Inner Conflicts During Remission: Depression and Fear of Relapse

A friend referenced this article and asked me, "Do you find such inner conflicts in your remission/recovery?"

The article discusses the fear of relapse among other issues, though the fear of relapse stood out to me the most.

This was my response to my friend. I share it in order to share how I dealt with depression and fear. Unfortunately, there's not much advice I have for fear. My lack of fear was just miraculous, provided by God. It happened; I didn't do anything except exercise diligent effort prior to leukemia trying to live a life of faith (and experiencing great reward for doing so).

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I don't think I'm the typical cancer recovery patient. Honestly, I have a lot more faith and experience than most. I've met some incredible people who I admire, but for the most part, people do not know how to deal with depression. It comes on them and overcomes them.

I have faced depression two or three times in my recover caused by the medicine or the damage done to my body or something. The depression is real and unavoidable. It's like getting mad. It's just there. You can't control the feeling, nor can you make it go away.

That's where my similarity to others who suffer with depression ends. A friend of mine teaches pretty often that we need to know what is from us and what is not.

The couple major times that depression has come on me, for weeks in the hospital after the transplant and a week or two over the summer afterward, I did not treat it like it was me. I treated it like it was a feeling that came from chemo and damage to my brain or body from the treatment. Sometimes I "hid" from it, taking even days to just rest and do nothing, talk with people, and refuse to think the way depression wanted me to think, even if that meant just curling up, sleeping a lot, and trying not to think at all.

I treated it like a disease, and a couple times I asked for Ativan or some other mood enhancer to help me overcome it or sleep better. I did not apologize for doing no work on those days. I was very sick, with depression. Some of those days I spent the day in bed.

That worked for me. I was literally depressed and satisfied and happy all at the same time. The satisfaction and happiness was me, based on my faith in God and helped by my wonderful family, friends, and brothers and sisters in Christ. The depression was sickness, brought on by cancer treatment.

I have a grossly unfair advantage, though. No one has a support system like I do. Well, maybe some do, but no one has any better. My wife was miraculously wonderful, God gave my family great grace, and people showered me with love. I have a very large family, both biologically and spiritually. I can't say my extended family is close, but I was astonished at how they rallied to my side, at least electronically if not actually in person.

As for fear of relapse, I've been a crazy Christian for a long time. I take risks with God, and I take risks with believing.

I think God told me as soon as this wonderful adventure with leukemia began that leukemia wouldn't kill me. I've just always believed that, so I don't wonder about relapse.

I had a very rough treatment, and there were a lot of hiccups in my recovery. The treatment was a lot more likely to kill me than relapse, in my opinion.

There's some pretty strong medical evidence that I'm unlikely to relapse, too. They did a very thorough job of destroying my old blood system. One round of chemo was so intense that I can't find record that anyone has been given more than 40% of that particular chemo that I received. "High dose" cytarabine is usually given at a maximum of 3000 mg/m2 for eight doses. I got twelve doses of 6000 mg/m2.

Even my oncology nurse, who only works with leukemia patients, had never heard of such a dose. She said, "This is a big dose. Are you really getting eight of these?" When I told her I was getting twelve, she just walked out of the room, saying nothing but, "Oh."

Further, those who get a transplant from cord/placenta blood usually have a slow engraftment and a gentle new immune system. I had a rapid engraftment and I have an aggressive immune system, as though I had been transplanted from an adult. This means more side effects, but less chance of relapse.

Turn Your Eyes Upon Jesus

Yesterday I finally got a taste of worry.

It wasn't a bad kind of worry. It was just an honest, responsible kind of worry. "I need to be realistic. I need to make sure my affairs are in order."

Photos by Ashelie Hartle

I was even thinking positively. It's people with a good attitude who beat leukemia, and everyone tells me I've got as good an attitude as they've ever seen. I just need to maintain that attitude.

But a tinge of doubt came in. I was no longer sure I could "maintain that attitude."

I turned to good, religious thoughts. "God's in control. It's faith that matters, not good attitude. A good attitude is the product of faith."

But I was no longer sure I could maintain faith, either. After all, doubt--no matter how small the amount--had already crept in.

To be honest, I was in that state for hours. I wasn't directly thinking all the thoughts I just wrote. Instead, I was maintaining a good attitude. I was being cheerful. I was talking with the nurse and trying to be as encouraging to her as possible. I was enjoying the day. I got 15 pages done on Thrilled to Death. I was enjoying the time with my wife as she came in and out from laundry, cleaning the trunk of the car, and other various errands. I was keeping up with others by Facebook between chapters of the book.

My attitude was very good; very positive.

But by evening, at least compared to previous days, I was tired, and worse, I was unhappy.

Turn your eyes upon Jesus
Look full in his wonderful face
And the things of earth will grow strangely dim
In the light of his glory and grace

A simple shift of attention.

No condemnation. No need for penance. My Father simply swooped me up in his arms, pulled me back to his bosom, and flooded me with grace.

Doubt? Doubt about what?

Doubt about walking with Jesus tomorrow? It's so good today. Why would that ever go away?

Doubt about dying? We're all going to physically die. Nothing to doubt there.

My job is to live in the presence of God. My job is to talk about what he's talking about. He's actually said something about my dying. He's said I'm not going to die, at least not from leukemia. So I say that as well.

But really, it doesn't matter.

Doubts that I can maintain a good attitude? I no longer care about a good attitude. My good attitude is, quite apparently, mostly useless and definitely fleeting. I want Christ's attitude. It's supernatural, powerful, and eternal.

I started to write a little excursus on hearing God a little above, but I thought it disrupted the flow and went better on my Rest of the Old, Old Story blog, so I put it there.

(Hmm. "Excursus" is another word blogger can't handle. It's correct, though.)

Finally, for the more practically minded, despite all I said above, I "set my affairs in order" as soon as I got a diagnosis. To this very moment, I believe it would have been irresponsible not to. That wasn't very hard because I'm part of the body of Christ--the visible body, not the wishful thinking body--and well taken care of.