The Cancer and Mental Health Equation

You might have noticed October is Breast Cancer Awareness Month. Perhaps you’re all too aware of the fact it’s breast cancer awareness month, because every month feels that way to you. You, like me, might have very mixed feelings about breast cancer awareness month. But before the calendar page flipped and turned from September to October, my pals at Breast Cancer Care launched an incredibly important campaign.

Because the thing is, they do this stuff all year round. They advocate for patients 365 days a year, like so many other amazing charities do. But this caught really caught my attention because it focused on the mental health impact a breast cancer diagnosis can have on a patient. It’s a report that explores the way people feel after going through 10 months, or more, of relentless treatment that strips you of your wellbeing, your fitness, your identity. Because that’s the thing. Breast cancer goes well beyond the tumour that grows in your breast. You know all this because of how much I talk about it – but this campaign from Breast Cancer Care, in partnership with Mind, goes to show just how far reaching these issues are and that I’m far from alone in this.

Over 8 in ten (84%) women with breast cancer in England are not told about the possibility of developing long-term anxiety and depression as a result of their diagnosis.

The research also reveals that 33% of the 3000 women surveyed experienced anxiety for the first time in their lives after their diagnosis and treatment, while almost half (45%) experience continuous fear that the cancer may return, which can severely impact day-to-day life. These figures aren’t really a surprise to me, but it’s pretty sobering to see them written down in black and white. That so many people live in fear or with heightened anxieties as a result of their cancer diagnosis probes that the support patients receive needs to continue long after being told they don’t need to come back to the hospital until their annual check up.

Screen Shot 2018-10-26 at 14.13.49.png

Samia al Qadhi, CEO of Breast Cancer Care explained “We know people expect to feel better when they finish treatment and can be utterly devastated and demoralised to find it the hardest part. And though the NHS is severely overstretched, it’s crucial people have a conversation about their mental health at the end of treatment so they can get the support they need, at the right time.”

The body- mind connection is undeniable. The two are inextricably linked, and when one is put under pressure, the other naturally struggles too. Stephen Buckley, Head of Information at Mind, says:

“It’s understandable that being diagnosed with or treated for something as serious as breast cancer will impact someone’s mental wellbeing, even if they have never experienced a mental health problem before”.

And it is totally understandable. I spoke to a CBT practitioner at a festival a few months ago and she compared cancer treatment to falling off a cliff edge. You have hit every single branch on the way down and found yourself at the bottom of the cliff, battered, bruised, broken and completely dazed having fallen several hundred feet. But then someone comes to you and says “yeah – but you’re alive, time to get on with it!” but life doesn’t work that way. Because you can’t fall that far, hit the ground that hard and not need some time to process it.

I think the call for support from these two charities is absolutely crucial – but more pertinent to me is the reminder that those who do find it difficult to restart life after cancer, aren’t alone. There are many more of us who struggle beyond treatment than the world would have us believe.

cold,smooth& tasty. (2).jpg

There’s another thing that I think we don’t really talk about enough – and that’s those people who have a history of mental health issues and are then diagnosed with cancer (and I talk about cancer here because this is what I know, but I feel the same about any illness). What about those people? How are they coping? I mean, I obviously ask this because I am one of these people, but while the conversation around mental health and cancer is unfolding, it’s important to ascertain this too. It’s important not to ignore this crucial part of the discussion. And that’s why I wanted to write my book.

We are getting so much better at talking about mental health but we’re still missing out huge chunks of the conversation – we don’t talk about the nuances of bipolar disease or about those who live with psychosis, even though we can talk openly about our experiences of depression. And we can talk until the cows come home about the impact cancer has on your mental health after the fact, but what about if you were already struggling to tread the tightrope before the diagnosis? Does that impact survival? Does that impact the severity of the mental damage that occurs afterwards?

The truth is, unsurprisingly, I don’t know the answers to these questions, nor how to direct the conversation around the less “fashionable”* side of mental health because I am only one person and only know the experiences of this one person well enough to examine. But I suspect there are different challenges faced by those who have already got health challenges to contend with.

1 in 2 people will get cancer in their life time. 1 in 4 people will suffer with mental health issues in their life time. There is almost certainly a cross section of these people who need to know they are supported. They need access to treatments that can help them put the pieces of their life back together after this, or any other serious illness bombards their lives. And this campaign from Breast Cancer Care is a start. A brilliant start to a conversation that could potentially change and save lives.

“With this book though, the thing you are actually holding in your hands, I wanted to let people know they are not alone. I wanted to offer Albus Dumbledore’s light in the dark. Not necessarily to insist things will get better, because I know that’s not necessarily what you want to hear – but to remind people that the human race knows a thing or two about both suffering and survival. I feel like with that in mind, it’s more difficult to feel totally isolated in your struggles – whether they’re related to mental health or cancer, or something completely different. Someone has been where you are right now. And while that doesn’t make your shitty situation (shituation, some may say) any less shitty, it suggests that survival is possible. Even if it’s just surviving one day at a time. One moment at a time. You’ve made it through every single one of your bad days until now – you can take whatever life throws at you. We are surviving even when we are just living through today and that is enough.”

Life, Lemons and Melons – Foreword

*this is a flippant use of this word. I hope you know I don’t think any mental health is “fashionable” but some is more socially acceptable to chat about than others

** If you’d like to pre-order Life, Lemons and Melons, you can do so right here. The first stage of edits is complete.

Cancer Changed My Life – Does it Define Me?

Every time I meet someone new, I feel nervous. I’m a people person and I love getting to know people, but more often than not I find the first few minutes (possibly longer) of a new encounter excruciatingly awkward. I’m not like my Mother who embraces new people with ease. I have to work incredibly hard to forge conversations, often relying on a bank of stock questions that I pull out when faced with conversing with a stranger. To be honest, even thinking about one of those first time encounters makes me feel awkward.

