“When the doctor announced my illness, cancer, I gritted my teeth, testifies Adeline, 40 years old. I wanted to be strong for my children, for my partner and for my parents. And then, I think I didn’t really realize it. In a state between denial and the desire to win the battle, I went through medical appointments, examinations and treatments. I was there without being there, super busy with my medical care and, fortunately, very supported by those around me. It was like a kind of whirlwind without respite. I healed. A week or two after the doctor told me it was over, that I didn’t need to see him for six months for a routine check-up, I collapsed.»
Like her, a certain percentage of people who have experienced an illness with long-term treatment develop depression or anxiety disorders after their remission or recovery. «I saw myself resuming the course of my life where I had left off, returning to my job, my usual activities… And I was unable to do so. It’s as if all the fatigue, all the stress, all the fear were hitting me in the face. I was empty and at the same time very anxious and agitated. I cried a lot, I had trouble concentrating. I felt guilty about being in this state even though I was cured, and my companion had a little difficulty understanding what was happening to me. It took me time and psychotherapy sessions to get better.”
These mental health disorders are “a subject often studied for cancer, explains Charly-Nam Hecquet, psychologist and popularizer on the TikTok and Instagram account Culture Psy. Regarding this disease, it is estimated that 10 to 25% of people in remission will be affected by depression and/or anxiety disorders. Fatigue, sleep problems, sadness, loss of pleasure, anxiety, feelings of guilt, poor self-image, difficulty concentrating are all symptoms.
Illness, a physiological tsunami
To understand why this can happen, it is important to understand all the upheaval that illness represents, after which it is a matter of getting back on our feet and finding ourselves again. “From an emotional point of view, from the first consultation, the illness is a fragile period. I tend to say that it’s a roller coaster with no end in sight, expose Charly-Nam Hecquet. The examinations, the announcement of the diagnosis, the treatments are all moments which can generate significant shocks with the weight of the representations surrounding the illness. This can in particular give rise to important existential questions.”
The psychologist continues: “In addition, there is a real upheaval in daily life, for example with going back and forth to the hospital.” To this must be added fatigue, pain and physiological disturbances. “The disease causes a real battlefield on a biological level”comments Charly-Nam Hecquet.
There are also all the upheavals linked to treatments, whether medicinal or surgical, and their adverse effects. The Dre Céline Floret, psychiatrist at the Regional Cancer Institute in Montpellier and president of the French and Francophone Society of Psycho-Oncology, discusses in particular the effects on mood of hormonal therapy used in the treatment of certain cancers such as breast and of the prostate. “Beyond hot flashes, weight gain, sometimes also joint pain, there are effects on emotions and this is true for women and men. It can be quite disturbing”she points out, also mentioning the bodily and physical changes that certain surgeries can induce, particularly for breast and ENT cancers.
Traces et traumas
There is physically and psychologically a before and an after illness. Just like the marks left on the body, existential questions and fears do not disappear as soon as the person enters remission is announced. The latter can play a role in the occurrence of depression but also in the appearance of anxiety disorders, or even symptoms found in post-traumatic stress disorder.
“After recovering from an operation for a pituitary adenoma, I started having nightmares every night, illustrates Sylvain. It was either quite abstract but scary things, or I was reliving the moment when I was being put to sleep for surgery. I barely slept anymore. During the day, I had some sort of flashbacks. I saw myself again in the doctor’s office or in the MRI machine. And I started to be hyper attentive to all the signals that my body could send me. At the slightest fatigue, at the slightest heatstroke, at the slightest pain, I began to imagine the worst.» He tells “felt like I was constantly on a caffeine drip”.
Survivor’s Depression
Being sick also means experiencing a real change in terms of social status, going from being healthy to being sick. This status is a break, it means being considered differently, to a certain extent on the margins of the healthy. It is also sometimes the subject of expectations, if not injunctions. “There is, particularly around cancer, this myth of the fighter which means that the person may not allow themselves to experience certain emotions, to feel everything that overwhelms them”signale Charly-Nam Hecquet.
«This culture of “warrior” which still remains very present can have something beneficial, particularly in giving meaning. But it can also be a little dangerous and exclusionary with the idea that those who do not fight the disease are weak. Furthermore, after the fact, if we have forged this identity of warrior, what becomes of us? Someone who put away the weapons?», asks the Dre Celine Floret.
“I spent a few weeks in a stupor, not really knowing what to do with myself.”
In fact, having overcome the ordeals of illness as one fights the battles of a war, by charging forward without respite and without allowing oneself to be afraid or sad, there is the risk of finding oneself as lost when The armistice is declared and we return home. This is one of the reasons why this depression which occurs during remission is often called depression survivorship in Anglo-Saxon literature. “We survived, but what do we do now?”means this term to us.
«After my recovery, I was in a strange state, testifies Pierre, 45 years old, who suffered a stroke. For several months, my life was punctuated by medical appointments, physiotherapy sessions, etc. And, suddenly, I no longer had anything planned. It left a sort of void and I no longer knew how to keep busy. And everything came back: fatigue, the feeling of having escaped death, the fear of what would have happened to my husband if I had died… I spent a few weeks in a state of stupor, not wanting to I don’t know what to do with myself.”
If falling ill can be seen as a downgrade, so can getting well, in this game that touches on identity. «In breast cancer, in particular, there are many very active associations, magazines, sporting activities, all a community and a strong sound dimension, explains the Dre Celine Floret. All this gives a strong identity and it can be difficult to move on, even if some women continue to be involved in community life after their recovery.»
Gendered and social risk factors
So, obviously, not everyone is affected in the same way by possible psychological distress after remission of an illness. As Charly-Nam Hecquet explains, “there are predisposing factors such as the pre-existence, for example, of an anxiety or depressive disorder, and risk factors such as young age, being a woman or lack of social support, which are not relevant not determinism though.”
What to do about this? It is undoubtedly important for the person concerned and their loved ones to know that this distress can occur during the remission phase or after recovery. Leave space, without guilt, for emotions to be expressed. And ensure that social support is maintained.
In addition, you should not hesitate to seek help from a psychiatrist and/or psychologist, who will be able to set up follow-up. “Cognitive and behavioral therapies and psycho-education are often recommended”explains Charly-Nam Hecquet. For its part, the Dre Céline Floret insists on the benefits provided by adapted physical activity. Add to this other supportive care such as socio-aesthetics, sexology or even nutrition.
Source: www.slate.fr
