"I used to be as beautiful as a flower" | Depression in breast cancer patients after surgery

“I was once as beautiful as a flower.”

Ms. Lin stood by the window sill on the 12th floor, looking at the withering cherry blossoms in the distance and sighing. She didn't know when the tears in her eyes fell. She thought, if she fell like a petal, would it not be so painful? Her husband sighed as he looked at his wife by the window. This scene has happened more than once since that incident. At first, Ms. Lin's husband, Mr. Li, would patiently guide and comfort her, but countless times of comfort eventually exhausted his patience. He even felt that his world began to become darker.

The story began two years ago. At that time, Ms. Lin, 29, was a celebrity in the workplace. She married her boyfriend whom she had known since college. The two supported each other and had a deep relationship. They both achieved good results in their respective fields. Ms. Lin had many friends and loved shopping and dressing up. In the eyes of the older generation, she was the legendary "other people's child". Unexpectedly, the physical examination at the company brought out bad news. A nodule was found in Ms. Lin's right breast. At the same time, the careful doctor found a swollen lymph node in the right armpit during the physical examination. After various examinations, Ms. Lin was diagnosed with breast cancer.

The doctor told her that she had to have her right breast removed and chemotherapy after the operation. She was reluctant at first, thinking, "If I remove my breast, will I still be a complete woman?" But after seeing the news that the 33-year-old female singer Yao Beina died of breast cancer recurrence in 2015, she became scared and her husband supported her to have the operation.

After the operation, Ms. Lin recovered well and was discharged from the hospital soon. She thought everything was back on track, but she was still in a low mood. She felt unconfident when she walked on the street, and she felt that everyone looked down on her when she heard people discussing her affairs at the company. At night, Ms. Lin's husband, Mr. Li, got up to go to the bathroom, turned on the light and found his wife in bed. He opened the door and found her sitting on the sofa wiping tears.

It turned out that Ms. Lin was always sad and had trouble sleeping during this period. She woke up at one or two in the middle of the night and could not fall asleep again. She sat in the living room for fear of disturbing her husband. In the following period, Ms. Lin became less and less willing to socialize. She took a long vacation and stayed at home. She didn't like to laugh anymore and often sighed by the window. The Ms. Lin that everyone envied was gone. It was not until the husband found his wife in the bathroom in the middle of the night after cutting her wrists and bleeding unconscious that he realized that there was something wrong with his wife.

He took his wife to the hospital, and soon Ms. Lin woke up. Mr. Li was very happy, but the doctor reminded him that Ms. Lin might be suffering from depression and suggested that he take his wife to the mental health center for treatment. The doctor at the mental health center diagnosed Ms. Lin with severe depression and admitted her to the hospital.

When she was first admitted to the hospital, considering that Ms. Lin had serious suicidal behavior, in order to prevent her from harming her life again, the doctor recommended that she undergo modified electroconvulsive therapy (MECT). Mr. Li panicked when he heard about MECT, thinking of the painful treatment of the male protagonist in the movie "A Beautiful Mind", and he quickly asked the doctor what MECT was?

What is modified electroconvulsive therapy?

The doctor patiently explained to him some details about MECT. Electroconvulsive therapy (ECT) is a treatment method that uses short and moderate electrical pulses to induce synchronization of electrical activity in the central nervous system (similar to a grand mal seizure). In layman's terms, it is a method of pressing a "restart" button on the brain to quickly control the symptoms of mental disorders.

Traditional ECT can easily lead to complications such as hypoxia, fractures, cardiovascular accidents, and bring patients painful experiences such as fear, tension, and anxiety. Modified electroconvulsive therapy is based on traditional ECT treatment, using anesthetic drugs and muscle relaxants to eliminate the pain, muscle spasms and other adverse effects brought to patients by the treatment, while retaining the good therapeutic effect.

After listening to the doctor, Mr. Li signed the consent form with confidence. After a MECT, Ms. Lin's condition improved significantly. At the same time, Ms. Lin took fluoxetine for antidepressant treatment, and the doctor also prescribed her some drugs to help her sleep. The effect was very good. Ms. Lin's spirit recovered a lot, and now she receives psychological treatment once a week.

Fortunately, Ms. Lin cooperated with the treatment and she will be discharged from the hospital soon.

Preventing depression after breast cancer surgery

Breast cancer is currently the most common malignant tumor among women in China. After contracting the disease, a considerable number of patients need to undergo mastectomy, chemotherapy and other treatments. Faced with problems such as damaged bodies and hair loss, patients' mental health is severely tested.

Current surveys show that the incidence of anxiety and depression one year after breast cancer diagnosis is as high as 50%. Faced with such a high incidence, more and more voices are calling on everyone to pay attention not only to the physical health of breast cancer patients, but also to their mental health!

References

[1] Jia Yuping, Jiang Jiangling, Xiao Wenbin, et al. Research progress in anesthesia for improved electroconvulsive therapy[J]. Journal of Shanghai Jiaotong University (Medical Edition), 2020, 40(7): 980-984.

[2] Yang Min, Lan Bo, Ma Fei, et al. Research progress on anxiety and depression in patients with breast cancer undergoing adjuvant chemotherapy after surgery[J]. Journal of Clinical Oncology, 2019, 24(8):757-761.

[3] Li Lingjiang, Ma Xin. Guidelines for the prevention and treatment of depressive disorders in China (Second Edition)[M]. Beijing: Chinese Medical Electronic Audio-visual Publishing House, 2015.

The picture comes from the Internet. If there is any infringement, please inform us to delete it.

Author: Wang Yun Zhang Wenting

About the Author

Wang Yun

Master of Medicine, Attending Physician, Shanghai Mental Health Center

Has been engaged in clinical diagnosis and treatment of psychiatry and teaching of medical students for a long time

2019 Outstanding Teacher of Shanghai Medical College, Fudan University

Secretary of the CSNP Chinese Depression Researchers Alliance

The first author has published more than ten papers in domestic and foreign journals

Expertise: Clinical diagnosis and treatment of depression and anxiety disorders, neurosis, schizophrenia, and consultation on general psychological issues such as study, work, marriage and love.

Clinic hours: Psychiatry on Tuesday morning, psychological counseling on Thursday afternoon and Saturday morning.

About the Author

Zhang Wenting

Zhang Wenting, Class of 2017, Clinical Medicine, Shanghai Jiao Tong University School of Medicine (eight-year program)

Shanghai Jiao Tong University Ruijin School of Clinical Medicine

Funded by Shanghai Science and Technology Commission's Science Popularization Project

(Project No.: 20DZ2311100)