“What do you do?” is one of the first things we’re asked when we meet someone new and I never know how to answer. I worry about the “what do you do” question for reasons beyond being unable to define my job. One of my key beliefs is that work is not who we are, it is just what we do and I have long since struggled with the fact that our work is usually the first thing we’re asked about. Is that really what defines us? Is there a moral value attached to our careers? When I was interning, I muttered about being an editorial assistant. In my last full-time job, I used to say I worked in marketing, often redirecting the attention to my husband and his infinitely more “grown up job” putting myself down for “messing around on the internet while he’s actually doing something that makes a difference”. Now, I often still defer to Chris’ grown up job but mainly because I don’t know how to define myself. I do so much more than just one thing Am I a writer? Am I a copywriter? Do I work in marketing? Do I tell people I’m writing a book? Because that leads to more questions and ones which are immediately very revealing and very personal. And it means I drop the breast cancer clanger pretty quickly.

Define Me

Since being sick, something I’ve really struggled with is whether I’m “letting” cancer “define” me. The inverted commas around both of these words is important – because I think they both carry a moral judgement. Both have agency attached to them. Both have negative connotations. Because in “letting” cancer “define” me, I’m passing the power from my hands into the “hands” (ha – that’s quite a funny image. A tumour with hands) of a few mutated cells and allowing them to control the narrative of my life. It is something we are told we must not do. “We must not let cancer define us because then it wins”. There are countless articles on the internet telling us just that. But my career is so intertwined with my life outside of working hours now. And a big part of that is my experience with cancer. It’s led to me writing my book, it’s all over my social media channels, it’s smattered across the internet on various websites (including this one, obviously).

To say I am “letting” cancer “define” me comes with a myriad of problems I think, similar to the idea that the way I choose to earn money defines me. Because it suggests that there’s nothing more to me than cancer and my job. It doesn’t allow for my beliefs or my personality traits to come through. There’s no space left for the other experiences I’ve had. And that word “letting” suggests a weakness in a way.

As part of the bigger picture though, would it be a bad thing to let cancer “define me”? It’s a thing that happened. It’s a big thing that happened. And it has dominated my life for the last three years. It changed my life. So, by definition, doesn’t that mean it has defined me in a way? Why does it have this negative connotation attached? I mean, other than the fact that it’s a thing that tried to kill me. Obviously that’s not so great.

Unavoidable

Cancer comes up for me again and again. It is pretty much unavoidable. I know this isn’t the case for every person who has experienced cancer, but it is the case for me. It is so intrinsically linked with pretty much everything I do that I really care about. It’s why I’m a Boobette for CoppaFeel! It is is why I am a trustee for the charity. It is why I am self employed. It is why I can’t commit to working more than three days a week. It is why, until recently, I was in the hospital every couple of months. It has changed my view on the world, it has changed my view of myself. It has changed my relationships and altered my heart in ways I never could have expected.

But, before I got sick, there was so much more to me than my job, and now there is so much more to me than cancer. That said, it has helped me to achieve things I never would have imagined.

I don’t know if cancer has defined me. Before I started writing this blog post I was determined that it shouldn’t be a thing that defines me. I had a work meeting this morning and had to explain why I couldn’t commit to working more than three days a week. Yes, I could have said that it was because of other work commitments, but that’s not the whole truth and if there’s one thing cancer has given me, it’s the courage to be honest.

I was furious this morning because I felt like I had been reduced to a person who can’t be a standard, paid up member of society because I can’t work full time. But the truth is, I know that right now, if I tried to work four days a week, I’d make myself sick. I spent three days at a festival this weekend and in the 48 hours since I got home, I’ve slept for about 28 of them. And I’d have no time for the stuff that is a part of me beyond my work. For my CoppaFeel! stuff. For cultivating the relationships I have and cherish. For looking after my body and my mind and treating them to the things they deserve.

Now, I’ve sat down and worked through it though, ironed out some of the kinks in my mind, I think I’m probably not defined by cancer. Because no person is ever defined by one thing, or one facet of their life for long. We are countless characteristics and experiences and relationships and thus I can never just be a person who has had cancer.

More Than One Thing

I am a person who has had cancer. And it has had a huge impact on my life. But I am also a wife, a sister, a daughter, a friend, a writer, a copywriter, a social media manager, a journalist, a blogger, a lover of the sky. I am passionate and I am humble and I am grateful and I am a maker of great bread. I am a person who loves to read, who loves to write, who loves to cook, who loves thirty second dance parties and singing at the top of my voice. I am a person who has had cancer. I am a person who has survived cancer. I am a person who lives with cancer in their life, even though the cancerous cells have gone. But I cannot be reduced to just one thing. Humans, by their nature, are multifaceted. So even if cancer comes up in conversations with new people and even if it’s the thing they remember after meeting me for the first time, the more they get to know me, the more they’ll unravel the layers. Looks like cancer “survivors” (I use that word in inverted commas too) and ogres have layers in common.

No matter what narrative I choose for my cancer experience, no matter how much it impacts my life beyond my treatment, maybe I am defined by cancer, maybe I am not. Either way I am so much more than my experience of cancer. I am so much more.

Life, Lemons and Melons – An Extract (3)

Over this week I have been sharing a chapter of my book Life, Lemons and Melons. Since October, I have been pouring my heart and my soul into a Scrivener document covering the last three years of my life. I’ve written about infertility, self confidence, chemotherapy, my exploding breast, notes from a mixed up mind and tonnes more. Earlier this week, I also saw the illustrations that my exceptionally talented friend Georgia is rustling up to be printed in the book and let me tell you, I cannot wait for you to see them. But without further ado – here’s a chapter of Life, Lemons and Melons. Pre-order your copy by dropping me an email here. Read Part One and Part Two here.

***

But my medication was a salvation to me throughout all of this. And it continues to be. It means that those thoughts don’t linger as long as perhaps they would have done had I not been medicated. They mean that I don’t follow through when my brain is telling me I am worthless and that I do not deserve to be alive. That tiny tablet means the voice that tells me I should have been the one to die, rather than all the others I know who have had secondary breast cancer diagnoses and who have died as a result of this dreadful disease, doesn’t shout as loud or is easier to shrug off than it would be without the medication.

And I know I am lucky. I spend my entire life qualifying everything I say about my cancer experience with “I am grateful to still be here,” but the truth is, I might be, but sometimes my brain isn’t. Sometimes the cruel thoughts in my head tell me that I deserved to get cancer, that I deserved to die from it. That I still deserve to die from it. And it is only a matter of time before I do. And it is a process. It’s something that I am constantly working on rectifying. As I sit here now, overlooking the stunning bay at Port de Soller, watching the birds swoop over the crystalline sea, hearing the bustle of the streets below, wrapped in a blanket and writing about my experience, I am grateful. But I also know that it won’t be long until the dogs start snapping at my heels with their messages of self-destruction. And I think this is something that doesn’t get spoken about often enough, both in the world at large, and in the world post-cancer.

