Question re: Depression

[Darci]

Hi everyone, first a little update on my FIL. Physically, he is doing very well. He looks great, seems to have pretty much recovered from surgery, chemo and radiation. His scans have all been clear thus far - he finished radiation in March or April.

However, I am very concerned about his emotional status. He has always had kind of a bad temper, and can be a negative person to be around. These things seem to be greatly intensified these days. His last two visits to my brother in laws house were not good at all - he was just mean and ornery and grumpy. A couple weeks ago, we had him and my MIL come to our house, and we (me, my dh, my bil) took my FIL to see his beloved Cubs play the Brewers. It should have been such a great night for him - he is a sports nut, doesn't get to see the Cubs live very much (and they won!!), he was with his two sons - but the trip there was almost unbearable. He was upset about everything from traffic, to young drivers to the minimum wage rate.

I was able to talk to my MIL a little bit, and when I asked how she thought he was doing she said that she thought he was "different". Like he doesn't enjoy the things that he has always enjoyed so much. I also know that he yells at her a lot for little things that get him upset. We talked about how he is going to be different, because of everything he has been through, and that he needs to find a new normal life, post cancer diagnosis.

I talked with her about depression, and how common it can be for someone who has faced a major illness like cancer. We talked about talking to the doctor about it, but I am afraid if she tells the doctor in front of him that she thinks he is depressed, he will be angry and feel betrayed by her.

I said that maybe she could just mention to the doctor that he seems different, and doesn't enjoy things like he used to, and see where the doctor takes it.

I feel so bad for them - I feel like he has a new lease on life, because had they not done the routine chest xray last June and found the original tumor, he would be in a much different situation than he is right now. Last February he told me he just wanted to do what he has always been able to do - when I asked him what that was, he said mowing his grass and golfing - well, he is doing that. He is 82 years old, he takes care of his own grass, he golfs a couple times a week...but now he just doensn't enjoy it.

It is getting to the point where family doesn't want to visit...and they don't need their family staying away now.

Any thoughts? How do you tell someone that you think that they would benefit from anti-depressants?

[mitzu]

I think this personality change should be investigated. I don't know if your FIL had brain scans or a brain MRI, just to make sure everything's clear "up there". When they go for his MD visit, your MIL should inform the doctor about the change in your FIL's mood. If nothing is prescribed, I would confront him about this change and gently suggest that he gets some help. I would definitely do a scan first, though.

I hope you all find a way to help him.

[Andrea]

I agree with Mitzu about checking for physical problems first.

Assuming all is clear on that end, I don't have great advice on how to go about getting him on antidepressants, but wanted to share that we had the similar struggle with my dad. My mom was fine with giong on an antidepressant when she was diagnosed b/c she was devestated. She also enjoyed the occasional xanax at first. My dad was very resistent but he was just so depressed, it was obvious, and I had a little temper tantrum and I think to save my sanity he agreed to try them and it really helped him. Both of my parents benefited greatly from the meds. Maybe you can tell your FIL how common it is to be put on one?

[Carleen]

Hi Darci,

I think there is a way to talk about the changes with your FIL without using terms with negative connotations such as "depression".

I know that with my husband, he had such a positive attitude that when I was concerned about something, I did not want to deplete his hope and optimism with negativity so I would talk to his onc without actually saying that I felt there was a problem.

When I was concerned about his weight loss, I politely asked the onc for information on megace or decadron and asked if he felt those would benefit my Keith. The onc knew what I was asking and why. There would be no other reason I would ask about those particular drugs.

There was also a time that I felt Keith would benefit from an anti-depressant, more so for anxiety and agitation than mood (as he had a great attitude). My comment to the onc was to tell him that I've noticed that Keith was restless when he was suppose to be sleeping, that I felt he had a great deal of tension and wondered if something like Celexa, Ativan or Lexapro would help. The onc knews these are all anti-depressants, he got the message without me having to say I think my husband is "depressed" or "crazy" or "moody". Basically he trusted me to research things I felt would help him, he trusted his onc to give him only things that were going to be of a benefit, so he really didn't care too much why and what the hidden messages were as long as we both felt it was needed.

I just feel that certain words have a negative perception in our society (even though they shouldn't) and I couldn't even begin to associate anything negative to the most wonderful and perfect of men. But I still wanted him to get the support and help he needed.

Talk to your MIL and give her some suggestions of passive aggressive statements she may use in her discussions with his onc.

