When I was told that I would have to do chemotherapy for cancer treatment, I was terrified of the physical effects it would have on my body. The list of side effects is long and terrible and somehow even includes more cancer. Physically chemotherapy proved to be hard, especially the red devil, but I failed to appreciate the seemingly bottomless free fall treatment would have on my mind. The anxiety and feelings of worthlessness are perhaps not surprising, but are surprisingly overwhelming.

I brushed off anxiety for most of my adult life. About 37 years to be precise. Now that I’ll be struggling with cancer-relapse-anxiety for the rest of my life I am attempting to confront it. The truth is, this is not my first rodeo.

For most of my life I did not fully appreciate the difference between anxiety and perfectionism. The two probably go hand in hand, and both are not an entirely bad quality to have as a lawyer when harnessed as a powerful motivator. Lawyering is a job that is meant to stoke anxiety. Living and mom-ing should not be.

Anxiety became serious for me when I was a new mom.

During my first pregnancy I started feeling unusually unsettled. With a first baby stress is “normal”, right? We were going through an awful time in our professional lives and I was endlessly worried about my baby’s health (for no actual reason, he was fine) but I chalked it up to new parent jitters. My first birth experience was traumatic in a variety of ways, and probably contributed greatly to the dark months that followed. 

As a first time mother I was consumed by fear. We brought our new son home from the hospital and I was inexplicably convinced that he would die. I fretted endlessly while he slept and I laid awake nights when my body desperately needed sleep, my hand on his chest, worried that he would succumb to the unthinkable – SIDS. 

I was terrified to take my newborn out. My time as a criminal prosecutor opened my eyes to the horrors of the world, and paralyzed me as a new mother. The constant stress and anxiety was intensified by my in-laws who, in their eagerness to see the new baby, pushed me into situations I found uncomfortable and questioned my hesitations when I declined. I could not properly articulate my fears because they sounded crazy, even to me. But I was debilitated.

In those days the term postpartum depression was fresh on the tongues of popular culture. Celebrities began to open up about their difficult days of early motherhood and the feelings of helplessness and despair that plagued their experiences with their newborns.

But I didn’t identify with postpartum depression. I was not sad. I was not upset. I did not dislike my baby, in fact, I was so over the moon in love with him that I tortured myself thinking of ways he might die and the measures I could take to protect him. I had no clue that postpartum anxiety was even “a thing.” My son eventually turned into a beefy toddler and the fears subsided.

I tucked that weird chapter of my life away and moved on.

I was lucky enough to avoid postpartum anxiety with my second child. I figured what I experienced was normal “first baby” issues. Then came my third.

Somehow I managed to pick up a cold in the hospital when I delivered my sweet Penny Lane, my third child, a healthy little girl. When I was discharged I was so convinced that I would inadvertently give her RSV and she would subsequently die that I bought about ten cans of Lysol spray on Amazon. (This was a stroke of good fortune because six months later I was immune compromised in the middle of a global pandemic and Lysol spray proved to be the Amazon equivalent of gold.) I was so paranoid that she would be killed by a virus that I actually sprayed a washcloth with Lysol and rubbed it on her head, worried that she had been exposed to my older daughter’s cold sore. 

I am pretty sure that both the parent company of Lysol and medical professionals would agree that “infant heads” are not a recommended cleaning surface for Lysol products.

My postpartum anxiety seemed to crescendo from there. As a planner, I perused sales online to buy clothes for my kids for the coming year, and as I packed “12 month” outfits away in my cart for my new baby, I wondered if she would survive to be twelve months old. How did anyone manage to bring a baby into the world in the fall, on the cusp of cold and flu season, and usher said baby through winter to survive by spring? My mind was preoccupied with ways that she might die in infancy and I obsessed about ways to protect her.  

The grueling pace at which I forced myself back into the office (being self-employed is not ideal for childbirth), coupled with the endless demands on my time at home left me with little rest and such an anxious mess that I nearly cancelled our family’s trip to Disney World. I cannot articulate how insane this would have been for me to do, since I spent the entire previous year planning the trip and and it was everything our entire household had been looking forward to for twelve months.

My mind was truly spiraling out of control. But this was my third baby. I knew my thoughts were not rational. I also realized I needed to put my needs first. To have a healthy baby, mom needs to be healthy.

Nearly a decade of mothering taught me to set some boundaries with my newborn. I had visits from people who fed my soul. Not just baby well wishers, but friends who “got” me. I skipped parties and events and even Thanksgiving dinner. I took naps and indulged myself in my last baby. I let myself be selfish and hold her and snuggle her to myself. I ate cake, I drank wine, and I allowed myself to be more gentle with my recovering body. As a veteran mom, I could tell that the anxiety was probably not normal, but I knew that it would pass with time.

Thank heavens I gave myself the gift to enjoy my last baby, even if just for a few weeks. I was diagnosed with breast cancer in on that infamous trip to Disney World. The baby snuggles were quickly substituted for IV chemotherapy and our lives will never be the same.