Citalopram has been a saviour for me. It doesn’t come without side effects. I’m heavier than I feel like I should be. I get a dry, metallic taste in my mouth if I don’t drink regularly. Perhaps it exacerbates the fatigue that I experience post-cancer. But when the darkness seeps in at the edges of my life, like a blot of a watercolour paint on a piece of parchment, spreading slowly across the page, Citalopram slows the progress. It makes the black less dense as it makes its way across my life. It doesn’t make the hole I am teetering on the edge of less deep or consuming or terrifying, but it makes it easier to escape from. Citalopram offers a rope to climb. It’s still a difficult journey that takes every ounce of strength and leaves my body and mind exhausted from the intense effort, but it makes it doable. It makes getting out of The Dark Place possible.

And I know there are people that say the longer I stay on medication the more likely it is to stop working. I know others argue that it has a placebo effect, that it doesn’t actually make any difference. Some believe that I will never be able to come off my tablets, but after the last three years and knowing my own mind as I do, I’m not sure I’d be comfortable coming off them anyway. I have fought long and hard to get to some semblance of normality and I still have a long way to go – so why would I give up the thing that makes it easier? I go back to the diabetes reference – I wouldn’t give up Insulin just because the newspaper said my “dependence” on it was problematic. I wouldn’t turn down the chemotherapy that would save my life. So why are antidepressants any different?

Living through cancer is a nightmare, in so many ways. I’m not saying that every person who experiences a cancer diagnosis needs a prescription for antidepressants, but what I am saying is as simple as this: we need to give our brains the same amount of attention we give our bodies when we are going through cancer treatment. We need talking therapies to deal with what is happening to us. We need counsellors to guide us through the hellfire and treat the internal burns that we get as a result. There is no part of your life that is unaffected by a cancer diagnosis and there is no shame in asking for a hand to grab onto at the scariest time of your life. If you’re going through treatment and you are struggling, ask for help. Talk to your medical team about counselling. They know that there is a disconnect between the physical and the mental treatment of cancer and there are conscious efforts being made to bridge that gap. So ask for help. You are not weak, you are not overly emotional, you are not letting the side down by not being positive all the time. You are asking for what you need and that is something to be celebrated.

And remember, despite what the tabloids might say, if you and your doctor believe you should be on medication to deal with your mental health, cancer diagnosis or no, there is no shame. That’s a decision between you and your medical team. Ignore the people who don’t know what it’s like to live with a  gremlin in their heads. Ignore the splashy, attention-grabbing headlines. Ignore the people who bash others down on Twitter. You know your brain better than anyone else. So trust yourself. Even if the gremlin and the media are telling you differently.

Life, Lemons and Melons – An Extract (2)

Over the next week, I’m going to share a chapter of my book Life, Lemons and Melons. Since October, I have been pouring my heart and my soul into a Scrivener document covering the last three years of my life. I’ve written about infertility, self confidence, chemotherapy, my exploding breast, notes from a mixed up mind and tonnes more. Earlier this week, I also saw the illustrations that my exceptionally talented friend Georgia is rustling up to be printed in the book and let me tell you, I cannot wait for you to see them. But without further ado – here’s a chapter of Life, Lemons and Melons. Pre-order your copy by dropping me an email here and read part one here.

***

That’s not to say that choosing to take medication has been a fix-all for me, or that it was an easy process to begin. I felt like hell on earth for the first two weeks on my “happy pills”. It was a while ago now and I’ve had chemotherapy since then so my memory is a bit mushy but I vividly remember feeling like the whole world was falling down around me in those early days. There was a day when Chris wouldn’t leave the house because I had woken up crying and couldn’t stop. At the time, I thought he just felt bad leaving me because I was in such a state, but I know now that he felt like he couldn’t leave because he wasn’t sure if I was a danger to myself. I have no idea if I was a danger to myself but I felt like I my chest had been ripped open and I didn’t know how to stem the intense emotion that was bleeding out of it. When I wasn’t crying, I was lethargic, confused and numb. Without a doubt, the antidepressants initially worsened my symptoms before they made them better. But I was lucky. I had a long-suffering partner who was able to support me as I found my feet and I was well cared for by a stretched but determined primary care system where I had appointments every two weeks in the early days, and every month thereafter until I had settled into the medication.

Not only that, but before I said yes to medication, I said yes to talking therapies. After a few weeks on a waiting list for CBT, I found myself at a session with an incredible specialist called Steve. Together, we began trying to unravel my thought patterns and determine what made my brain tick in the destructive way it did. I began to learn how to combat the voice that told me I was a failure, the one that convinced me I was useless and would never amount to anything. I began to question whether my brain was serving me a thought or a fact. When I told myself that I was worthless, I began to weigh up whether there was any evidence to back up that accusation. Could I, in fact, prove that I was worthless? Or was that just the bully in my brain talking smack? Unless I could provide evidentiary proof, that would stand up in a court of law, I was able to tell myself these weren’t hard facts and I started to pay less attention to them, when I could.

Much like medication, CBT doesn’t work for everyone, but I was so lucky that I was able to go and see a practitioner in the flesh so we could not just talk about strategies for keeping depression and anxiety at bay, but to discuss the things that were on my mind. The human interaction of my CBT was hugely beneficial to me. My therapist never made me feel like I was an inconvenience or a fraud or I was wasting his time – all things I had convinced myself he would. And as I moved through the process and learned more techniques and got used to the medication I was on, I slowly started to feel more human. I was finally figuring out who I was with depression and how I could deal with it so it didn’t impact my life too much. I had begun to recognise the signals, my triggers, the little notes I left myself to suggest that a dark wave was on its way. But then, to quote Joan Didion, life changes in an instant.

It was just as I was finishing my CBT that I found out I had breast cancer. In fact, I went along to my final CBT session two days after I’d been told. At the start of every session, I’d sit down with my therapist and he’d ask me that open-ended question “How are you?”. And his asking of this question was not the perfunctory greeting we so often offer up to those we meet. It was more loaded, a “how are you – really? How is your brain? How is your mood? Have you thought about killing yourself this week? Have you thought about hurting yourself this week? Have you felt at risk at all this week?”

