Ask Dr. Giles: I am filled with depression, anxiety and feel distraught every minute.

Sophie writes:

Dear Dr. Giles, I am a 62 year old woman with cc and 75% of my liver metastisized. I have had to be so strong all my life and thought I was, but now I don’t believe I am. I live by myself, and my mind is so dark all the time. I am filled with depression, anxiety and feel distraught every minute. Lately I have been logging onto the cholangio site more, but the number of old friends I have read about for the past year are being called home. I try to express my condolences, but I don’t know what to say to anyone. I read the other posts, and they are so supportive and encouraging and offer such sympathy and generosity of heart, and I just don’t know what to say. I am sobbing every time I’m on this site. I want to give others the same support that they have given me, and I feel just numb. I do have a minister who comes over a couple of times a week, and my nieces have been incredible, but they live far away. Family members have called me every day since my diagnosis about 14 months ago, but I can’t seem to find any peace nor the ability to enjoy my time with family members.


My heart goes out to you during this difficult time. Please remember that being challenged doesn’t make us weak–being challenged is what has made us strong. This cancer may represent your most significant challenge, yet, and therefore offers the most significant opportunity for strength.

You mentioned anxiety. Let’s talk a minute about anxiety and how to deal with that. Anxiety is all about the unknown. Anxiety tries to get us to dwell on what is not known at the expense of what is. As a result, we cease to live in the moment and, instead, we exist in an in-between state–between what is and what might be. In your case, Sophie, it appears that your diagnosis has created a shift from what your life has been for 60 years to a life where cholangiocarcinoma casts a long shadow over everything.

May I suggest a response to this condition? Rebellion. I propose that you rebel against this oppressive regime called Anxiety. To rebel, you must reject anxiety’s insistence that you remain preoccupied with the unknown. Anxiety wants you to dwell on questions such as “how long will I live?” or “why is this happening to me?” This leads to having a brain that is bogged down with unanswerable questions, which leads to a kind of emotional stupor and even depression. Instead, I would have you attend to the “here and now.” Focus on today–on right now. Focus on the sensory information available to you. What do you hear? What do you smell? In the process of re-orienting yourself to the “here and now,” I would have you pick out things which are right: the song of the bird outside your window, the smoothness of the countertop in your kitchen, the sight of your minister’s caring face. Stick with the known rather than the unknown and you may find that the darkness that you mentioned will diminish and be replaced with clarity. That clarity will improve your day-to-day experience.