Cancer & Emotions Part III: A Guide for Patients and Family – Depression and Anxiety During Cancer Treatment

Cancer & Emotions Part III: A Guide for Patients and Family – depression and anxiety during cancer treatment 

You’ve been diagnosed, you’re going through treatment, seeing (too many) doctors, going back and forth, appointments, prescriptions, health insurance phone calls. All of a sudden, the enormity and terror of it all hits you like a ton of bricks. Your life has changed so drastically that you don’t even recognize it. Depression and anxiety during cancer treatment hits everyone, often in unexpected ways.

As if all of these this weren’t enough, you’re lying in bed at night (or first thing when you wake up in the morning) after an overwhelmingly “busy” and appointment-filled day and that feeling hits you. That empty, helpless, scared feeling; deep down in your gut. That worried “What am I going to do?” feeling.

Normal Reaction to Abnormal Situation

This (what I have described) is so common. It is actually the most common occurrence that people diagnosed with cancer describe. That’s if and when they get around to describing it because there is an unsolved mystery surrounding mental health: In general, people just don’t want to talk about it. The brave ones who do, tell strikingly similar stories, which means that depression and anxiety during cancer treatment is often part of the typical “package” of dealing with cancer. You are not alone.

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Not Your Fault, Is Your Challenge

Things can get a little confusing too because sometimes it’s hard to tease out where the depression and anxiety are coming from. What is causing the symptoms is important because that will lead to a clearer understanding of how to treat the emotions and feelings. The majority of people think, “It’s me, there’s something wrong with me,” when in reality depression and anxiety during cancer treatment can occur due to a variety of reasons.

One reason is that some medications and specific treatments have depression and/or anxiety as part of their side-effect profile! If this reason is ruled-out, then maybe it is “you.” But I have news for you: if the depression and/or anxiety is coming from within you, then congratulations you are a normal human being. Experiencing depression and anxiety is a normal part of the diagnosis and treatment process.

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It might be easier for you to understand this concept if you think of the opposite scenario: Imagine someone undergoing cancer treatment and not feeling depressed or anxious. Aside from this being very weird, it’s also not normal. You would think that this person is either in complete denial or that something else is seriously wrong. I know that we are all different and everyone reacts differently to change and stress, but the take home message here is that becoming depressed and anxious during cancer treatment is your body’s way of processing everything that’s going on. It’s a normal response to an abnormal situation.

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What You Can Do Now

Keep in mind that although it’s normal and part of the “process,” depression and anxiety during cancer treatment can be addressed and alleviated. Your physical health is not the only thing that cancer has touched. Your mind and in fact the very heart and soul of you at your core need healing, too. You can use this depression and anxiety to aid your entire healing process, to help you grow stronger, and to help you learn the skills you need to face not only this illness, but also life and all the ups, downs, surprises, changes, and challenges that life has in store. This is a special strength that not everyone has the opportunity to build on because not everyone has been given this challenge that you are faced with.

I work with cancer patients and their loved one. It’s a passion and a path. If you or someone you know’s life has been touched by cancer, please consider sharing my information with them.

“Release your struggle, let go of your mind, throw away your concerns, and relax into the world. No need to resist life; just do your best. Open your eyes and see that you are far more than you imagine.”
Dan Millman, Author of Way of the Peaceful Warrior

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Cancer & Emotions: A Guide for Patients and Family Part II: Coping with Grief & “Why Me?”

Cancer & Emotions: A Guide for Patients and Family
Part II: Coping with Grief & “Why Me?”

Any article on grief when you’re coping with a cancer diagnosis and undergoing treatment would not be complete without the often-cited “Five Stages of Grief” by psychiatrist Elisabeth Kubler-Ross. Often cited is actually an understatement. The “Five Stages of Grief” model is discussed or mentioned in almost every article, blog post, book, or magazine publication on illness, death, loss, or any moment in life when things don’t go as we plan (i.e., the rug is pulled from under our feet or we fall smack down on our faces and don’t know what to do). It’s understandable, though, because Dr. Kubler-Ross definitely knew what she was talking about. Although the model was initially created to help people prior to death, it is now used to help people going through all sorts of issues, whether you’re dealing with an illness yourself or you’re supporting someone who is going through difficult times. Here I offer my spin on the “Five Stages of Grief”.

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Stage One: Denial (“Who? Me?”)

When initially diagnosed with cancer, some people believe that it’s a mistake or that it can’t be happening to them. They might even put off beginning their treatment because of disbelief, but at a deeper level, they are really just overwhelmed with emotions, questions, concerns, and fear. When we’re stressed or scared, denial is our friend because denial is a survival instinct: It protects us from the potentially dangerous and damaging effects of stress. If you don’t believe that something is happening, then as far as your mind is concerned, it’s not happening. Denial kicks in when we need to process something new, unknown, and/or scary, but we need to process it slowly, at our own pace, so that it’s not so overwhelming.

Stage Two: Anger (“Why me?!”)