And for the first time, I didn’t answer him with a breakdown of what had affected my mood or exacerbated my depression that week. We didn’t break down, day by day, things that may have triggered a feeling of lowness. I told him what had happened two days previously.

“Well, Steve, I’ve just been diagnosed with breast cancer”.

That was not what he was expecting to hear, but then again, neither was it what I was expecting I was going to need to say.

From there, it became a whole other ball game. I dread to think what kind of position I would have found myself in after hearing the words “you have” and “cancer” in the same sentence and relating to me. If I hadn’t had that CBT and if I hadn’t already been on those antidepressants, I genuinely believe that my depression at that moment would have been a bigger threat to my existence than the cancerous tumour growing within my breast.

What was going on in my brain quickly began playing second fiddle to the things I needed to do to prevent the cancer from getting any worse. I quickly slipped into cancer mode and everything I learned about maintaining my own mental health fell into a massive ditch at the side of the treatment road I was hurtling down at alarming speed. I no longer had time to think about the shitty things my brain was telling me, because it was full up with cancer-related thoughts. Was I going to die? Was the cancer going to spread? Should I have a mastectomy? Can they take both my breasts off? Am I a carrier of the BRCA gene? What will that mean for my family if I am? Am I going to die and leave Chris on his own? How will chemotherapy make me feel? What is going to happen?

Before I really knew what was happening, everything I’d learned in CBT evaporated. It was no longer a priority. My focus swiftly shifted to surviving. The self-care of checking my thoughts and their patterns felt superfluous when I had something actively trying to kill me growing in my body. For a while there I didn’t give my brain anywhere near enough of the attention it needed, when it probably needed it most. I went from combining talking therapies with medication to relying solely on my medication to keep my brain in check. About half way through treatment I found myself really struggling. Christmas 2015 saw me undergo my fourth chemotherapy session. I was exhausted in a way I can’t even begin to explain to you. My spirit was broken and I felt like I was losing myself. It was during this period that I hit below rock bottom. I hit sub-zero. I got so low, I could practically feel the heat of the earth’s core licking at my feet. I had, as I think most cancer patients do, been questioning whether the treatment I was undergoing was worth it. I wondered if it was worth losing my breast and losing my hair and feeling like hell and being poisoned. But for me, there was something else too. I’d gradually gained a grip on my depression as I worked through my CBT and cancer had made me forget what I had to do to stay alive. What I had to do to make sure my negative thoughts didn’t consume me, didn’t take over my life and begin to dominate my waking thoughts. It’s something that I hate thinking about now, but at the time I remember wondering, not only was it all worth it, but did I really want to live in a world after cancer? On more than one occasion I have thought to myself, “If only I had left that lump for longer. If only I hadn’t been in the habit of checking myself, then perhaps it would have spread, and perhaps I wouldn’t be forced to deal with the complex aftermath of surviving this disease”. I hate that I thought that. I hate that there are still times when I think about it.

Because I have wanted to die in the past, and now, post-cancer there is a reason why I might. Sometimes now, I don’t think about killing myself, I think about cancer coming back and doing the job for me.

 

Next part of the chapter coming later this week!

Life, Lemons and Melons – An Extract

Over the next week, I’m going to share a chapter of my book Life, Lemons and Melons. Since October, I have been pouring my heart and my soul into a Scrivener document covering the last three years of my life. I’ve written about infertility, self confidence, chemotherapy, my exploding breast, notes from a mixed up mind and tonnes more. Earlier this week, I also saw the illustrations that my exceptionally talented friend Georgia is rustling up to be printed in the book and let me tell you, I cannot wait for you to see them. But without further ado – here’s a chapter of Life, Lemons and Melons. Pre-order your copy by dropping me an email here.

*****

When I was a kid, I struggled a bit with asthma. It seems that if there’s a weak spot in my the historic health of my family, it’s our ability to breathe well under duress. Any one of us in the Purkiss clan who gets a cold ends up with a hacking cough – you know, the sort that people move away from on the bus. The sort that makes people glare at you on the tube. Or one that once upon a time earned me the filthiest looks I have ever received when I had the audacity to have a chest infection whilst attending an event at the Royal Albert Hall. But when I was a kid, I was given inhalers to deal with my problem. I dutifully took my brown inhaler every day to prevent the symptoms. I took the blue inhaler when I needed instant relief, or when I wanted to look like I needed to stop running in cross country, which, truth be told, was often.

At age 13, I had horrible problems with my periods. They were heavy, full of clots, and often left me completely washed out, a weird white-grey colour and regularly unable to hold my head upright. I went to the doctors. I was given tablets. I tried these tablets. They didn’t work. I tried other tablets. They didn’t work. Eventually I was put on the pill. Every day, I took this little tablet to try to control my periods. I stayed on the pill for about ten years and the problematic periods faded to being pretty manageable. Well, as manageable as periods can be, given that a large portion of the population finds them utterly hellish. But the medication helped.

There was a time when I regularly got migraines so severe that the right hand side of my face would droop. I actually looked a bit like I’d had a stroke. It took a while for these migraines to bugger off, with my symptoms often lasting for four or five days. I saw a neurologist who put me on a preventative tablet. I took this every day to “break the cycle” of the migraines, which were clearly linked to my menstrual cycle (sorry for mentioning periods twice in two paragraphs, but women bleed out of their uteruses around once every twenty eight days and I’m a woman, soooo, buck up Bronco). I was on these tablets for over a year, no questions asked.

So why is it then, when a doctor suggested to me that I went on medication to combat the crippling depression I was experiencing, I resisted? Why did I think that my brain not working quite as I would have liked it to, was any different to my lungs not working quite as I’d like them to? Whilst not quite as useful an excuse to skive out of PE (perhaps that’s a discussion for another time?), it was still a problem for me. By this point my depression had begun pervading my life in a noticeable way. If it had once been a cloud lingering over my shoulder, it was now a surrounding fog that refused to budge. I was struggling to make even the simplest of decisions on a daily basis. If I managed to drag myself out of bed, get dressed and leave the house, the question of which shoes to wear for a day in the office often left me crippled on the doorstep. Deciding what to have for lunch became such an ordeal it was all too easy to skip lunches. I had begun to feel completely numb and consistently felt as though something awful were about to happen. I lived in a state of anticipating impending doom, a disgusting and suffocating case of “low mood” and a paralysing anxiety. But still, I felt that taking a tablet to help was a foolish step. I think part of me saw it as an admission of weakness, of defeat. I felt like I should be able to handle everything the rest of the world was handling. When a GP pointed out to me that if I was a diabetic, I wouldn’t turn down insulin, I realised that perhaps I had been affected by external perspectives on what taking antidepressants means.

