This week I've got an exciting collaboration with Shirley Myers. We're talking about cancer and mental health. If this is a difficult topic then take it steady, but we hope you can join us behind the cut to look at ways to manage your mental health when you have a cancer diagnosis.
If you've been reading my blog for a while you'll know that I've worked in a lot of different areas. I worked in an oncology centre for a year about eight years ago, and it taught me a lot about how people live and cope with cancer. I'm going to share some of that with you today, and Shirley is going to talk about support services for people with cancer. Shirley's in the USA, so I've included some links at the end for people in the UK. This post is a joint effort between both of us, so I hope it's helpful to people!
Anyone with cancer knows the shock of being diagnosed with a life-threatening illness, and many people feel afraid, anxious and depressed. While anxiety and grief are a normal part of the process for anyone involved, not everyone knows how to deal with them. Like physical conditions, mental ones are easier to manage when caught in their early stages. Medical specialists usually focus on treating the illness itself, making it important for patients and caregivers themselves to know about emotional disorders and grief.
The Connection Between Cancer and Mental Health
Approximately 1 in 3 cancer patients also struggle with their mental health, and the incidence of depression is three times higher than in those who don’t have cancer. If you think about how we view cancer as a society, that's probably not too surprising to you. Children and young adults face an even higher risk than older people. Because some people become low or anxious in response to their diagnosis, whilst some people were already struggling with their mental health before they were diagnosed, it may be difficult for medical professionals to tell the difference. It may be up to family and friends to watch for long-lasting symptoms of sadness or worry.
In addition, undergoing treatment for cancer can lead to sleeping more (because you're tired due to the treatment), not eating as much (because chemotherapy can make food taste weird or metallic), and generally being less active than usual (because of the fatigue we've already mentioned, or because of pain). Some of you might recognise these symptoms as being the same as those of depression, or even anxiety in some people. That means that it can be really hard to tell what's going on for someone who has cancer, and even they might not know what's due to the treatment and what's due to their mental health.
While depression, anxiety and grief are completely normal reactions to a serious illness, they can lead to more serious problems if they don’t go away or are not treated. They can also lead to post-traumatic stress disorder (PTSD), a condition that occurs when people remember and relive a shocking event. Although these complaints might seem small in the face of chemotherapy or surgery, ignoring them can have serious consequences.
People with depression or anxiety are less likely to take care of themselves, exercise, sleep well or eat healthy diets. They may also neglect doctors’ appointments, forget to take medication and use alcohol to try to cope with overwhelming emotions. All of these things are ways to cope,, but in the long term they're not the best things to be doing and can actually make you feel worse overall.
Finding Help for Mental Health Difficulties
It helps to provide doctors with a comprehensive medical history, including previous incidents of depression and other mental health difficulties (note: in the UK, your doctors should be aware of this from your GP, so should be looking out for it, but it never hurts to mention it). It's important to remember that depression is an illness, not a weakness. Doctors also need to know about medications like antidepressants or sedatives. Patients and their families can help by addressing unpleasant feelings with medical specialists or talking to a therapist. Psychological therapies, like clinical psychology or counselling, provide a safe place to vent, and people can learn relaxation techniques and cognitive behavioural techniques that help them cope with stress.
When you have a cancer diagnosis, many hospitals have support groups that allow people to meet and share with others in similar situations, and online groups provide a round-the-clock connection. Some types of cancer also have websites that serve as 'clearing houses' for resources and communication - meaning, the advice you read on there is likely to be evidence-based and best practice. Examples include Breastcancer.org, a place where women can share everything from their feelings to sensitive images, and Mesothelioma.net, a site where veterans and other victims of a rare cancer caused by asbestos exposure can get help and learn about the disease. In the UK, Macmillan can provide financial and emotional support for people.
Other things you can do include trying to stay in as regular a routine as possible, to help manage difficulties with sleeping. Try to eat, even if it's painful or it tastes funny - it will help you keep your strength up. Do low-energy activities on days where you feel like you don't have any motivation, such as reading or listening to music - if you sit and dwell too much on your situation you're likely to just end up anxious or low, and there's probably not much you can do to change things right in that moment. On days where you feel better, walking and swimming can be helpful activities to use your body and improve your stamina.
Loved Ones Don't Forget - It's Hard On You Too!
Family and friends often report the same feelings of helplessness, grief and worry that people diagnosed with cancer do, and they can also benefit from therapy and support groups. Loved ones can feel as though they can't show any "weakness" to the person struggling with cancer, which can mean that they try to take on everything themselves and end up burning out, which isn't good for them or the person they're trying to care for. It's important to talk about how you're feeling, even if it's difficult at times.
In addition to counselling and healthy living, many people find comfort in spiritual practices like meditation, yoga and journalling. Complementary and alternative medicine, such as acupuncture and massage, are also becoming more popular to treat the side effects or chemotherapy or to manage stress (note: these things might not be available on the NHS but can be really helpful in allowing you to relax and de-stress).
Coping with cancer or other serious illnesses is difficult, but you can make the process easier by taking care of yourself. The NHS website and MacMillan in the UK can give you more tips on how to get support for a person living with cancer, or a friend or family member who is struggling. The important thing to remember is that you're not alone, and there are things you can do to boost your mood and manage anxiety whilst undergoing a treatment like chemotherapy.
Have you got any more tips to help people cope with cancer? Let me know in the comments.
(Please note: any money generated from this post has been donated to Wakefield Hospice)
Dr Sarah Blackshaw: Clinical Psychologist, blogger, tea drinker, interested in dinosaurs and shiny objects