Hearing the words “you have breast cancer” is devastating enough, but when you have bipolar disorder, it is a double whammy. With bipolar disorder, depending on your stage of the disease and level of stability, your life is already a daily struggle of maintaining normality and fighting to remain as close to baseline as possible with no episodes of mania or depression. What sucks even more is knowing that having bipolar disorder actually increases your risk of cancer 2.6 times according to recent John Hopkins research.

For individuals without bipolar disorder, cancer can bring depression, anxiety, and definitely fatigue. You’re now in the fight for your life, and it’s one you have to fight with everything you have if you’re going to win. As if that isn’t enough, the side effects of the chemotherapy treatments and repetitive surgeries and recovery periods are enough to bring anyone down, including the happiest of individuals. Even those with the most positive mindsets are going to have their bad days when a little depression is likely to creep in, if only for a short while.

If your chemotherapy is one that puts you into early menopause, that just makes it worse. Add the bipolar and, if applicable, the anxiety you are already dealing with and whoa! Talk about having your hands full…and you really do, but the good news is that it is manageable, and you don’t have to do it alone. This is something I’ve dealt with personally, and I know that I didn’t do it on my own – I needed a strong support system of family and friends, a good doctor and therapist, and the right medications. All of this combined allowed me to not only maintain stability, but also maintain a positive attitude throughout my cancer treatment – something that my doctor feels contributed to my current success with the disease.

There are several things I did at home to help my condition. I used a journal, daily devotional, regular massages, acupressure, music therapy, prayer, and aromatherapy. Some other recommendations include hypnosis, meditation, progressive muscle relaxation, support groups, tai chi, and yoga.

Breastcancer.org also makes several recommendations on how to cope, several of which I used successfully. These include setting realistic goals and expectations.

• You can’t do it all at once, and you can’t do it all by yourself.
• You’re not the superwoman you used to be, and that’s okay.
• Ask for help, and accept that help graciously. It will make your life a lot easier.
• The chores you insist on doing yourself, break them into small pieces you can do, and take breaks in between each piece. Work for 15-30 minutes and take a 15-20 minute break.
• If you insist on doing the grocery shopping, use the motorized shopping cart instead of walking the store. Trust me, it makes it a ton easier to handle an hour long shopping trip without being totally exhausted. Remember, you still have to put those items away when you get them home.
• Try to be around people for at least a short period of time every day. I would make myself go to Wal-Mart every day, even if I only bought a pack of gum.
• Find activities that help you relax. Maybe it’s going to a sporting event, listening to music, taking a long, hot bath, painting, or volunteering. I began fostering a cat for a local rescue group. It was a low effort way to volunteer, but because I was saving another life as I was saving my own, it really helped build me up, not to mention the love and companionship he gave me while I was home all the time. He was also sick when I got him, so I had to nurse him back to health. It was encouraging to see him get better, knowing that I could do the same.
• Make sure to eat a healthy diet and exercise when you can. Just taking a short walk will do wonders for your mood. There were days all I could do was walk to the mailbox - and that was a very short walk - but just being out in the sunlight made me feel better. I would just stand outside and soak it in for a few minutes.
• Avoid drinking alcohol. It actually makes the depression worse as its effects wear off. Although it might help you get to sleep, but it interferes with quality sleep and makes you more tired in the end.
• If you don’t have to make an important decision right away, put it off until a day when you feel better.
• If you’re a smoker, quit smoking. If you can’t give it up altogether, try electronic cigarettes instead. That’s what I did, I got a starter kit. I’ve been using them for almost two years, and I haven’t wanted a real cigarette since I started using it. My oncologist has actually given the okay for me to use these, as you still get the nicotine you are used to, and you still experience the stress relief and the action of smoking without the harmful chemicals. I’ve used them while in the hospital after surgery and even use them while sitting in the chemo room receiving treatment.  
• If you choose to start taking an antidepressant and are on Tamoxifen, ask your doctor about drug interactions. Cymbalta (duloxetine), Paxil (paroxetine), Prozac (buproprion) and Zoloft (sertraline) all interfere with the conversion of Tamoxifen into its active form in the body, which means you don’t get the full benefit from the drug. If you’re taking Tamoxifen, you’ll need a different antidepressant; there are plenty others to choose from. There is good news about Tamoxifen, however. It has been shown to dramatically reduce symptoms of the manic phases of bipolar disorder according to the National Institute of Mental Health. It works by blocking the protein kinase C (PKC) enzyme that is thought to be over-active during manic phases. It also works more quickly than traditional medications used to treat mania in bipolar patients; however, due to the biochemical properties of Tamoxifen, it is not a viable treatment for patients who do not also have breast cancer because it also blocks estrogen.