This stage is characterized by feelings of frustration, especially towards those closest to the grieving individual. Some people will enter the Anger stage immediately after diagnosis, while others will experience Anger after Denial. Feelings of Anger sometimes occur when the grieving person can no longer stay in the Denial stage (i.e., the diagnosis becomes too real). In this stage, a lot of blaming can occur. The grieving person wants to blame someone, anyone, for the illness. Some individuals feel they are being punished for some reason and will blame themselves.

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Stage Three: Bargaining (“I’ll trade you.”)

Sometimes, people wish to try to avoid their illness and feel like they can still go back to the way things were before diagnosis. Individuals will promise themselves or others (or a sky-borne deity) that they will change their ways or sacrifice something in exchange for health. Bargaining involves a misplaced sense of responsibility or blame that the grieving person puts on themselves for the cause of their illness. They feel that if they become “a better person” then a miracle will occur or they will be given a second chance and they can be well again. This implies that the person feels as if they were “bad” before and the illness is their “punishment.”

Stage Four: Depression (“What’s the point…”)

Some individuals will enter a depression stage after they recognize that they can’t avoid their illness and that the illness is real. Just like in the Denial stage, they are overwhelmed with their circumstances, but unlike the Denial stage, they accept their illness (and feel like giving up). The thought of fighting the illness feels bigger than what they believe they can handle. Many individuals will withdraw from family and friends and demonstrate an “I don’t care” or “Leave me alone” attitude.

Stage Five: Acceptance (“Everything might be alright.”)

Many individuals come to the point where they accept their illness and even embrace it. They figure that there’s nothing they can do about it, so they may as well accept it and stop stressing. This stage involves the person having a more calm view of the illness and more stable emotions about their circumstances.

Research hasn’t supported Kubler-Ross’ model, but regardless, people like it and people can relate to it and I guess that’s important too. These stages can occur in any order and some people might skip some stages, repeat two or three of the same stage, or remain in only one stage. Grieving is a process that is so unique to every individual, but understanding the process makes us feel a sense of relatedness. A sense that we are not on this journey alone and that when we read things like this article or the numerous other self-help texts and advice on how to cope, we know that these things exist because others have gone through and felt what we are feeling. This is proof that we are not alone in our struggles.

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Cancer & Emotions: A Guide for Patients and Family (Part I)

Cancer & Emotions: A Guide for Patients and Family (Part I)

If you or a loved one has received a cancer diagnosis and are undergoing treatment know that experiencing both physical and emotional effects throughout the process is an expected and very normal part of the journey. Emotional changes are a normal reaction to the many adjustments and changes that patients and families experience after a cancer diagnosis. There are emotional effects that some individuals experience upon receiving the diagnosis and some that arise when undergoing treatments such as chemotherapy and radiation. Depression and anxiety are the most common mental health conditions associated with the course of the illness, from diagnosis and treatment to remission. And while your oncologist will help you with your physical health during this time, a counselor who is seasoned and experienced in working with cancer patients will help you with your emotional health.

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Physical and Emotional

The physical side effects of chemotherapy medication (e.g., nausea, loss of appetite, fatigue) are often accompanied by emotional side effects (e.g., depression and anxiety). Depression and anxiety alone are common side effects of chemotherapy, but one or both can occur as a result of the bodily changes that individuals experience during chemotherapy treatment. The stress associated with receiving and coping with the diagnosis itself can also cause emotional difficulties. It can be difficult to distinguish between the cause of the emotional difficulties, which is why it is important to discuss any mental health symptoms with a physician in order to understand the symptoms, determine whether they are stemming from stress or from the chemotherapy medication and to get a referral for a cancer-specialist counselor.

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Chemo Brain

Many cancer patients refer to the term “chemo brain” to describe the difficulty they have concentrating and other cognitive side effects of chemotherapy (e.g., memory lapses, decreased attention). Chemo brain disappears shortly after treatment in some individuals while others experience the effects long after treatment ends. Radiation treatment can also cause chemo brain. Another common side effect of radiation therapy is fatigue or decreased energy. Low energy can sometimes be confused with or appear like the patient is depressed since individuals with radiation-related fatigue experience decreased motivation and interest in doing things they normally enjoy (a typical symptom of depression). Other side effects of radiation therapy (e.g., skin problems, hair loss, eating difficulties) can sometimes cause emotional distress, as coping with these symptoms can interfere with the individual’s daily activities and effect overall well-being.

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Over and Under Diagnosing

Over-diagnosing and under-diagnosing depression and anxiety is common among cancer patients due to the overlap of symptoms and side effects. It is important to normalize feelings and emotions and avoid labeling patients as “depressed” or “anxious” during the diagnosis, treatment, and recovery process. At the same time, these emotional difficulties should be appropriately addressed especially it they are excessive or distressing to the patient. Keep in mind that stress wears on the body and during cancer treatment, you want your body’s energy to be focused on fighting the cancer and regaining your health. Communication between the patient, caregivers, treatment team and the patient’s support system is key and will contribute greatly to an improved prognosis and a better quality of life for you and your loved ones.

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Thanks for visiting our blog. Stay in touch for the rest of the articles in the Cancer and Emotions series, or even take a look at some of the other great articles we’ve posted already. Journey Well!