Topic: Pre-existing mental illness now w/cancer

Forum: Breast Cancer with Another Diagnosis or Comorbidity — Meet others who have breast cancer but also have another health diagnosis/comorbidity such as diabetes, MS, bipolar disorder, HIV or AIDS, Parkinson's Disorder, schizophrenia, etc.

Posted on: Sep 10, 2010 11:47AM

Posted on: Sep 10, 2010 11:47AM

bellapazza wrote:

I did not read through the endless pages here, I'm sorry.  But new.  I see there is a forum and I've favorited it re: anxiety, depression, PTSD as a result of cancer, but I have had severe anxiety and depression my whole life, and now breast cancer -- I am 51.  I also have a limited support system and a very poor marriage.  My family was seriously dysfunctional and abusive.  No one left either ... which in a sense is good.  I'm an only child as well.

I don't know how to deal with this.  I have a therapist, am on psychiatric meds.  I'm awaiting an Oncotype Dx which if low would spare me that horror, but I've also been told I will need 5 years of Tamoxifen.  Apparently the side effects of that are anxiety and depression which I have anyway!

I am on three psych meds which apparently don't need to be changed, but I cannot function without them.

Is there another forum that deals with this specifically?  I will continue to post in the other forum.  I am also considering a Blog to add to a website I have about my experience with mental illness.

Thank you all strong women out there!

What a journey we all must take!

Tamoxifen 9/26/10, Oncotype 10 Dx 7/13/2010, IDC, 2cm, Stage II, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Oct 26, 2017 11:56AM Foosfan72 wrote:

Hi Auroaya,

Thanks for the reply. I had a typo in my post. It should have read Lupron. I am currently on Celexa 30mg and Lamictal 150mg. I had a bad reaction to decadron during chemo but I compromised with my oncologist to only take it with the infusion and not take the additional dose at home. I'm going to take your suggestion and look up interactions before consulting with my oncologist before hormone therapy starts.

Best wishes to you.

Paula





Dx 3/3/2017, IDC, Right, 3cm, Stage IIIA, 8/10 nodes, ER+/PR+, HER2-, Dx 3/3/2017, IDC, Right, 3cm, Stage IIIA, 8/10 nodes, ER+/PR+, HER2-, Surgery 4/23/2017 Chemotherapy 6/7/2017 Radiation Therapy Hormonal Therapy
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Oct 27, 2017 07:52AM Faithonfire wrote:

hi, I am still kicking after treatment 10 of 16, but have had a few setbacks that really knocked me down and it's been hard to cope with it all.

I had a bad reaction to Benadryl with my taxol treatment that I had to endure for 3 weeks because of the respiratory risk with the drug. During this time I picked up a cold and despite clearing 2 chest X-rays and not missing a single treatment but I bruised my ribs on my left side from coughing!

I was adamant before we started my treatments that we avoid as many narcotics as possible because I was concerned about side effects and dependence being much greater for me living with ptsd during this health crisis.

After every alternative failed, I had to use narco 5 mg and 325 acetaminophen to maintain self care. After about a week the pain level continues to get worse and the narco does nothing to improve my quality of life at all now.

I have found that sea salt baths are most helpful and aromatherapy helps me stay calm as I pray for help and patience to make it through my endless days of therapy.

My therapist is very concerned that the recent opioid crisis is greatly changing how cancer pain is being handled and treated by doctors.

Having a ptsd diagnosis to start off my stage 3 breast cancer left me trusting on blind faith that all my hard work for years of documented therapy and medical records to confirm my repeated denial of narcotics for other medical options would be taken seriously and I would not be denied pain relief if I said it was too much to handle with any other alternative.

Last week I was, and with tears in my mothers eyes we sat together bewildered at the response we got after I was cleared for treatment. If my blood tests still look as good as they tell us, how can I be falling apart physically and emotionally this severe?

I am reporting my side effects and clearly showing my entire prescription history of every dose and duration to every specialty team I work with and I cannot help but to feel punished for being transparent and asking for help with severe breakthrough pain.

I have never displayed any drug seeking behavior despite multiple surgeries and trauma injuries in my medical history, and I was left feeling like a junky begging for relief because every last non narcotic option had been tried and failed to control my pain so I could even care for myself.