It’s interesting isn’t it? Because more and more people are talking about their mental health on the regular these days. Thanks to the internet, the conversation has opened up and continues to do so exponentially. As a result, the stigma surrounding discussions of a sensitive nature seems to be fading. But from where I’m sitting, this stigma has relocated. Most people no longer judge others quite so harshly for having issues with their mental health (I’m not arguing that this has completely gone – we’ve a long way to go on that score) but society is distinctly less forgiving of those who take antidepressants, God forbid they should need to do so over a long period of time.

I’m writing this in 2018, but sensationalist headlines like “A Nation Hooked on Happy Pills” are still splashed across the front page of one of the biggest selling newspapers in the country, while previously disgraced journalist Johann Hari has just released a book which begins by throwing doubt on the efficacy of antidepressants. While I’ve no doubt that Hari genuinely believes the claims in his book it’s my firm belief that claims such as these are seriously damaging to huge numbers of people. I wish my antidepressants were happy pills that made me as perpetually jolly as the characteristically named Green Giant but they aren’t. They help me to be functional some of the time rather than just a shell of a person all of the time. They don’t stop me from arriving at The Dark Place, but they do usually mean my stays there aren’t as long-lasting or as terrifying. They mean I can usually find my way out of that shit hole. They’re the map that means I still have to find my own way, but they are also a light in the dark that helps me figure out what I need to do to escape.

I know that medication doesn’t work for everyone, but I also know what a massive difference a small dose of a tablet makes to my life – and the lives of people I love and care about – on a daily basis. As a result, I’m able to recognise the impact of the kind of blasé statement that lambasts people for taking potentially lifesaving drugs. There will be people who read things like this and think they’re doing something wrong when they take their little tablet every night after they’ve brushed their teeth. Even though I absolutely believe that taking drugs like this is right for me, there are times when reading a scathing headline or a review of a book which suggests “everything I know about depression is wrong” will make my resolution falter. If I am in a bad way, I can doubt my decision to take 30mg of Citalopram every single day. I wonder if I’m making a terrible mistake and come dangerously close to convincing myself to come off them. And I am resolute in my belief that this medication makes my life better. So what about those people for whom medication feels like accepting failure? Or those whose lives are being saved by medication but they feel shamed because they need support from a tablet. This rhetoric puts people like this at genuine risk.

There’s a reason the National Union of Journalists bans this kind of colloquialism in reporting – because it is dangerous. Would you ever see a headline that says “A Nation Hooked on Chemotherapy”? No, you would not. Come to think of it, ever seen a colloquialism for chemotherapy used in the press? No. Because people who have chemotherapy are not demonised by the rags who run these types of headlines about mental health problems.

Next part of the chapter coming later this week! If you’ve already pledged to the book via Kickstarter and you don’t like this chapter…well…it’s kinda tough I guess. NO REFUNDS.

Trust Your Touch with CoppaFeel!

Pretty much within the hour of being diagnosed with breast cancer in 2015, I decided I wanted to do something with what I was anticipating was going to be the most negative experience of my life. Not long before I finished treatment, I got in touch with CoppaFeel! – a breast cancer awareness charity set up by the inimitable Kris Hallenga. Kris had been diagnosed with breast cancer when she was 23. A late diagnosis meant that by the time she was diagnosed, her breast cancer was already Stage 4. There is no stage 5. Kris’ cancer had become what was known as secondary, or incurable, breast cancer.

Kris was determined that she wanted to do everything she could to stop more young women ending up in the situation that she was in. She realised that early detection of breast cancer saves lives and, along with her twin sister Maren, embarked on a campaign to educate the nation to that tune. CoppaFeel! was born.

I first encountered Kris when I saw her documentary “Dying to Live” during my time at university. I was blown away by the woman I saw before me, and I knew as soon as I was diagnosed that I wanted to join in the mission to stamp out late detection of breast cancer that Kris had started. Little did I know that CoppaFeel! would worm its way into my heart and life in ways I could never have imagined back in the summer of 2015.

I became a Boobette for the charity – one of around 100 women under 35 who have all been affected by breast cancer in one way or another, whether through a personal diagnosis, a scare or a hereditary connection with the disease – about 18 months ago. This group of women is beyond phenomenal. The army of the boob world, the Boobettes go into schools, colleges,  workplaces, universities, community centres, WI’s – basically anywhere that will have them – to bang on about bangers and to stress how important it is to know your own body. I am proud every single day to be surrounded by such a tour de force for breast awareness – and essentially self care. These women have been to hell and back and have chosen to tell the story. I have the utmost admiration for every single one of them.

Then a few months back, I was approached about becoming a trustee for the charity. Much like Liam Neeson in Taken, I had a very select set of skills. Skills I had acquired over a very long short career, that meant I would be a good fit for the board. Social media skills – check; marketing skills – check; previous breast cancer – check; down with the kids – TBC. But of course, I couldn’t say no. I was incredibly honoured to be asked to come into a role which meant I was able to work with the insanely talented team they have in the office and help drive this remarkable charity forward.

And on Friday, these guys made history. History that I was lucky enough to be a part of and that made my feminist side really bloody thrilled. They created an ad campaign which led to the first female nipple being aired on TV. Vogue wrote an article about the campaign. It was featured in the top spot on the BBC news app. Huffington Post, Refinery29 and The Independent all got in on the action too. And I’m so honoured that I got to be part of this. Once again, I got my boob (and where my boob used to be) out in the name of breast cancer awareness.

So isn’t it about time you trust your touch? Give you norks a feel today because knowing your boobs could save your life. Check out CoppaFeel! to see what you should be looking and feeling for.

