Now, here is an article and a theory that I love to hate. By Salene Wu and colleagues in the Journal of Behavioral Medicine, this piece suggests that depression is common in women with breast cancer because people with depression somehow create stressful events and then become more depressed. This theory is called "stress generation", and I am infuriated by it. Talk about blaming the victim! Of course breast cancer is inevitably accompanied by stress. We could make a long list: worry about death, financial problems, distress for our families, surgery, perhaps losing a breast, radiation, chemotherapy, hair loss, sexual issues, etc., etc., etc. It would be impossible to go through cancer treatment without feeling distressed, and most women cope. Do we sometimes feel sad and scared and angry? Of course. Do some of us experience clinical depression and need meds? Of course. But we are not the cause of these problems and these feelings. Cancer is.
Here is the abstract:
Abstract Depressive symptoms are frequently elevated following breast cancer diagnosis. The stress generation hypothesis states that people with depression generate stressful events and these stressors lead to subsequent depression. This study tested the stress generation hypothesis over the first 5 years of cancer survivorship. Women with stage II or III breast cancer (N = 113) were accrued. Five mediation models were constructed, one for each year. Each model tested whether stressful events in each year mediated the relationship between depression at the beginning and end of that year. Stress generation was observed in the first 2 years following cancer diagnosis but not from 2 to 5 years after diagnosis. The relationship of depression to future stress in breast cancer patients may be moderated by phase of survivorship. Screening and treatment of depressive symptoms in cancer survivors may need to consider the generation of stressful events.