I felt ashamed that I could not just "suck it up" or that my ptsd was not even considered in the decision of how to address my pain and fear during treatment.

My therapist and I agree that I am not asking for anything unreasonable and the manner that my request was handled brings to sharp focus the need for sensitivity training in the medical community for mental health rights and patients with combined chronic diagnosis having treatments that disrupt prior mental health treatments already being used at the time of additional diagnosis to be treated for the entire prognosis simultaneously.

This issue is very personal for me, I am a very strong advocate for mental health and very dedicated to making this an opportunity to start some important discussions about the critical issue of how to handle being put in severe pain after being told you cannot have relief provided by the very doctor that promised to protect you from that breaking point.

After all the pain fear shame and guilt I have had to endure in my life, nothing broke me more than being made to feel that for being honest about what I am feeling and asking my doctor that I trusted to save my life for help and being denied without explanation or a word face to face.

It's very fortunate that I have a great therapist to help me through this crisis, but I felt this was important enough to share with you all so together we can change the standard of care for anyone who feels that they are not receiving the quality of care they deserve because of combined diagnosis.

I will try to stay strong and let you all know how surgery goes once I find the right team of doctors to use for my double mastectomy and reconstruction but after my first appointment went so awful I can hardly bring myself to think about that yet.

I don't have the strength to tell that tale now, and until I find any good from it to share I will keep it to myself and pray nobody ever has to be made to feel the way I was by being given incorrect information in such a manner by a doctor claiming to have had breast cancer

Dx 6/25/2017, IDC, Both breasts, Stage IIIC, ER+, HER2- Chemotherapy 7/13/2017 Abraxane (albumin-bound or nab-paclitaxel), Cytoxan (cyclophosphamide), Doxil (doxorubicin), Methotrexate (Amethopterin, Mexate, Folex), Taxol (paclitaxel), Taxotere (docetaxel) Chemotherapy 9/1/2017 AC + T (Taxol) Surgery 1/8/2018 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/8/2018 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction, Tissue expander placement; Reconstruction (right): Nipple reconstruction, Tissue expander placement
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Oct 27, 2017 03:22PM auroaya wrote:

Faith on fire im sorry you were mistreated the way you did. I’m lucky that my pain is controlled by 800 mg ibuprofen because I am a recovering alcohol and pill addict. I also tell all my doctors my pre existing mental conditions and thankfully I’ve been lucky and I feel they understand me.

My only suggestion is if your current team dos not treat you with respect to your personal needs I would look for second or even third opinions and switch to an oncologist who understands.

Thank you for advocating for mental health. Now that you have to deal with breast cancer in addition to pstd you are going to self advocate also in that area.

I’m sending you cyber hugs!

Aurora

Dx 12/23/2009, Stage IIA, 11/16 nodes, ER+ Chemotherapy 1/9/2010 Taxotere (docetaxel) Surgery 5/4/2010 Mastectomy: Right Hormonal Therapy 8/31/2010 Radiation Therapy 8/31/2010 3DCRT: Breast, Lymph nodes Dx 7/17/2013, Stage IV, 0/0 nodes, mets, ER+ Hormonal Therapy 7/18/2013 Arimidex (anastrozole) Radiation Therapy 8/31/2013 3DCRT: Bone Chemotherapy 3/22/2015 Abraxane (albumin-bound or nab-paclitaxel) Hormonal Therapy 4/11/2016 Faslodex (fulvestrant) Targeted Therapy 4/11/2016 Ibrance (palbociclib) Surgery
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Oct 29, 2017 11:55AM Faithonfire wrote:

thanks so much for all the hugs and encouragement! I am still fighting the good fight and my therapist completely supports me in my struggle to keep the medication to a minimum without compromising the quality of care I receive.

I had 10 months alcohol free before I was diagnosed without aa so I am sure it won't be a problem to handle the pain medication after surgery with a plan in place now to address it as well as the shifting industry standards on pain management in general and how to ensure doctors are held accountable for their decisions on drug choices in a more public manner for transparency in treatment for each patient!

I hate to be turned in to a tattle tale this way, but if a stage 3 cancer patient with complications does not deserve pain medication to treat the side effects of chemotherapy drugs they are all too happy to give me then who does?!?!

Those are the questions nobody wants to answer, and that's the real problem driving the national crisis of addiction that puts the blame squarely where it belongs! It is not my fault I need them, because I didn't need any until treatment started and not being treated at all is not an option I will survive!

