The cancer or its treatment may make them ill. They lose not only their health, but also a sense of well-being and security about the future. Some even find that former friends disappear, unable themselves to face the losses. Those who pretend to others and to themselves that everything is fine do so at a cost. False cheerfulness takes energy, at a time when they may have little to spare.
Emotional dishonesty keeps others at a distance.
We live in a culture that does not acknowledge sadness as part of life, that considers it evidence of weakness or moral failing. Sadness is unwelcome, a social barrier that makes others uncomfortable. When people with cancer pretend to be cheerful they may make it easier on their family and friends, and health professionals, by not requiring them to face their own grief. Sadness is not depression. Major depression can take the form of despair, a bleak outlook that colors everything.