These days it is becoming harder to distinguish between feeling exhausted and feeling depressed. The truth is I am probably both, and one is feeding into the other like the chicken and the egg.

I was re-diagnosed in December of 2021. This incarnation of my disease has spanned 2 years and 3 seasons and I am only 2/3 of the way through treatment. It is enough to call even the most even-keeled person’s mental state into question, and I don’t think anyone who knows me well would call me even-keeled.

I am having a very hard time falling asleep at night, even though I feel like I could slip into a nap at almost all times while the sun is out. This is partly due to restless leg syndrome, which is a silent enemy, and also to do with a racing mind. Since I work in a school and it is summer, I can sleep in, which has turned into part of the problem. I find myself sleeping in far too late most days. In part because I fall asleep late and, I fear, also because depression fears daylight.

This morning, in a stunning break from tradition, I woke up at 5am, my mind churning. I got out my phone and composed a list of things that were on my mind ranging from, ‘When the kids go to their one-week sleepaway camp, do I need to be able to fit the pillow in the duffel bag?’ to ‘ uterine surgery- do I still need this?’ I did what any insane person would do and put on my gym shoes and went for a jog. I needed to clear my head by way of clogging it with the test of ‘will I survive this exercise?’

The jog helped, but gave way to a nap from 10am-noon, which is on a depressive person’s cheat sheet for getting through the day- sleep through as much of it as you can.

Contributing to my deteriorating mental state are the obvious anxieties: the re-diagnosis of a deadly disease and excruciating treatment, but also a whole ton of ancillary issues like the feeling of alienation from all the well people, weight gain and loss of sense of self.

I see my my sister truly living her best life, looking better than ever and feeling happy and fulfilled. I watch my friends traveling with their families to cool and exciting places. Of course I know that no one’s life is perfect, but mine is crumbling at the foundation.

My kids are spending way too much time on their devices this summer because their mom can’t take them on adventures. I feel particularly terrible about this. I lay in bed gazing out the window at the flowering trees and blue skies and know my son is in the next room, face buried in an iPad watching utter nonsense for hours on end.

Another area that feels dismal is my marriage. My husband and I have different love languages which is normally fine, but when one of us is a shell of a human being, the differences slam into focus. I long to be listened to and looked at, whereas he wants to offer acts of service. He has been working hard to start philanthropies on my behalf, which is so wonderful, but all I want is eye contact. I am the walking personification of all the sad things in our lives right now. Though he won’t admit it, I know he avoids looking at me because it hurts him.

Does everyone know that when you lose your hair to chemo, you lose your eyelashes too? The combination can really make a person look ill. And I promise you they likely feel as ill as they look. I understand that looking at me these days carries with it a heavy burden. I am the disease. I embody everything it has taken from our family.

This lack of human connection is difficult, for obvious reasons, and because I am a woman who feels self conscious under the best of circumstances. I look 15 years older and am 15lbs heavier and gooey. Facebook hit me with a photo from 4 years ago earlier today and it was instantly upsetting. I looked so vital. I had hair, eyebrows, lashes and a flush in my cheeks that wasn’t from a menopausal hot flash. The loss of this version of myself is painful, and though I will never know the truth, I fear my husband, by way of being human, feels the loss too.

I have never been afraid to admit that I struggle with anxiety and have dipped towards depression before. I have taken an SSRI for over a decade for these reasons. During this cancer, I have started seeing a new psychiatrist who has been so helpful managing all of my many medicines. One new med he started me on is Zyprexa. It is used off-label for chemo-induced nausea, but its main use is as an anti-psychotic.

It is not lost on me that I am taking something that isn’t allowing me to be psychotic. I wonder how much worse my mental state could be without this drug? I am 2 weeks from being done with chemo, and hope that they won’t take me off the anti-psychotic when it is all over. I am not too proud to admit that I likely need the drug for its intended use.

Speaking of crazy…I have to let my mental health take a backseat to my physical health right now. That means spending sunny days behind my curtains and feeling like the chirping birds are the enemy. I will continue to pine for the summer vacations of my friends and the figures of the able-bodied. It has to be okay. I have no other choice.