The negative physical and psychological consequences of breast cancer diagnosis and treatment have been well documented. Women who survive breast cancer often struggle with depression immediately after. Their change in physical appearance, inability to function as they did previously, worry about reoccurrence and treatment side effects can cause a woman to experience significant negative mental health problems. However, most research shows that women who did not have clinical levels of anxiety or depression prior to developing breast cancer usually see remission from their symptoms 5 years after they have been cancer free. But few studies have looked specifically at how depression and anxiety persist in sexual minority women (SMW). SMW (e.g., bisexual and lesbian) generally have more mental health problems than heterosexual women due to several internal and external factors. They experience more discrimination, shame, and fear because of their sexual preference. And statistically, SMW tend to use alcohol and drugs more and be more obese than heterosexual women. These factors place them at increased risk for mental health issues and cancer. Ulrike Boehmer of the Department of Community Health Sciences at Boston University wanted to find out if this segment of the population, already predisposed to decreased psychological health, was more likely to have persistent depression or anxiety after breast cancer treatment than heterosexual women.
For the study, Boehmer evaluated several hundred heterosexual women and SMW breast cancer survivors and found that the SMW had nearly equal levels of depression and anxiety at diagnosis. However, Boehmer discovered that the SMW had much less anxiety when assessed several years later. Because the participants were from Massachusetts, a state in which same sex marriage is legal, many of the SMW were married. Therefore, Boehmer concluded that marriage provided protection from depressive and anxious symptoms in these women. However, the married heterosexual women experienced more anxiety than the single heterosexual women long-term. Other factors that increased anxiety and depression in both groups of women were unemployment, economic status, and medication usage. Specifically, the SMW and not the heterosexual women experienced more depression after treatment if they were on a mood stabilizer prior to diagnosis. This might be due to the fact that SMW have higher rates of precancer mental health problems, seek treatment more often, and therefore are prescribed mood stabilizers more frequently than heterosexual women. Boehmer believes that the results of this study should increase awareness among clinicians treating SMW breast cancer survivors and added, “Among sexual minority and heterosexual survivors are certain subgroups that have greater need for mental health services, or possibly unmet mental health needs, including survivors with lower educational levels or lower income and younger survivors.”
Boehmer, U., Glickman, M., & Winter, M. (2012). Anxiety and depression in breast cancer survivors of different sexual orientations. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0027494
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