January 16, 2019 by Laura Pincus and Patty Shillington
‘My Depression Saved Me’: A Patient Story
Medical experts have established a link between depression and cancer. Last year, psychologist Paula Levine, Ph.D., experienced that link first hand. In fact, she credits her depression with leading to her diagnosis of ovarian cancer.
“It was caught in stage one. That is really the miracle,” she says. “I had no symptoms. Had it not been for the depression, I don’t think we would have discovered the cancer.”
Levine’s story began with the sudden onset of major anxiety and depression symptoms. Months of psychotherapy and heavy doses of medication failed to provide relief. So at the urging of her daughters, she sought help from her long-time family physician, Cindy Mitch-Gomez, M.D., of Baptist Health Primary Care in Pinecrest, Fla.
(Video: The Baptist Health News Team hears from Paula Levine, Ph.D.; Cindy Mitch-Gomez, M.D.; and M. Beatriz Currier, M.D., about Ms. Levine’s case involving depression and cancer. Video by Carol Higgins.)
‘This is So Unlike You’
“I immediately said let’s continue your treatment with the psychiatrist, but let’s look for something else because this is so unlike you, and I just couldn’t believe that it was all just a primary depression,” recalls Dr. Mitch-Gomez. She ordered a full battery of tests. A blood test for ovarian cancer came back normal, but a CT scan revealed an abnormality with Levine’s left ovary.
Under the care of Nicholas Lambrou, M.D., chief of robotic surgery for Baptist Health South Florida, Levine had a hysterectomy and was diagnosed with ovarian cancer. Levine remembers Dr. Mitch-Gomez visiting her afterward in the hospital. “She said the most amazing thing. She said ‘no wonder you were so depressed, this cancer has been sucking the life out of your body.’”
Dr. Mitch-Gomez referred Levine to psychiatrist M. Beatriz Currier, M.D., medical director of the Cancer Patient Support Center at Miami Cancer Institute, for continuing psychiatric therapy during her cancer treatment. An expert in the cancer-depression connection, Dr. Currier was able to offer Levine an explanation for what she was going through.
Link Between Depression and Inflammation
According to Dr. Currier, “Cancer patients are three times more likely to develop depression within five years of their cancer diagnosis when compared to the general population. And there’s now compelling evidence that the link is systemic inflammation.”
Currier says the presence of a malignant tumor will increase systemic inflammation in the body, and inflammatory signaling molecules, called cytokines, can cross into the brain and produce symptoms that mimic depression. “(Paula) was actually relieved to discover that the issue that was producing these behavioral symptoms was not a clinical depression but rather a manifestation of the systemic inflammation that was being produced by the cancer,” Dr. Currier said.
Dr. Currier believes it’s important for cancer patients to receive mental health care from someone familiar with cancer treatments and medications.
“Cancer treatment is complicated,” she says. “I think it speaks volumes about the mission of Miami Cancer Institute that they realize that in order to be a world-class cancer center you need to be able to provide the support to address all the needs of the cancer patient.”
For Dr. Mitch-Gomez, Levine’s story emphasizes the importance of having a family doctor.
“It’s really, really important to have somebody who knows you, who understands you, and not only you but your family history,” Dr. Mitch-Gomez said.
Thanks to the dedication of her family doctor, a gynecological oncologist and an expert psychiatrist, Levine is now cancer- and depression-free and has resumed her normal life.
“I have a new understanding of depression,” says Ms. Levine, “I will be much more diligent with my patients who come to me with psychological issues to explore with them what might be going on physically, and I’d like all mental health professionals to do the same thing.”