Life, Lemons and Melons

Hello friends. So today, I have some pretty big news. This has been in the works for quite some time. There have been setbacks and restarts but I think, I’m finally there with the preparation, and so I’m turning to you guys to help.

About a year ago, I had an idea, formed as the best of them are, just as I was nodding off one night. I’ve always wanted to write a book, and suddenly the basis for one presented itself to me. I decided I wanted to write a book about what it’s like to get breast cancer when you’re 26, and you’ve just started getting help for the long lasting problems your brain has given you over the course of your adult life. I am, of course, talking about my old pal depression.

It had reached a point where my dark days were getting deeper and lasting for longer periods. I knew what it was like to reach rock bottom and I didn’t like it there. I wanted help. I didn’t want to hang out in the dark orifices of my brain. They were not nice places to be. I finally made the decision to go to the doctors. I started CBT. I went on medication. And two days before my final session of CBT, I was told that I had breast cancer.

Shit. I’d just spent a few months figuring out who I was and how I could deal with the darkness when it came along, and I was thrown another curve ball in the shape of a tumour growing in my right breast. Oh great, thanks.

Life, Lemons and Melons is the story of figuring out life when it hands you a whole heap of lemons and you don’t have the energy to make lemonade or even reach for the gin. It’s a funny story about things that aren’t that funny and a coming of age story that came a few years later (or earlier) than expected. It’s about mortality, health, the pressures of the modern world, trying to be positive when your heart feels like it’s being repeatedly trodden on by an elephant and finding humour in getting diagnosed with breast cancer aged 26 when you carry a black dog around with you every day.

It’s essentially about the life of every twenty something – but with some added mental anguish and the mild inconvenience which is cancer thrown into the mix. A recipe for disaster? Maybe. A good story? Hopefully.

So why am I telling you about this? Am I about to tell you the book has been snapped up by a publisher in a heated battle between two of the big wigs? Well, no. Not quite. Despite a lot of interest from publishers thanks to my wonderful agent, Robert, it turns out I don’t have a big enough social media following for publishers to be interested in me. They loved the story, they loved the proposal, they loved my writing. But the social media following (or lack thereof) was too big a sticking point for them.

But this is something I have to do. It’s something I have to do for me. I have this book inside me and it is burning to get out. Practically clawing at my insides to make it’s way from my brain to my keyboard. So, I’m going to do it myself. I’ve decided to self publish. But I need your help. And it turns out, the way you can help me is by giving me your hard earned dollar. I’m crowdfunding for the project. I have a heap of options for whatever your budget is, and for every budget you get a copy of the book (whether hard or digital) including my words and images created by my insanely talented and perpetually brilliant pal Georgia Wilmot. And 10% of any profits made will go to my friends at CoppaFeel! so you’ll be helping them help more people get into the healthy boob-checking habit of a lifetime too. I also hope that this book will help anyone who’s ever heard the words “it’s breast cancer” and who’s ever had a fight with their brain.

So how can you support for Life, Lemons and Melons? Head on over to Kickstarter and choose a pledge then share the campaign with your friends, family, colleagues, dog walker etc. If we hit my target of £3k within 30 days, the book will happen. I’ll have to sit down and write it, but as the outline is all there and ready to go, I’m hopeful I’ll just be able to “write the shit out of it” as my friend said. If we don’t hit the target, you won’t lose a penny and I’ll crawl into a hole and pretend this never happened drop the idea, knowing I tried everything I could.

THANK YOU in advance for your help, whether it’s a pledge or a share. I can almost feel the dream of holding this book in my hands becoming a reality.

 

Things I Wish People Knew About Surviving Breast Cancer

More and more people every year are being diagnosed with cancer, in one form or another. Whether it’s lifestyle, environment, diet or any other factors that is causing the increase is very much up for debate, and not a debate I have enough authority to cast my opinion on. But with every new cancer diagnosis, research and treatments are vastly improving too. Now, if you’re diagnosed with primary breast cancer, you have an 80% chance of surviving 10 years after your diagnosis. Fewer people (though still too many) are dying of cancer but we still don’t know  what to do with survivors. The NHS is often too stretched to support people with the mental, physical and emotional turmoil that cancer leaves behind and not equipped to provide the kind of spiritual support people need after going through a life changing experience. So more and more people are surviving cancer, but their needs are often not understood – even by those closest to them.

In the 17 months since I finished treatment, there’s so much I have learned about “surviving” cancer and I thought it might be good to share these with you – so if you’re undergoing treatment, or know someone who is, you might get a better idea of what it’s like when you’re released back into the world. If you’ve been through treatment, some of these might seem pretty negative – but I think it’s important to normalise what life’s like after cancer so that if you feel any of these things (and you might think they’re all WRONG), you won’t feel alone and scared and worried and all the other emotions you experience in The Aftermath of this Life Changing Big Deal thing that happened to you. Buckle up campers,  this is a long read.

1. When I say “I’m tired” I don’t just mean I didn’t get enough sleep last night. It’s not because of the antidepressants I take. It’s not because I need to eat more veg, or get more exercise (but I should probs get a bit more, shouldn’t we all?). It’s because these days, post treatment, I reach a point where I splutter to a grinding stop like a car that’s been running on fumes for the last 20 miles. I crunch to a standstill with zero ability to continue, no matter how hard I try. Nausea. Headaches. Dizziness. Feeling faint. The works. There’s tiredness – which I was very familiar with before cancer – and then there’s fatigue and comparing tiredness to fatigue is like comparing cricket to walking on the moon.

I know lots of people who’ve had cancer treatment don’t find that their fatigue lasts as long as mine has and I am a) jealous and b) want to know all their secrets, but for many people who’ve been through cancer treatment fatigue lingers for various reasons.  The day my friend Izzy came round and did all the dishes I’d let build up because I was knackered was one of the best gifts she could have provided. She told me she found it therapeutic but I know she was doing it because she knew what a difference  it would make to me. These things make a difference, no matter how long it is since you’ve finished treatment.

2. Survivors guilt is real. Real and pervasive. Every time I hear about another person, whether I’ve met them, kind of half know them or have never heard of them at all, who has been diagnosed with secondary breast cancer or have died from it, I get a little crack in my heart. These cracks deepen the more of this news I hear. I wonder why I was, for now at least, more lucky than them. I wonder why I deserved to survive. I feel an overwhelming sense of responsibility to them to be better, to do more, to make the most of the life that I’ve been given. I feel guilty for still talking about my experience because at least the active part of treatment is over for me. What about the thousands of other people for whom treatment will never end? They don’t want to hear me wanging on about this when I’m lucky enough to have wrapped up my treatment.

