32. Cancer gets the sympathy vote; depression doesn’t

I have been brewing this blog post for months. Now, with the world's sudden awareness that an illness such as depression is serious and can happen to nice people, I cannot leave it any longer. This post is serious but important. Please bear with me.

It starts with a reflection on how the mere mention of the C word gets me everything I need. This is quite miraculous.

Expensive (but free) tests; full and swift treatment; a cancer support nurse; a golden ticket to breeze me through the blood clinic or through A&E; enough cancer information booklets to make my shelf groan; leaflets about free make-up sessions/wig sessions/fashion shows/extensive courses in mindfulness-for-cancer-patients/complementary therapies, so that we can feel good about ourselves despite a lack of hair or breasts.

But it doesn’t stop there. I have been overwhelmed by people’s sympathy and understanding.

There has been instant and full support from all quarters (family, friends, colleagues, work managers) for my inability to function or focus on anything other than myself. Nobody has raised an eyebrow at my need to have time off work or to sign off from family responsibilities. In fact, it has been quite the opposite. At the slightest sign of me trying to struggle on, people have said: Don’t worry, I’ll do it, anything I can do to help, just focus on getting better, of course you can’t.

My depleted energy levels have, I am sure, been a result not only of the physical effects of cancer treatments but also of the huge psychological and emotional adjustments I have had to make. It is not something I can just lift myself out of. The boundaries between physical and mental health are paper-thin.

And again, there has been nothing but understanding for the fact that it is not only my body that needs time to recover from the onslaught of cancer; it is my mind, too.

Cancer has been the most effective and all-round excuse I have ever come across.

I decided early on that it was best to be open about my diagnosis, because it meant that there was instant understanding of my inability to do things. Sorry, can’t give that lecture/write that research paper/sing in that concert/attend that parents evening. Cancer, you see. Bingo. Of course you can’t. Anything I can do to help etc etc.

Even my husband benefits from this fount of sympathy. He is not one to draw attention to personal circumstances at work, but he has found that Sorry, can’t attend that meeting, need to attend to my wife… cancer…”  is an eminently acceptable reason for absence, met with understanding from colleagues and clients alike.

All this support has been hugely welcome. It has meant that as a family, we can focus on getting through this rough patch and hopefully emerge relatively sane at the other end.

I don’t think any cancer patient would take advantage of such sympathy. Women of the multitasking generation are mostly worried about not pulling their weight.

Although, admittedly, it has been tempting. Like that morning when we spotted our youngest daughter’s bright green fingernails, against school rules. It takes at least five minutes to cycle to school, and it was five minutes to school-bell time. Should we say anything? We decided to stick with the teach-them-to-take-responsibility-for-themselves style of parenting. It wasn’t as if she hadn’t been told before, by us, by her teacher. We’ll get the head mistress onto us! my husband said, conscious of dear daughter’s tendency for lateness as well as a certain lack respect for school rules on grooming. Never mind, I suggested, I’ll just tell her that I’m really sorry but I’ve got cancer so I can’t help my daughter.

The thing is, if I had made such outrageous use of the Cancer Card, I suspect it would have made the head mistress reach for her own nail varnish remover and attend to my daughter in person, with care and compassion. I don’t think she would have been tutting in her office over my inadequate parenting.

If you are going to get a serious illness, cancer is not a bad option.

We used to say this during my days of hospice nursing, whenever we were struggling to access resources for patients with chronic heart failure or dementia. Perhaps it was the greater unpredictability of the course of other illnesses (you could only access certain resources, including benefits, if the doctor was able to give a clearly limited prognosis). Sometimes, it was simply because certain resources were for cancer patients only.

And that doesn’t even touch on the sympathy vote. I often think back to the patients who died of AIDS – in the 1990s, they were coming through the hospice doors in their dozens. Not for them the compassion of friends and strangers. Many suffered in silence, sometimes even unable to draw on the support of family.

Which brings me to the compassion and support needed by people with illnesses like depression.

Ever since my diagnosis, I have been thinking about the disparity between my situation and that of people with mental health problems.

Suddenly, this is headline news, prompted by the incredibly sad death by suicide of the brilliant comic actor Robin Williams. Suddenly, there is talk about the need to see depression as the serious illness that it is. An illness that can kill you, in the same way as cancer can kill. An illness that deserves treatment, resources, understanding, much like cancer does.

Will it change anything? I fear not. Because that requires a profound change in attitude. Just before turning on the BBC news that reported on Robin Williams’ death, I hopped across a panel of comedians who, to my horror, made fun of patients in “mental hospitals”. The worst job one panellist had ever done? Keeping mental patients away from the food bins. Cue joke: bet nobody could tell the difference between you and a mental patient, hahaha…

Bet they couldn’t. That’s the whole point. Anyone could be a patient. I don’t look like a cancer patient either. (Not until next week, anyway, when my hair will fall out.)

Perhaps part of the problem is that people can imagine (or at least fear) that cancer might, just might, happen to them. Nobody imagines that mental illness can ever happen to them. (Or AIDS. Or having a child with an intellectual disability.)

I am just trying to imagine people’s response to the following…

Sorry, I am depressed so I cannot help my daughter get to school on time with clean finger nails.

Sorry, I can’t speak at that conference, I am in a bout of deep depression.

Sorry, I can’t attend that meeting, I have to attend to my wife who is suffering from depression.

Hm. Not sure it would work quite as well. And yet it should.

I am left thinking of the deaths of two friends.

One died of breast cancer; the other died of depression. Both kept their suffering to themselves (even the friend with breast cancer, who chose not to tell people about her illness for years and years, as she hated being the target of a sympathy vote). Both were warm and wonderful people with an easy smile, and with a husband, a wife, daughters who loved and needed them. Both must have had a moment where they knew with absolute certainty that they would die of their illness. Both were utterly helpless to prevent that happening.

Both were in equal need of sympathy and support. But at one funeral, our distress at our friend’s fate could be freely talked about; at the other, it couldn’t.

Given the choice between chemo-induced nausea and the unimaginably deep dark despair of depressive illness, I know which I would choose. Next time I need to stick my arm out for another dose of Red Poison, I will think of my friend who got to a point where no amount of family love could prevent him taking his own life. And I will be grateful that my illness is cancer.