Being expected to just suck it up and accept no explanation why is a level of disrespect all too common in doctors that WILL no longer be tolerated in any professional setting.

As a parent I feel active shaming would be most effective for social enforcement of morality in a field so painfully devoid of personal accountability for their direct effect on people's lives. The letters md after a name are just a description of job skill, and makes no person above reproach for their personal or professional behavior.

TIme we make that reality as painful as the conditions that demand their care

Dx 6/25/2017, IDC, Both breasts, Stage IIIC, ER+, HER2- Chemotherapy 7/13/2017 Abraxane (albumin-bound or nab-paclitaxel), Cytoxan (cyclophosphamide), Doxil (doxorubicin), Methotrexate (Amethopterin, Mexate, Folex), Taxol (paclitaxel), Taxotere (docetaxel) Chemotherapy 9/1/2017 AC + T (Taxol) Surgery 1/8/2018 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/8/2018 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction, Tissue expander placement; Reconstruction (right): Nipple reconstruction, Tissue expander placement
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Nov 3, 2017 12:44AM Faithonfire wrote:

Thank heaven I made 11! I had treatment on Halloween and dressed up as eeyore so it was a nice subtle commentary on my outlook on chemotherapy lately.

So after I put my foot down about being told my pain was not valid enough to treat properly when I asked at treatment after clearing my 3rd chest X-ray in 3 weeks I bet I glow from space by now!

I took a trip in to the emergency room for a Ct scan Friday this time and I was ok but in visibly bad shape enough to get some more appropriate pain options like a lydocane patch for my left side until I get in to palliative care before surgery. This had a nasty tendency to be so overbooked that patients can't get in for pain management until chemotherapy treatments are almost complete in many cases.

Oncology Doctors ditch any pain med request to an office the patient cannot get an appointment with until the pain is unmanageable due to lack of proper care by direct doctor causing pain with the treatment given to patient!

Everyone knows how much chemo hurts and sucks so much to be told to just suck it up because it only hurts if we acknowledge it does! I have a very high pain tolerance fortunately but extremely low for indignant lack of compassion!

To have a separate department for pain management that patients can't get appointments to instead of leaving that to the treating doctor's discretion like any other facility? It makes no sense to anyone except the doctor and their ability to manipulate care issues like pain management by claiming they do not have the ability to properly manage the drugs that treat pain, only cause it!

Not what I signed on for in any circumstance and I am extremely vocal about the attempts to shame me in to accepting the level of pain I was in because my doctor didn't feel like reporting the severity of my issues related to my specific treatment. I was on much stronger drugs the first 8 weeks and felt nothing close to as bad as I am now that it was switched to just taxol.

Taxol is a new level of raging hell I never knew existed and the more problems I am experiencing each week the more I am pushed to finish out my last 5 treatments and just be done! Don't have much of a choice considering how I have to pick my battles here, but I will see to it that ALL my symptoms are directly reported along with a professional review of my medical report upon completion.

I think that kind of determination will reshape the healthcare experience by keeping doctors more aware of the direct concequence of their specific drug choices should be based on the patient medical profiles and the best options on the planet instead of what smug drug company representatives give for filling quotas of their "industry standard" products and prevent any research proving validity to serious side effects or how long one must suffer from them to be considered permanent!

Nobody likes a sucker punch, and I probably would have gone about the issue in a less hostile manner if it were not for the cheap attempt at character assasination I was made to feel for my persistence.

If me asking not to be in pain during treatment makes me a junkie? What does that make the person I pay to put me in pain but refuses to relieve it as promised? Disgraceful!

In breach of contract to say the very least... but the charges get as large as their egos because the world does not need people practicing medicine just to get rich at patients expense.

