss to become clear. This stage can manifest as reduced concentration, inability to sleep and sleeping too much. You may have physical symptoms like headaches and body aches, or digestive issues as well. Feelings that may accompany the depression stage of grief are as follows Loneliness, sadness, emptiness, anhedonia, which is the inability to feel any joy from anything, and, lastly, self-pity. So this one, this stage of grief, depression in general, this was the toughest for me. As you can imagine, I had ample opportunity and circumstances to retreat into some pretty dark spaces. This did not occur for me until Leo was born. However, it happened very quickly and very suddenly after his birth. So there's already postpartum depression. Right, this is a really real thing. It's very common and affects more than 3 million women per year. The Mayo Clinic states that postpartum depression is not a character flaw or a weakness. Sometimes it's simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and help you bond with your baby. Some symptoms of postpartum depression include depressed mood or severe mood swings, crying too much, difficulty bonding with your baby, withdrawing from family and friends, loss of appetite or eating much more than usual. Inability to sleep, called insomnia, or then also sleeping too much. Overwhelming tiredness or loss of energy, less interest and pleasure in activities you used to enjoy. Intense irritability or anger, fear that you're not a good mother, hopelessness, feelings of worthlessness, shame, guilt or inadequacy, reduced inability to think clearly, concentrate or make decisions, restlessness, severe anxiety and panic attacks, thoughts of harming yourself or your baby, reoccurring thoughts of death or suicide. Along with postpartum depression after childbirth, there also exists a possibility of developing postpartum psychosis. The symptoms here are more extreme and tend to develop very shortly, a week after birth to be precise. These symptoms include feeling confused and lost, having obsessive thoughts about your baby, hallucinating and having delusions, having sleep problems, having too much energy and feeling upset, feeling paranoid, making actual attempts to harm yourself or your baby. Studies have also shown that new fathers or partners can also experience postpartum depression. They may feel sad, tired, overwhelmed, anxious or have changes in their usual eating and sleeping patterns. Postpartum depression in fathers or partners, sometimes called paternal postpartum depression, can have the same negative effect on partner relationships and child development as postpartum depression in mothers can. So we're already susceptible to potentially developing some real depression just in the way of having a child, pile on cancer treatments, watching the slow deterioration of my body surgeries and side effects of said treatments and surgeries. Now being on the other side, I feel like a mental gold medal Olympian. I want to talk more about something I said at the top of the show that my depression didn't hit or sink in until Leo was born. That could very well be because of postpartum depression, but I think for me it was how I had been mentally managing my experiences and my ongoing grief. I thought up until Leo was born. I really allowed myself to take it one day at a time To celebrate my small wins, small victories. It didn't matter if I didn't do anything all day and all I did was unload the dishwasher. That's a victory because it's not nothing, and this day to day outlook worked really well long term for me. But whoa, if there isn't something about a newborn baby, they just immediately rocket you into the future. I would sit and hold my baby son, look at his little face, count his little toes, account for each and every fingernail and find myself musing about his future. Who will he grow into? What interests will he have? I wonder what hobbies he'll be into. I can't wait to love him for every single one. I can't wait to wait. Hold on a moment. Aren't I in the middle of a life-threatening disease? Is this about to get a whole lot worse? Hold on. What if I don't make it? Is that a possibility? Could I really not be alive at the end of all of this? What if I do miss the person he grows into? What if I never see who he becomes? What if he grows up without a mom, without knowing his mom, without me and his life at all. Could I not wake up tomorrow and never see Kevin again, or my sister? How can this even be real thoughts that I'm sifting through. I want to live. I don't want to die. Could I die? It was at this point I really started to comprehend what I was up against. It had not become clear to me until that moment, until I was holding my little baby Leo, that I realized phrases like survival rate and likelihood of mortality were directly correlated to my situation. As I begin coming to these realizations, with each new thought or question, I start to feel the ground chip away around me a little more, each one cutting deeper than the last. After a couple days of this, I started to feel like an island. The earth had been completely chipped away from all around me and I was just adrift, completely isolated, floating away from my family. There's something impenetrable about the feeling of isolation. How could anybody else even possibly begin to understand how I felt? As this depression sunk in, I really started to become sad and then angry. Angry and then sad. I'd move through hospital appointments, and it's at this point. I'm at the hospital three to five days a week, even, from reception, nurse assistance to just people on the street I see I start to become frustrated with. Look at how lucky they are, able to sit at a desk and text who knows who, thinking their problems are large. My life is on the line and they're healthy, relatively happy, able to go on about their day. And it's also at this point that I really start to look sick. I've lost all my eyelashes and my brow hair. Every last hair on my head. I've developed what my oncologist called a chemo rash. It covers the top of my bald head, down my face, neck and chest. The rash is bright, red and pink, mimicking rosacea. On top of that bright, red and pink rash are large pus shawls as well as deep, painful bumps. Watching my face feels so foreign, like a combination of bubble wrap and a popcorn ceiling. As someone who worked within the beauty industry for close to 15 years, let alone just any human in general, it was nauseating to look at myself. I don't know her. The same trader. Joe's bags I