We’ve spent the last couple of weeks discovering the various stages of grief during cancer – if you haven’t already, check out our articles about denial and anger during cancer or bargaining during cancer. This week, let’s dive into the final stages of grief from the Kübler-Ross framework – depression and acceptance. Of course, we’ll cover how depression and acceptance may reveal themselves during and after cancer, how to cope, and how to accept… acceptance.
What is depression?
Depression is a well-known and common mental state, and is experienced by 264 million people worldwide. So, a.) you’re not alone and b.) depression affects people differently, both in the way it reveals itself and the severity of its symptoms. In general, depression is described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.
In the last few years, depression has gone from taboo to being perhaps recklessly misused to describe “normal” low mood. It’s totally normal to feel the ups and downs of regular life. And though depression can be mild and temporary – which is common when grieving – depression can also develop into something more serious and long term, which is called clinical or major depression. Symptoms of depression vary, and according to Healthline, some experience it through changes in mood, while others are affected physically.
In short, it can be mild or serious, long or short, physical or mental. Unique to you. For the sake of this article, we’ll focus on depression as a stage of grief rather than make sweeping (aka unhelpful) generalizations about a complex mental health condition.
Depression during and after cancer
1 in 4 people who go through cancer experience depression, and many more experience temporary signs of depression – sadness and lowness that negatively impacts their health.
If bargaining is a mental state that keeps you in the past, depression is the point at which you arrive in the present. Rather than denying it (denial) or trying to make it go away (bargaining), we face it head on and are, ironically, filled with emptiness. The realization of the loss means that we are struck with the impact of it. We literally feel the loss, the emptiness.
In the context of grief, depression is a completely natural state of mind. We cannot begin to accept a new reality if we never allow ourselves the space to feel what it’s like to live without what we’ve lost. Depression, like all stages of grief, can affect anyone affected by cancer, whether you or a loved one has been diagnosed. Maybe you don’t feel hungry, or maybe you feel more so. Maybe you can’t seem to enjoy something that used to bring you joy. Maybe you don’t know if you’re experiencing any symptoms because cancer affects your body and your mind, just like depression, and mixing the two doesn’t leave much space for clarity.
However it manifests itself, feeling empty is an individual experience. It may come and go, it may stay for awhile and then say its goodbyes. The official site for the Five Stages of Grief clarifies that depression during grief is not an illness. It is, in fact, “the appropriate response to a great loss.”
How to cope with depression
Oftentimes, people who experience depression or know someone who is currently dealing with it, feel that it’s unnatural and feel the need to be cheerful and snap out of it. In the context of grief, though, how unnatural would it be to actually be cheerful?
So if you’re mourning the loss of your freedom or the life of a loved one, and when the reality of this sadness sinks in, it’s normal to feel that everything else in comparison loses its meaning. This separates us from the world and others around us, which is why many people who experience depression retreat into themselves.
An antidote to this is summoning the courage to share your grief with others – whether they’re loved ones who listen rather than try to cheer you up, or others who understand. The War On Cancer app is a great place to share with people who understand what it’s like to lose something or someone because of cancer.
Another way to help deal with feelings of depression (and acceptance, for that matter!) is to try out mindfulness, prayer, meditation, or other types of spiritual activities. This may mean simply sitting with your breath and becoming aware of the physical present, letting anxious or difficult emotions go with every breath, or praying your burdens away.
Oftentimes, nature has a way of relaxing our beings. Going on a walk if that’s available to you can be helpful. Fresh air, fresh thoughts. Or, try doing an activity that brings you joy, even if it currently doesn’t bring you as much joy as it used to. If nothing else, will help you express your thoughts through the activity or help you focus on something that gives you energy in this world. Here’s how Amy coped.
A helpful perspective to have may be that fully feeling this loss, this sadness, is not only okay, but good for you. When you allow yourself to feel, you also allow the process of grief to do its job. Feeling things for the weight that they are allows us to free ourselves from that weight too – which is where acceptance comes in.
The fifth stage: Acceptance
It’s easily mistaken that acceptance is simply coming to terms with the loss we’ve experienced as a result of life with cancer. However, seldom do we simply get over loss. Instead, we learn to live with it. Once we’ve allowed ourselves the space to grieve – feeling the emptiness, aka depression – we are also more capable of seeing clearly, and better navigating, a new reality with its limitations or loss. In COVID times, you’ve probably heard a lot of people talking about “the new normal” – how life will return “to normal” after the height of the pandemic. However, after such a significant event in our lives, seldom does life ever go back to the way it was. We are not meant to go through life unchanged.
Instead, we are formed by our life experiences, that is part of their job. This evolving – learning how to live in a new way, without what we once had, or with something new – is what is meant by acceptance during the grief process. At the beginning, we return to daily routines and resume life as it was. As we do that, we realize that some things may no longer be possible, and new opportunities present themselves that we otherwise wouldn’t have been able to do. We adapt, we grow, we make new connections, become aware of our needs, and see life with fresh eyes. In coming closer with our grief – indeed, learning how to live it with, rather than get over it – we begin to find meaning, slowly but surely. Retrospect breeds wisdom, and the meaning we find breeds hope.
Though depression and acceptance are commonly known as the last stages of grief, a sixth stage has recently been added by David Kessler, grief expert and co-author of Kübler-Ross’ book “On Grief and Grieving.” Check it out if you’re interested – in a few weeks time, we’ll be diving into post-traumatic growth, and meaning has a lot to do with it!
Join the conversation in the War On Cancer app.
The information shared does not constitute a medical consultation and is not intended to replace professional medical advice, diagnosis, or treatment. Consult with your doctor or other qualified health providers for questions regarding a medical condition, especially during the active period of Corona / Covid19. Please do not disregard professional health provider advice or delay in seeking it because of something you have read here. In the event of a medical emergency, call a doctor, 112 or 911 immediately.