Ha, after winding me up that far I bet the one question that will remain to haunt them the longest is what if we had just done our job without pushing their version of morality on me for reporting severe symptoms instead

Dx 6/25/2017, IDC, Both breasts, Stage IIIC, ER+, HER2- Chemotherapy 7/13/2017 Abraxane (albumin-bound or nab-paclitaxel), Cytoxan (cyclophosphamide), Doxil (doxorubicin), Methotrexate (Amethopterin, Mexate, Folex), Taxol (paclitaxel), Taxotere (docetaxel) Chemotherapy 9/1/2017 AC + T (Taxol) Surgery 1/8/2018 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/8/2018 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction, Tissue expander placement; Reconstruction (right): Nipple reconstruction, Tissue expander placement
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Nov 16, 2017 01:04PM Tigger51 wrote:

Hi

I am in the beginning of this difficult journey with preexisting bipolar and now stage 1 breast cancer. I am petrified beyond belief to even try hormonal treatment of any kind. Only my psychiatrist has any understanding of my immobilizing fear. I. Have scoured the Internet for any information regarding hormone treatment and bipolar to only find two articles and a psychiatric oncologist who told me we have lots of meds to control symptoms. I am on five meds already to control my bipolar. HELP

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Nov 16, 2017 03:55PM auroaya wrote:

Hi Tigger welcome to the thread but I wish I was under different circumstances. I’m bipolar too which is controlled with Cymbalta 60mg Depakote 500 mg and risperidone 2 mg. I totally understand your fear but let me tell you that I’ve been navigating these diseases for7 years and I only had problems when I ran out of insurance and I ran out of my meds for bipolar I was without them for a month and I don’t have to describe the hell my life turned into on that month. After I got back on the meds things got bettter and have stayed the same since. The only contraindication I found was when I was taking Prozac and tamoxifen (one of the anti-hormonal) but I went to my psychiatrist and he switched me to Cymbalta. Let me tell you Cymbalta is the bomb. Not only helps control my mood swings but it helps with joint pain which can be caused by the anti- hormonal.

Please try to overcome your fear as nowadays breast cancer is controlled even at the late stage like I’m in.

Don’t hesitate to come here and share and if you need help I’ll try to help in anyway I can.

Aurora


Dx 12/23/2009, Stage IIA, 11/16 nodes, ER+ Chemotherapy 1/9/2010 Taxotere (docetaxel) Surgery 5/4/2010 Mastectomy: Right Hormonal Therapy 8/31/2010 Radiation Therapy 8/31/2010 3DCRT: Breast, Lymph nodes Dx 7/17/2013, Stage IV, 0/0 nodes, mets, ER+ Hormonal Therapy 7/18/2013 Arimidex (anastrozole) Radiation Therapy 8/31/2013 3DCRT: Bone Chemotherapy 3/22/2015 Abraxane (albumin-bound or nab-paclitaxel) Hormonal Therapy 4/11/2016 Faslodex (fulvestrant) Targeted Therapy 4/11/2016 Ibrance (palbociclib) Surgery
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Nov 16, 2017 06:43PM Faithonfire wrote:

hi tigger,

so sorry you are joining us on this long road but I hope a few things I have learned so far might help a little.

I had ptsd for at least a decade before stage 3c breast cancer and had been completely medication free for years using only cognitive behavior therapy for symptoms before my diagnosis.

Needless to say the combined diagnosis left me in a position where that was no longer a viable option for me and some of the side effects of the nessicary medication during chemotherapy like taxol or steroids made my symptoms infinitely worse on top of new awful things I have never experienced.

I found it critical to have a great therapist see me every week to help me keep it together and stay positive in a way no family or friends can. He helped me understand what is happening to my body and mind at the same time as we make sure the treatment plan and goals are followed by the entire cancer team.

That little ace in the hole is invaluable when challenging treatment decisions and advocating for the best care possible. It gives me the strength to focus on healing myself.

I hope you find everything you need to aid you in your treatment and healing also, I'm happy to answer any questions you think of about new options I have had experience with.

Dx 6/25/2017, IDC, Both breasts, Stage IIIC, ER+, HER2- Chemotherapy 7/13/2017 Abraxane (albumin-bound or nab-paclitaxel), Cytoxan (cyclophosphamide), Doxil (doxorubicin), Methotrexate (Amethopterin, Mexate, Folex), Taxol (paclitaxel), Taxotere (docetaxel) Chemotherapy 9/1/2017 AC + T (Taxol) Surgery 1/8/2018 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/8/2018 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction, Tissue expander placement; Reconstruction (right): Nipple reconstruction, Tissue expander placement
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Nov 28, 2017 10:49AM blooming wrote:

Hi All,

I'm a seeking some help about the issues of depression (or bipolar depression) and aromatase inhibitors as I prep for a visit to a MO for a second opinion (urged by my other docs because the first MO suggested that I take Tamoxifen even though I'm postmenopausal). Sorry if others have addressed these issues.I've tried to comb through other posts on bco.org but I'm feeling overwhelmed!