Also Congratulations on you FIL doing so well. It really is a blessing and a gift and I'm so happy to hear he is beating this beast.

God Bless

Carleen

[Darci]

Thanks for your responses!! Actually, one of my biggest concerns is that something is going on physically, and he can feel it, and that that is causing him to react the way he is. Either consciously, or subconsciously.

I did let my MIL know that no matter how much we don't even want to entertain the possibility that the cancer could come back, that his dr. needs to know of any changes in his condition - physical or otherwise. That we are better off knowing one way or another!!

To the best of my knowledge, my FIL has never had a brain scan...but he doesn't seem to be having any of the symptoms that seem to accompany brain mets...that he has told us anyway!!

I just would like him to be able to enjoy whatever time he has left in his life. It pains me to see him angry and upset all the time, and seeing that it is starting to keep people away from him only makes it worse on he and my mother in law.

[kamataca]

As you mentioned, our loved ones are facing very tough realities, and those certainly can cause moods to alter. My mom goes through her low points, but luckily she has been able to work through them, since she has had bad physical reactions to two of the antidepressants she has tried.

Carleen brings up many good points in how we approach loved ones about concerns. Hopefully you can work with your MIL and the Drs to find something to help. Keep us posted!

Kelly

[Suzie Q]

Just another thought to kick around...maybe he needs an outlet for his anger? Because you are describing anger and a lack of patience more than the sad or flat, unemotional disinterest in life in general usually associated with depression.

Increased age and serious illness can amplify our negative behaviors.

Your mom could call the onc nurse and express her concerns, including the fact she does not want to present this issue in fromt of him, and perhaps the onc can ask him how he is doing emotionally and ask leading questions or have the opportunity for your mom to say that his personality has changed. I think Carleen has explained a very good way to bring up unpleasant issues without actually saying the words no one wants to hear.

And certainly, the onc should know about this as he may want to order a brain scan.

Bless you for loving him so much that you want to enable your mom to help him in the least upsetting way.

Best wishes to all of you.

[ztweb]

First, I have to say that some of what you write here seems much like the situation with my dad. My dad did have times though where he was very approachable, and it was in those times that we addressed some of it...however, I can say that dad believes he is on antidepressants to sleep...he takes them at night, and though a side affect was sleepiness, it also serves its purpose in "lightening the load" that a cancer patient has on their brain.

I am a fan of antidepressants these days, in a way that I have never been prior to the cancer roller coaster we got on in March. I think there is just so, so much that a cancer patient feels and such, that I cannot imagine that being easy at all. I assume those with cancer will post here also to give their perspective on this.

Best of luck!

Jen

[nonni]

Hi Darcy....just let me stick my two cents in here as a survivor not a care giver....

When I was dx and after surgery...and it really sunk in that I HAD LC...I was livid...I used to go around the house talking to myself...saying "what the he$$ where you doing in MY body"..felt like a terrible horrific invasion...and believe me I went into many mood swings...and my family and friends understood...I was mad...I was angry...I jumped the gun at every little thing..all my scan's were good too..but still very upset and grouchy...set my poor husband crazy and he just took it and took it...until I finally realized myself that I needed something to calm me down...and then came the Zanax and that was a life saver...

I didn't want any Zoloft or anything that was long term for depression...I wanted a quick fix for when I would fly off the handle...

Things have settled down quite a bit with me now...cause I am now about 3 weeks away from 2 years post surgery...

See ..I understand your FIL completely...I wasn't interested in anything that I loved to do either for a long time...and I know all of you caretakers are concerned for the patients well being..and you all do a wonderful job..but that being said.. say what you may...You really don't know the feeling till you went thru it...and of course everyone act's different...I was like your FIL

And from my understanding...your don't get a brain scan unless you show some kind of symptom's..like pain...but what do I know...

I hope and pray that your FIL get's back into the swing of things shortly but an occasional 'happy pill' will do world's of good for him...I think you are a great DIL to be concerned ..keep up the good work....So that is my story and I am sticking to it... hugs...PamS..

[Littlegirl]

I agree with Carleen in the approach of suggesting anti-depresasnts without calling them anti-depressants or mentioning depression. Although my mom is the one who got the cancer diagnosis we knew dad was the one who needed the anti-depressants. My sister takes care of getting my dad's meds set up each week and she explained to them that these pills help the neurons in his brain release endorphins. I know of another family that called it a nerve pill and explained that it helped keep the nerve endings in his hands and feet working properly.

Hope you see an improvement soon! Hang in there!

Karen