Question: Hello Stephanie, I've been diagnosed and treated for prostate cancer which is now recurring at an extremely aggressive rate. The Dr. (Yes, I understand this is a statistical number) indicates that I have between 2-5 years, but then later indicated that since he doesn't have a crystal ball, it could be as high as 5-9 years. So, I'm struggling to come to terms with that. I believe I'm suffering from depression and am looking for a way to deal with the inevitable and the depression in the meanwhile. What would you recommend?

Stephanie Adams Says...:

There's no way to make news like this one "okay." It's a life-altering diagnosis. People react to this kind of diagnosis in different ways. Some feel like giving up, some decide to do things they've never done before, and some try to go on with things as they were.

You can only begin to overcome this particular kind of depression by asking yourself what you want out of your remaining years (whether those years number two, five, nine or twenty) and how to make a plan to achieve as many of those moments as possible. The answer to that one is complex, and different for everyone. For some it will be time with family, special events, for others it might be taking a risk or realizing a dream like writing a novel. But the most important thing right now is that you don't let yourself just wait for the worst to come...and instead choose what you want the remainder of your life to be. The former is the fastest route to depression, and the latter one of the most freeing choices you can make.

Outside of that, remember that dealing with all that comes with a diagnosis like this one really requires a team approach: you need to lean on your family and friends, seek out the support of spiritual leaders if applicable, and speak with doctors about treatment options. I would also recommend having a face-to-face session (or more than one) with a therapist knowledgeable in the areas of depression and terminal illness. Ask your doctor for a recommendation.

Try this, and remember - it's not over until it's over. You never know how things will play out.

Question: I am drinking too heavily and I believe I would benefit from talking to someone about ways that I might be able to drink less. I am not sure why this is but often my good intentions to drink less get subverted by some process that I don’t really understand that gets me pouring into a glass each night without my even thinking about it too much. In the mornings I feel shame and regret but somehow I just keep repeating this process over and over again. I guess I am an alcoholic but I am reluctant to go to an AA meeting. I live in a fairly small town and I have a position of some importance and it would not be good for people to think of me as a drunk. Because of my desire for discretion and confidentiality I was thinking that telephone or internet counseling would meet my needs very well. I think that if I could set up a 5 minute conversation for the end of the work day every day then that might be enough to keep me from drinking at night. I know that therapists usually bill for hour long sessions but I was wondering if you had ever heard of an arrangement that was based on very short daily sessions as needed?

Stephanie Adams Says...:

To answer your last question, I have not heard of that regularly but it might be out there. What I'd be concerned about there would be creating dependency on your therapist, so that talking to him or her was the only way that you could see yourself not drinking. What about weekends? What if the therapist was sick one day? What if the phone connection didn't work? Where would you be then?

A better arrangement for your situation would probably be to make a plan in therapy for ways to change your pattern at the end of the day to strengthen your own resolve to stop drinking. That way you can always be safe, because you can always help yourself. If you live in Texas, I would be happy to help you with that through online counseling. If you're outside of Texas, I'm not able to be your therapist, but I'd be happy to help connect you with someone in your home state. Let me know how I can help!