I just found this thread about pre-existing mental illness. I realize that situations differ according to specific treatments that each of us needs for our breast cancer and for our specific mental health issues. At this point the treatment issues for me focus on hormone suppression.

My pre-existing Issues:

  • Mood: I have longstanding depression (reclassified at one point as BP type 2) that has been very well-controlled for years on lamictal (typically used for epilepsy that stabilizes mood). I have not reacted well to anti-depressants especially to the newer ones now being tried to aid with joint pain associated with AI.
  • Other Health:I have joint and orthopedic pain, especially arthritis in knee and spine (stenosis and disc problems) that affect my mobility and my ability to exercise. I am overweight with type II diabetes (currently controlled with diet alone).I'm concerned about the potential side effects of hormone suppression and the ways that hot flashes and lack of sleep could aggravate my depression and make it difficult for me to concentrate on work responsibilities.All in all, I'm worried that the combination of factors could lead to a very unhealthy spiral, making it difficult to exercise and to watch my weight, etc.

I reached out on bco.org in April.(Since then, I've been going through other things and now am about to start AI.)I'm figuring that others might have some thoughts. I've just tried to identify medical literature about depression and hormone suppression or AI and I'm feeling a bit overwhelmed.

  • Have any folks with major depression, esp. BP 2 depression, come through without SE's. Was this serendipitous? Are there any steps you took to minimize mood SE's?
  • Did any of you see a psychopharmacologist or other specialist for consult to help with choice of hormonal medication **or** for protective strategies (meds or otherwise)?
  • In the hormonal therapy comparison chart, only one med —not an AI but Tamoxifen – is listed with mood or depression SE's. Are those with depression more vulnerable to mood SE's or so some experience mood SE's but not enough folks that it's listed in the comparison chart?
  • Any complementary techniques help?(Accupuncture, tai chi,
  • Any other advice?I think I saw some folks using benadryl to help with joint pain.Gee, that could help in long run.

I'd appreciate any ideas or insights! I'm going to check for other relevant threads but please do let me know if you think I should be posting this on a different forumThanks so much.

Blooming

Dx 1/18/2017, IDC, Left, ER+/PR+, HER2- Surgery 3/30/2017 Lumpectomy: Left; Lymph node removal: Sentinel Surgery 5/18/2017 Radiation Therapy 7/10/2017 Whole breast
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Nov 28, 2017 01:21PM auroaya wrote:

Hi blooming I have BPD and I’m takin 500mg of depakote for mood swings I’m also taking 60mg Cymbalta for depression and join pain and risperidone 2mg it has kept me stable during my 4 years as a stage IV breast cancer patient the only difference is I went to my psychiatrist and he switched me from Prozac which had contraindications to the Al I was taking and he switched me to Cymbalta first 30 mg and upon further examination raised to 60mg that was 4 years ago and everything good. I suggest you contact your psychiatrist before starting Al I too am overweight and the Als did made me rounder around the middle but that is a se that many patients get with or without psych problems. Having a good psychiatrist and counselor that are well versed in breast cancer would be great.

If I was you I wouldn’t worry too much right now the important thing is to bring the tumors down and the cancer cells out of the way. If you have any questions you can PM.

Others may be able to help you.

Aurora


Dx 12/23/2009, Stage IIA, 11/16 nodes, ER+ Chemotherapy 1/9/2010 Taxotere (docetaxel) Surgery 5/4/2010 Mastectomy: Right Hormonal Therapy 8/31/2010 Radiation Therapy 8/31/2010 3DCRT: Breast, Lymph nodes Dx 7/17/2013, Stage IV, 0/0 nodes, mets, ER+ Hormonal Therapy 7/18/2013 Arimidex (anastrozole) Radiation Therapy 8/31/2013 3DCRT: Bone Chemotherapy 3/22/2015 Abraxane (albumin-bound or nab-paclitaxel) Hormonal Therapy 4/11/2016 Faslodex (fulvestrant) Targeted Therapy 4/11/2016 Ibrance (palbociclib) Surgery

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