Mental Health
You know yourself best. If during your cancer journey, you experience anxiety, depression, distress, anger, fear and other emotions, don’t be afraid to share them with your health care provider. If you don’t address these feelings, they can interrupt your treatment plan, causing you to miss medical and therapy appointments. They can even cause physical health problems, such as suppressing the immune system, decreasing the body’s ability to fight infection and increasing the risk for serious illness like heart disease and stroke.
Talking with a member of your health care team as soon as symptoms start – or even if something just doesn’t feel right – is a great way to take charge of your mental health. Often cancer and mental health problems will present with the same symptoms, making it difficult to distinguish between them, including fatigue, nausea, decreased appetite, cognitive (thinking) changes and sleep problems.
Anxiety about your diagnosis, treatment, recurrence or long-term survival is common. Waiting for test results during follow-up appointments and scans can raise anxiety levels because those test results often give you life-altering information, such as whether the cancer is responding to treatment. Referred to as scanxiety, cancer survivors, caregivers, friends and loved ones often face it.
Distress is most likely to occur during diagnosis, when a new symptom arises or the cancer has returned. It can also happen while waiting for treatment to start, when symptoms worsen or when another health problem is caused by treatment.
Fear is a common reaction to finding out you have cancer and facing treatment. Fears include not knowing what to expect, pain during or after treatment, inability to do daily activities while in treatment, a change in appearance (hair loss or scars), fertility issues and sexuality challenges. One of the ways to combat fear is to learn as much as you can about your cancer and your treatment. Talk to others going through similar treatment. Support groups, both in person and online, may be helpful.
Loneliness is a feeling of being alone and isolated from others. You may feel alienated or that no one else understands what you’re going through. It may help to talk to people who have the same type of cancer as you. Contact a support group, confide in a close friend or reach out to a member of your faith or spiritual community.
Grief is the feeling of distress or sorrow due to the loss of something. It is normal to grieve the loss of your health, your appearance or your ideas of what your future would be without cancer. Allow yourself to feel a full range of emotions. Ask your friends and family for support.
Sometimes negative feelings can advance to more serious issues. Below are general symptoms for serious mental health issues, but you should meet with your health care provider for an actual diagnosis.
Depression is characterized as ongoing sadness and/or loss of interest in activities. The following are signs of depression:
- Prolonged feelings of sadness and/or anxiety
- No longer being interested in activities you once enjoyed
- Difficulty concentrating or doing daily tasks
- Irritability
- Low energy levels
- Changes in sleep or eating habits
- Increased use of drugs or alcohol
- Have thoughts of harming yourself or suicide
Anxiety disorders are different than everyday worries. They may lead to intrusive thoughts that result in persistent anxiety. Symptoms include excessive worry and nervousness, mood swings and physical symptoms such as palpitations, sweating and shortness of breath. Treating an anxiety disorder may improve your ability to cope with your diagnosis.
Post-traumatic stress (PTS) and post-traumatic stress disorder (PTSD) reactions may include repeated frightening thoughts, being distracted or overexcited, having trouble sleeping and/or feeling detached from yourself or reality. PTS can occur at any point during the cancer journey. In some cases, PTS can lead to PTSD, which is often more severe and can last longer than PTS. Some typical symptoms may include avoiding medical appointments, blaming yourself for the illness, experiencing survivor’s guilt, and having difficulty sleeping and/or concentrating.
Recognizing Roadblocks
Many people are reluctant to, or face barriers to, receiving mental health services. Or they may not recognize their symptoms as indicators of emotional distress. Social norms and gender roles may prevent them from exploring resources, and the risks of rejection and stigma may stifle the desire to ask for help. Can you relate to those feelings or are you experiencing any of the following?
- Struggling to acknowledge the emotional impact of the diagnosis and, instead, coping by stuffing down your feelings.
- Having difficulty admitting you need help, asking for help or accessing help.
- Choosing to avoid facing painful emotions.
- Not wanting to talk about cancer at all to distract yourself from thinking about it.
- Having trouble expressing difficult emotions especially because you don’t want to burden friends or family.
- Fearing that sharing your feelings will cause friends and family to pull away from your relationship.
- Not believing that talking about feelings can even be helpful, regardless of whether it is to other survivors or to mental health professionals.
- Wanting to focus on “just getting through treatment.”
- Having physical symptoms that you assume are only physical side effects.
It may comfort you to know that all of these feelings are valid, and many people who have sought mental and emotional support during or after cancer treatment have found it helped. Some say it felt like a weight was lifted from their shoulders, and it made it easier to manage their everyday anxiety.
Let your health care team know as soon as you experience any symptoms. Don’t be embarrassed to speak up and share your feelings. The sooner your team knows, the sooner they can help.
Getting the Help You Need
How you have dealt with a serious life crisis in the past might set the stage for how to approach this medical crisis. If your methods worked well, they are worth repeating. If they did not, don’t try to use them for this situation.
Try these methods for improving your mental health:
- Increase your self-awareness. Find out what triggers you, such as certain people, calendar dates, treatment ending, the change of seasons, etc.
- Treat feelings as a visitor. Don’t fight them; acknowledge them and move forward.
- Treat yourself with compassion. Notice when you are in distress and show yourself kindness. Remind yourself that it is okay to feel distress, and remember that being imperfect is part of being human.
- Pay attention to the present. Try practicing mindfulness, which is the practice of noting the present moment or an emotion for what it is without feeling the need to change how you’re feeing or push the emotion away.
- Take good care of yourself.
Many cancer centers have counselors to help coach you, but you may need to ask for them. In general, a supportive care team includes social workers who can help you cope with life challenges, psychologists who are experts in how people think, feel and behave and psychiatrists who are licensed medical doctors specializing in mental health. They are trained to help people with cancer from diagnosis and for as long as needed.
Support groups are available online, through social media, by phone and in person. Some advocacy groups can connect you with helpful resources and may be able to connect you with another survivor who has a similar diagnosis. Peer-to-peer counseling, especially talking to someone else who may be at the same stage in life (just getting out of school, just married, a new parent or newly retired, for example), can be extremely helpful. Most survivors will gladly offer suggestions on what works for them.
Mental health issues don’t always stop after treatment ends. Emotions can come up months or even years later. Take the suggestions for managing your mental health to heart because it is as important as your physical health. Allow yourself to express your feelings freely. Being emotionally healthy will help you better cope with cancer-related issues. It’s okay to not be okay. The important thing to remember is that you are not alone.
If you or a loved one is experiencing a mental health crisis, dial 988 to talk to a trained mental health professional. It is free, confidential and always available.
