Mood swings as side effects... who woulda thunk it?

The other night I was up surfing the internet and I came across an article that connected mood swings and depression with Tamoxifen.  If you've been following the blog for awhile, you've probably noticed a lot of posts lately about my depression fears and my crying spells. It never occurred to me that any of this emotional stuff could be a side effect of my medication. I honestly thought that it was part of the baggage that comes with battling breast cancer. It is... but I think in my case, there's something more.

I've noticed that when I talk with other breast cancer patients and survivors... they seem to be more balanced than I am. Women who have battled cancer numerous times, have a smile on their face and a pep in their step that I simply do not have. That bothers me. Why aren't I more upbeat or at minimum more balanced about this ordeal? Why do I cry just about everytime someone says breast cancer out loud to me? In my head, I don't feel that I should cry...but for some reason, I do.


(more after the jump... click on the READ MORE link)


For example... yesterday I received an award for being a breast cancer "shero" and in all of my preparations for the acceptance speech, I didn't prepare for tears. Yet, when I got to the podium... I was a bucket of emotion and tears just kept streaming down my face. That wasn't my intention but (once again), it was what happened. Meanwhile, later in the day, several breast cancer survivors came up to me to talk and they all were so very composed, so very calm about their journey with breast cancer.

Why isn't that me? I had been told by many that time would make it better...but it doesn't seem to be working that way actually.

I've been telling myself (and others) that I'm just a cry-baby. But I will be calling my oncologist on Monday to discuss the possibilities of the Tamoxifen causing side effects that are playing with my emotions. When I think about all the ways that I'm not feeling quite myself... I see that there is a pattern that I have to address.

A few of the Tamoxifen side effects include:

• hot flashes
• low sex drive
• mood swings
• nausea
• headaches
• weight gain

Interestingly enough, a few days before I read the article linking depression and Tamoxifen, I read a few articles about the use of anti-depressants with Tamoxifen. To summarize... if I choose to take anti-depressants (assuming that I need them), I have to be quite careful which pills I take because some anti-depressants reduce the effectiveness of Tamoxifen. (geez!) Basically, I am dealing with occasional headaches, serious mood swings, weight gain, some nausea and hot flashes.

Compare those symptoms with some of the symptoms of depression:

• difficulty concentrating, remembering details, and making decisions
• fatigue and decreased energy
• feelings of guilt, worthlessness, and/or helplessness
• feelings of hopelessness and/or pessimism
• insomnia, early-morning wakefulness, or excessive sleeping
• irritability, restlessness
• loss of interest in activities or hobbies once pleasurable, including sex
• overeating or appetite loss
• persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
• persistent sad, anxious, or "empty" feelings
• thoughts of suicide, suicide attempts

I have quite a few of these symptoms as well... so, now I'm concerned. Calm, not scared... but definitely concerned. I hope to know something in the next few days...if nothing more than either there's something to be concerned about or there's nothing to be concerned about. I will keep you posted about what I learn. The way that I shift from laughing to crying... and vice versa has begun to concern me. I may have noticed it sooner if I didn't spend so much time alone. But, a talk with the doctor(s) is definitely in order.

My insomnia has gotten so bad that I have to double my ambien dose just to sleep more than 20 minutes. And without it, I do not sleep. Period. Its a little unsettling. And the other symptom that is beginning to really concern me is my eating habits. I have gotten to a point where I often forget to eat. Like today. Its almost midnight, I haven't eaten a thing all day. As soon as I finish this post, I'm going to eat. But for someone who likes food as much as I do... not eating for an entire day -- for no reason -- just isn't normal. (I feel scrambled eggs and maybe a bagel in my immediate future) This all just tells me that even when you're out of the phase of "active" treatment for breast cancer, you have to remain focused and diligent about taking care of your entire self. I've been so focused on my physical healing and scars that I was diminishing the possibility of having emotional scars that needed attention as well. I won't continue to make that mistake.