There are people literally fighting for their lives and sometimes I feel like I should sit down and shut up because my opinion of cancer isn’t relevant because it’s not trying to kill me. I remember when my article was in Red I got shouted down by a handful of people who thought my experience wasn’t valid and that they should have been telling the stories of people with secondaries instead of me. So often I don’t understand why I am still here and so many of my amazing Boobette sisters are not. It’s a bloody minefield – especially if you’re prone to excessive rumination like I am. Survivors guilt is real and will bring up a range of unruly emotions in you. Accept them and remember that you’re doing the best you can.

3. Cancer never really leaves you. Long after you’ve finished treatment, cancer has a way of rearing its ugly head and infiltrating on the life you’re trying to rebuild. Whether that’s annual checkups at the hospital that give you palpitations, nightmares about it coming back, scares about recurrences and the feelings of fear, sadness, heartbreak and everything else you feel are constant reminders of what happened to you. Sometimes I have flashbacks to things, traumatic moments of when I was in treatment, that I’ve blacked out. Sometimes these thoughts hit me like a punch to the temple and other times they just wash over me. I can never judge which way I’m going to react or how I’m going to feel when this happens. But they tell me this is normal.

Don’t forget about what happened to us. We don’t need sympathetic head tilts but don’t panic if we tell you we’re still thinking about cancer 5 years after diagnosis. Ask how we are – and not in a perfunctory greeting way. Really ask. If we’re ok, we’ll tell you. But if we need to talk, that question will feel like a life ring being thrown out to us in the middle of a black and stormy ocean, where we’ve been floundering miles from the shore.

4. I have strong opinions about the language around cancer. I HATE THE FIGHT ANALOGY. I hate the idea that if you die from cancer you “lose”. How can you lose when you’re giving everything you have? How can you say people have “lost their battle” when they were never armed with the right infantries to battle with. Cancer is like Danerys on Drogon, leaving devastation in its path but cancer is never the victor. And it doesn’t matter how hard you fight. Even the best will in the world, the strongest positive mental attitude doesn’t stop cancer cells from multiplying – it’s medicine that does that. And we are not in control of how our bodies react to medicine (whether traditional or alternative, whatever your choice). People die. Don’t use euphemisms. It does them a disservice.

5. I think about death. I think about my death. I make jokes about dying. And that’s ok. I don’t need you to tell me not to talk like that or to “stop thinking that way”. Talking this way is one of my self defence mechanisms and it’s one I really, really need. It might seem negative or pessimistic but it’s the way I’m dealing with this. I know it might be hard for you to think about my cancer coming back. I know it might make you uncomfortable when I crack jokes about not making it to 40 years old, but if I’m laughing, you can laugh too. Laughter is the thing that has saved my life. The reality is that cancer might not just make the one stop in my life and I’m coming to terms with that. I know it’s hard for you too but it’s how I’m going to survive the uncertainty.

6. It doesn’t end after radiotherapy finishes. Having had triple negative breast cancer means I don’t have any further lines of defence against breast cancer but for so many, taking daily Tamoxifen, a hormone suppressant for five or ten years after finishing active treatment is a reality, meaning their treatment continues long after that last blast of radiotherapy. Other breast cancer’s need to be treated with a drug called Herceptin which is usually injected in the months following active treatment. Then there’s the fear, checkups, post-traumatic-stress, depression, anxiety that comes with life after treatment. There’s so much more to cancer than just the treatment part of things.

7. I don’t give a hoot where you keep your damn handbag. And putting a heart on your wall to create breast cancer “awareness” is a sure fire way to make me give you a lecture on how to actually check your tits. Memes about how much you hate cancer are useless and to be honest, kind of offensive sometimes, unless they’re saying that you hate cancer and we all need to do our own bit to make sure we’re doing what we can to make sure we get treatment asap if we do get cancer. That was a long sentence but what I mean is, I’m only interested in memes that tell us what we should be looking out for when it comes to signs and symptoms of cancer, rather than just an “I hate cancer” meme. Dude, I’m pretty sure no-one likes it much.

8. Finding yourself might not be as easy as you hope, but you’ll get there a little at a time. And you’ll surprise yourself frequently by your ability to pick yourself up and get on with shit even when you feel you cannot any more. I still have no idea who I am after cancer, so much so that when I am asked for an interesting fact about myself, it’s all I have to do to stop myself from blurting out “I HAD CANCER” because I feel like it’s a huge part of who I am/was/will be in the future, but also, that’s not ideal when meeting new people. They’d think I was bonkers. They can wait to find that out.

Feel Good 100 with Feel Good Drinks

A lot of pretty cool things have happened to me since I got diagnosed with breast cancer in July 2015. I mean, chemotherapy was a riot and having a mastectomy and the followup surgeries was my favourite thing, obviously, but those things aside, I’ve been lucky enough to get some awesome opportunities. From having my name featured on a Formula 1 Car, to walking in the Breast Cancer Care fashion show,  joining an army of incredible women and regularly strapping on an enormous boob as one of CoppaFeel!’s Boobettes, to taking the jump and going freelance, pursuing my dreams of writing something that matters (though this may be temporarily on hold), I’ve been so very, very lucky. I’m grateful for all of these opportunities. The last two years haven’t been easy, but they’ve been pretty entertaining on the whole.

And I’ve started saying yes to things I never would have said yes to before. I think I’ve talked about this before, but I just don’t see the point in letting my nerves or fear or apprehension or anxiety stopping me from doing things. I’m pretty lucky to still be here, so why should I neglect opportunities that come my way? There’s a lot of things I can’t do right now (like surf) so why wouldn’t I say yes to things I can do? Even if they rip me out of my comfort zone and plonk me down next a beautiful lake in Malaga, completely naked and surrounded by 99 other naked women, all about to skinny dip in the aforementioned lake, I feel like I have a duty to do them. A duty to say yes. To myself as much as anyone.