After my cancer diagnosis, my old nemesis, Anxiety, has moved in, and he brought his messy friend, Depression with him.

Cancer treatment wore the protective parts of me away and laid bare my anxiety, heightened and demanding. Every scan and pathology report is more terrifying than the last. The idea that doctors are going to look for cancer in my body and not find it seems like an innocent fantasy.

Extreme anxiety arose with every activity when I was new to cancer treatment. Every time I scheduled a client into the weeks and months I was to receive chemo I wondered if the client would notice my thinning hair and weary face. When people spoke about events into the future I wondered if I would live that long. I’d casually glance at my baby and wonder if she’d remember a time when I held her. When I walked into the cancer hospital sometimes I was so worked up that my entire body trembled.

Anxiety seemed like an old friend compared to the crippling depression that surfaced with cancer treatment. I definitely did not expect to feel so “down.” My old self was the kind of person who could put on some mascara and fix my hair and face anything head on. In the middle of cancer treatment it seemed particularly cruel that I could do neither of these things, and it made the chasm between the world and I seem even deeper.

Before cancer, I could never understand when I would hear that someone who had terminal cancer decided to stop receiving life extending chemotherapy. People talked about quality over quantity, but I have to admit that in my mind the fear of death seemed to always outweigh embracing it. Having received five months of chemo, I can firmly say that I now understand. Chemo is basically life saving, or life extending torture.

There were many days when I did not want to get out of bed. There were days where I physically shut down and could not manage to brush my teeth. There were days where I fell asleep crying and woke up the same way. I remember looking out the window of the second story of my home and wondering what it would be like to hit the pavement and sit in a hospital bed with broken bones. Stuff that was fixable. Simple. It almost sounded kind of nice until I remembered that I got to this horrible place in my mind trying to fix my uncooperative body in the first place.

Getting well is the goal, stupid.

It is not surprising to me that anxiety and depression surrounding women’s healthcare are so widely overlooked. Many women are told that their actual physical health concerns are an overreaction. Even despite how many of those “overreactions” turn out to be cancer. (AHEM, MY OBGYN.) Postpartum depression is finally seen as a legitimate health care issue and physicians are instructed to regularly screen for it.

Yet somehow anxiety and depression are glaringly absent from the “you have cancer” conversation.

Being a woman who happens to be young even more isolating. The entire “cancer system” is set up for people who are retired. Social workers are eager to tell cancer patients about the “wonderful resources” available at local charities.

I do not have the good fortune of having received a cancer diagnosis in retirement. I still working my knuckles raw running my business. I have gross amount of federal student loan debt. I had two kids in school and a newborn baby the day I was diagnosed. There was no time to take advantage of the “wonderful resources” available to me. My body, mind, and calendar instantly went into fight or flight mode and that’s where I’ve been ever since.

When you get diagnosed with breast cancer you get referred to a “team” of doctors that include an oncologist, breast surgeon, and plastic surgeon. You always have the option of changing out players on the team (getting a second opinion, or whatever) but you don’t have to go and find a plastic surgeon to reconstruct your breasts in the middle of cancer treatment. It’s a great system and I’m very happy for the way it has worked for me. But why is a psychiatrist/psychologist not on this team?

It seems like it would be a good idea to give cancer patients a life jacket BEFORE they are pushed off of a boat by abrasive doctors. Instead, while we are drowning in the ocean, we are reprimanded for not having one.

Finding yet another health care professional in the middle of cancer treatment is an awfully daunting task. And now that I’m so far into treatment, it would be so incredibly painful to go back and re-explain every single awful detail of this hellscape. I was blindsided emotionally and was beaten down physically. I am going to put it off until I feel like I can emotionally tip toe back to that place without upsetting the insane juggling act I am constantly performing. If you think that I “need to talk to someone,” take a number and get in line. And then remember who you are in my life and stay in your lane.

I can’t tell you how many times I have been warned that as a cancer survivor, I’d suffer from post traumatic stress. I don’t know of a single person who has gone through cancer that did not suffer from anxiety or depression or both during treatment. Doctors, hospitals, and health systems who treat people with cancer know this. Why isn’t mental health even a part of the conversation from the beginning?

It’s like putting a band aid on, well, cancer.

Look. I don’t want you all to think that I’m rocking and crying in a corner every day. Most of my days are good. Despite the hell that is cancer treatment, I usually manage to put it in the back of my mind and live my life. I make light of my shit-luck and wear rainbow wigs, unicorn suits, and make crazy TikToks.

Are some of those smiles forced? You bet. Goofing off and smiling is one way I have learned to cope. Running has always been huge for my mental health and although many times during treatment I was unable to jog, I at least try to walk every day. (Sidebar: running for twenty plus years turned out to be the best gift I could have given my physical health.) Blowing off steam with friends, taking trips, and being social has always been another huge coping mechanism for me and I have even managed to do some of that through this stupid pandemic.

But the bad days inevitably hit. And when they do sometimes they hit very hard. Cancer is hard. Really fucking hard.

The United States has “the best healthcare in the world.” Unless you have a mind.