My Advice to a Person With Depression Who Then Got Cancer

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In each installment of this daily series, I respond to a composite letter that asks for my career advice.

Dear Marty,

I'm trying to keep it together but I don't know how long I can.

I've suffered from depression my whole life and when, 18 months ago, I was diagnosed with lung cancer (Stage 2a), I could barely get myself to my treatments and to work.

I'm exhausted, mentally and physically. I know that I'm protected by the Americans with Disabilities Act and so I don't think they'll try to get rid of me but I'm not sure. Besides, I feel guilty that I'm not pulling my weight--My coworkers and bosses have been very nice and accommodating to me but I can sense that they're quietly resenting having to do some of my work and, to be honest, clean up some of my messes--chemotherapy affected my cognitive functioning.

Most days, it takes every bit of willpower to get out of bed and to work. Some days, I think the ethical thing to do is to quit but candidly, I can't afford to. I get only a small amount of spousal support and I can't live on that, even if the company agreed to lay me off so I could get unemployment.

And of course, I'm worrying about a recurrence. The year of surgery, radiation, and chemotherapy was horrible--basically taking a year from my life. I was exhausted if not vomiting, not to mention having lost my hair. If it recurs, and there's a real chance it might, the treatment would probably be even more aggressive...Or I might decide to just opt for palliative care.

In the meantime, I don't even know what question to ask you. I just know I feel very beaten down and would welcome any advice you might have.

Despondently yours,

Beaten Down Bertha

Dear Bertha,

I can't begin to imagine how tough it is to suffer from depression and then to get cancer. But my sympathy may, at best, only help a little, so let me try to offer some practical advice.

First, are you taking care of the basics: Depression, unless severe, is usually best addressed through some combination of cognitive-behavioral therapy, exercise, and perhaps a drug. Have you figured out your optimal approach? Are you using it? If you're in therapy, is the therapist using the cognitive-behavioral approach not just for your depression but in dealing with your feelings regarding the cancer?

At work, yes, it's admirable that you're feeling some sadness about your coworkers having to pick up the slack for you but remember, cancer wasn't your fault. We all, in various ways, try to help the less fortunate. I'm sure that if someone else had cancer and you were healthy, you'd pick up the slack for them. I suspect you've already done this but have you reviewed your work tasks and schedule with your boss? Might additional adjustments be made: for example, trading a cognitively demanding task for some other work, or getting to telecommute at least part of the week?

Have you shown sufficient appreciation of your kind co-workers and boss? For example, might you want to send a nice card, homemade cookies, etc. Not only will those make the recipients feel good, it may lift your spirits too.

Are you doing enough to put some joy in your life? The way you describe your life, it's pretty sober. Should you take up some creative activity like painting or writing? Should you spend more time with friends or with family members you like? Even listening to music, watching good movies or TV shows can make life feel better? Or go wild and do something like take a day trip to some cool place.

Wishing you a life free of cancer and filled with productivity and joy,

Marty Nemko

Marty Nemko's bio is in Wikipedia. His 8th book, just published, is The Best of Marty Nemko.