Oh yeah. That lake thing actually happened. That wasn’t just some wild stream of whimsy consciousness I went off on there. A few weeks ago, along with some of my other awesome Boobette Babes and a bunch of other women from all over the UK, Feel Good Drinks escorted us out to Spain for their Feel Good 100 project. Their idea? To promote their 100% natural drinks they wanted to get 100 women in a 100% natural environment in 100% their natural state.

So here we were. Women of all shapes and sizes. A handful of breast cancer survivors. Models. Bloggers. Mothers. Every single person with a story that had led them to say yes to this opportunity.

So there I was. In beautiful sunshine in a stunning location with an incredible group of women wandering around with my The Artist Formerly Known as Breast out for everyone to see. Bizarrely, I felt more self conscious of the boob I still have than the war wound that marks my experience of breast cancer, but mostly I felt liberated. With all my wobbly bits and all my scars on show, there was something really honest about baring everything. Probably more honest than I had been with or about my body in a very long time.

Today marks two years since I had my mastectomy. Since the start of my treatment, I suppose. The start of my “triathalon”. In terms of surgery, it’s kind of turned into the Marathon des Sables, with 7 surgeries down and (hopefully) only two more to go. But at the end of this month I’ll go back to having two boobs as my (hopefully) penultimate surgery sees me have an expander implant put under the fat they’ve gathered from my legs and stomach in the past couple of surgeries. It looks like this is gonna be a big ‘un. Another scar. Drains. More liposuction. More bruising. More exhaustion. But I’m here, eh? I’m alive and kicking. Who cares if it works out that on average, I’ve had a surgery every three months for the last two years (I do a little bit. But only a touch).

The timing was really right for me with this campaign. I’m constantly searching for ways to feel alive at the moment and I really did feel alive and grateful for this opportunity. It kind of marked a transition in my treatment as I come to the end of living flat, 22 months after I had my implant removed. It’s the start of the end of my cycle of surgeries (hopefully) and I loved being able to celebrate my body honestly – for what it was before cancer, what it is now and what it will become. I still have so much growing and healing and learning to do.

feel good drinks

You can see the video created by Feel Good Drinks here – and I’d also recommend getting your hands on their infusions range. Genuinely delicious.

When I get that feeling, I want holistic healing

A couple of months ago now, someone reached out to me on social media after I admitted that I’d been struggling a lot with life after cancer. Her name was Sophie and she had been diagnosed with blood cancer – Hodgkins Lymphoma to be exact – when she was 23. She thanked me for being so open about the fact this shit is hard. Sophie and I met for a couple of hours, before she headed off to meetings and I headed back to work, feeling a little like I might have met a kindred soul. She’d treated me to a glass of elderflower cordial, we’d hunted out some of Denmark Hill’s prettiest flowers and she’d admitted to me that she too found life after cancer tricky.

Fast forward to last weekend, when Sophie created something truly wonderful for those living with and after cancer – Trew Fields.  A holistic wellness festival that focused on looking after your body and cancer awareness. There were an abundance of fascinating speakers, incredible workshops, great music and comedy that led to a day of open conversation about life beyond a cancer diagnosis.

For me, it was a real shift in my thinking about cancer and the impact it has had on my life. I have been scared and depressed (in the truest sense of the word) and angry and sad and exhausted a lot over the last few months. As I approached two years since my diagnosis, I had hoped that I would be so far away from cancer that I would barely have noticed the day, but the 7th July hung over me like a sickening black cloud. A reminder of the terrible things that had happened to me, but one that was not without it’s silver linings. I felt furious that I’m still so tired all the damn time. That even after seven surgeries in the last two years, I’m facing my eighth in the next couple of months and I’m still living with some kind of deformed attempt at a breast (nb – this is a work in progress and by NO MEANS a reflection of the work my surgical team are doing. I love them and they can do no wrong, so please don’t ever take my criticisms of the multiple surgeries I’ve had and the process of reconstruction as a criticism of them. I couldn’t be more grateful for my team). I find new lumps in my breast on a regular basis that I have to get checked and every time I do my stomach lurches up to the back of my throat, leaving me breathless and exhausted once again by the fact cancer has had this long term impact on my life.

display_Trew_Fields.jpg

But at Trew Fields, something really changed for me. I got some real holistic healing for my heart and my soul and my body – every part of me that needed some love and care. I listened to Boob Queen Kris (founder of CoppaFeel!) talk about her experience of secondary breast cancer IRL for the first time with candour and humour and realism and I witnessed one of the most powerful stories of cancer I’ve heard as the inimitable Sophie Sabbage took to the stage to talk about how you can win, even if you lose when it comes to cancer. About finding the gifts it offers you (and there are many) and realising what it’s trying to tell you. I know that sounds a bit bonkers but listening to Sophie, who is living with a terminal cancer diagnosis, I realised that there is a lot cancer was trying to tell me. I haven’t figured out exactly what yet. I don’t know if I will figure it out any time soon. But figuring out that it was trying to tell me something was a start.

And jeez. Can we talk about Sophie Trew too? She created something incredible – special and unique that can be rolled out and grow with ease. She opened up a conversation about some of the more holistic approaches to cancer care that don’t necessarily get the attention they deserve, but for me the most important thing was the advocation of the fact that cancer care should be a partnership between patient and medical team. I’ve been so lucky that throughout my treatment I played a key part in making decisions. I decided I wanted a mastectomy. I decided I wanted my mastectomy before I had chemotherapy so I only had to undergo six sessions instead of eight. I decided that I wanted to preserve my fertility. I decided that I wanted to have radiotherapy. Everything was presented to me as a choice – a choice with a recommended option (maybe there’s some kind of psychology in here somewhere) but a choice nevertheless. Every time I see my surgeon it is a conversation. I ask questions. Sometimes they’re hard questions that make him take pause. But this has led to a mutual respect between us that means we both feel confident I am getting absolutely the best care possible.

I’ve opened my life up to a lot of things since cancer and while some of the more alternative approaches aren’t for me (but I can see their merits for others) – I really do believe in a holistic approach to healing. And after cancer we need time to heal not only our bodies but our hearts and souls and brains as well. And we need to figure out a better way of doing that than stumbling around through life angry and sad and scared after the cancer bomb has been dropped. Sophie Trew has begun to create a place for that healing. And I’m so grateful that she has done so.