cut up to put on the floor. As I shaved my head, I taped them over my bathroom mirrors. I can't stand to look at my own reflection. I look like a monster. I hate that. This is the face that my newborn baby looks into. It must be so terrifying. I start to think this might actually be it. I start to think it's actually a good thing that I did have a child, because my son looks so much like me. I wish I did more with my time. I wish I left more of an impact on this earth. I'm so mad at myself for thinking oh, I'll do that later or I'll pursue that in a couple of years At least my family and loved ones will have my son to look at and remember me by. Why wait for a long, drawn out, excruciating or agonizing death? Watching my body decay in slow motion felt like a horrible way to go. Should I just take charge of things now? I could make it easier. It's at this point I realize I'm not well. Of course my body is physically breaking down and deteriorating, but mentally I am not okay. The feelings of isolation are guttural. I weep into my hands in the shower, into my pillows at night, loud, painful sobs that sound broken down and shake my whole body. I'm dying and I've never felt so alone. My mother has been depressed for most of my life. My parents divorced when I was 14 and instead of a physical deterioration. I had to watch on as my mother mentally and emotionally deteriorated into someone I did not recognize. Because of this and the impact it had on me when I was in my most formative years into my adult life, I became hypervill—because of this impact it had on me. When I was in my most formative years Into my young adult life, I became hyperv—I became hyperv—oh my god vigilant Into my young adult life. I became hypervigilant. Into my young adult life. I became hypervigilant on my mental health, seeing many different therapists on and off throughout the years, never truly finding the right fit. Before moving I had found someone great, a great fit for me, but she was pretty much booked solid and my insurance didn't cover all of the fees. The hospital actually has a social worker for oncology patients and my nurse navigator had been helpful with getting me in touch with her in the past. The moment I feel my thoughts drift, even at the loudest points. They're still at a whisper, but that whisper is saying to no longer be here. I know I need to talk to someone. I call my nurse navigator and she puts me back in touch with the social worker. They also get me in touch with the psychiatric liaison nurse who specializes in oncology, to evaluate me. After a few talks during my treatment, she determines I don't quite fit the bill for SSRIs. Ssris are widely used and are a type of anti-depressant medication. They're mainly prescribed to treat depression particularly persistent or in severe cases. However, I think we both knew my condition was not permanent. I just was incredibly overwhelmed by the prospect of fighting for my life. I'd like to cite something I read from the Stanford Center of Integrative Medicine. Stanfordedu writes many cancer patients go through episodes of depression. Depression makes your entire experience with cancer more difficult. We can show resilience and may hamper your overall adjustment. It also can undermine your will to live and compromise the courage, fortitude and determination that you need to face cancer and endure the necessary medical treatments. Depression is the exact opposite of what you need Energy and stamina, a vision of a brighter future, hope that inspires and sustains you, and the motivation and commitment to travel through the arduous road of cancer therapy. Cancer confronts us with our mortality and all the fears and losses associated with it. It can turn your world upside down, disrupting your life and threatening the roles, purposes and goals that give you meaning and satisfaction. Depression is therefore a serious threat to anyone dealing with cancer. Looking back now, I have no clue how I did it. When I dig deep inside myself, I pulled something out of what felt like less than nothing. I'm being really honest, listeners, I'm still in it. Cancer seeps its ugliness into every facet of your life my aspirations, my goals, my happiness, my resilience, work life, home life, mental and emotional health, financial health, especially living in the US that last one, financial health, more to unpack there on another day. Now, when I think about ciders looking in on our life and my life, and I think the general feeling is I survived, I'm on the upswing. It's only better from here. The reality is that I'm starting over from less than nothing. Cancer bled me dry of all of our resources, all of our financial stability, my health assurances, my sex life, my family life, my general well-being. We are having to rebuild, starting with bare-bone basic tools. In a way, I almost feel like I'm 17 again, trying to strike out on my own, except this time I'm starting out in a ton of medical debt and with a baby. It's exhausting most days and it's really hard. I would be lying if I said I still don't get depressed. This part is horrible, but I am alive. I can't believe it. I survived. I get to hug my son. I have a son. I delivered him while I was in active treatment for cancer. I couldn't nurse him because I had a bilateral mastectomy. I had my entire chest ripped out and then rebuilt. I had to understand that nipple sparing said sparing, because that's exactly what they were doing sparing my nipples. I've lost so much of myself, my body and my mind to this. Most of that I will never get back. Watching the sun rise or set, hearing my son laugh, feeling the wind dance across my face, my neck, my legs, just breathing. Every day I'm more thankful than the last. Even on the hard days, there is more to my story and I get to control it. It's so much harder now, but being alive grants me some sort of control. I am here and I can hear, smell, touch and taste. I can laugh, I can live. To my dear, dear listeners who are facing anything remotely similar to what I have, please know that you are strong, you're graceful, you're beautiful, even when you don't feel like it, even when you look in that mirror and you don't recognize a person staring back at you. You are capable of fighting in so much more. If I can do this, you can absolutely do this. You are light and you are love. We always choose love here. Thank you so much for listening to Going Through it. We'll be back the week after next week To unpack another stage of grief. 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