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A cancer diagnosis forces us to confront our mortality and all of the fears and losses associated with it. It can turn your world upside down, disrupting your life, and threatening the roles, purposes, and goals that give you meaning and satisfaction. Thus, feelings of fear, sadness and grief can be a normal reaction to an abnormal, difficult, unusual situation such as that during the cancer diagnosis and treatment process. However, when these normal emotions persist and start interfering with one’s daily functioning, then it can manifest as clinical depression.
Depression tends to undermine one’s will to live, weakens one’s resilience, and compromises the courage, fortitude, and determination that one needs to face cancer and endure the necessary medical treatments. It also increases the risk of non-compliance and poor tolerance to medical treatments. Thus, it can make one’s cancer experience more difficult and hamper one’s overall adjustment and quality of life.
Psycho-social support should ideally be a part of every patient’s cancer management plan from the start and should involve the primary caretakers and support system too as they may have their own concerns, emotional distress, and fears for the patient.
The first step would be learning and identifying the signs and symptoms of depression. For example, difficulty accepting the diagnosis, persistent low mood, crying spells, increased irritability, decreased interest in things previously enjoyed, feelings of hopelessness, helplessness, or worthlessness.
While it is important to remain positive during cancer treatment, it is also important to remember you are allowed to experience other emotions and express the same. Allow yourself to cry when needed – tears serve as a natural response to distress. It is easier to be optimistic when you don’t feel caged by your emotions and thoughts.
Accept that it is normal to feel some degree of worry, fear, and low mood when your life is being disrupted. I’ve had so many clients tell me that “I shouldn’t be feeling like this. It’s wrong. I should be positive all the time” – this is an unrealistic expectation at the best of times. However, if you’re having difficulty with acceptance, ask for professional help early on before your distress levels increase.
I’m sure you have a lot of doubts about your diagnosis and treatment plan – get them clarified by your oncologist. This uncertainty can lead to feelings of helplessness and worsen existing fears. Do not turn to the internet for answers as this can play on your fears and worries.
Ensure you’re getting adequate nutrition, fluid intake, and sleep. Eat small, regular, home-cooked meals. If you’re having difficulty with these concerns, discuss it with your oncologist so that you can work on creating a plan for the same. You could also consult a psychologist for sleep concerns.
Addictions are not going to ease your troubles during this time. Abstain from alcohol and drugs which could leave you feeling worse.
Ensure you’re getting some exercise on a daily basis for your physical and mental well-being: allow your physical health to guide you on the type and duration of exercise. Consider doing yoga.
Don’t try to control what you can’t. It will be futile.
Set small goals and slowly build up your goals. Give yourself a pat on the back for finishing your goals.
Surround yourself with friends and family who can brighten your mood just by being present may allow you to talk freely, and thus make the difficult decisions appear a little easier. Sometimes, just knowing you have someone to lean on with no judgment may also help ease the distress. So, yes a strong support system during cancer treatment is important.
You can consider having someone attend doctor appointments or tests with you to support you through it.
The diagnosis and the treatment can be scary, but sharing what you’re feeling with those who you’re comfortable speaking with can reduce some of that fear and worry. You can set your boundaries as to when and how much you want to talk about the cancer experience.
By this, we mean changing the way you think about and look at a situation so that you see the glass as half full rather than half empty. A patient once jokingly told me she was saving a ton of money on haircuts now that she was getting chemotherapy. While this didn’t change her concern about hair loss, it helped her cope with it better.
Deep breathing exercises such as 4-7-8 (inhale for 4 counts, hold for 7 counts, exhale for 8 counts) or progressive muscle relaxation exercises, can help you a great deal to calm your nerves.
Continue pursuing or starting new hobbies as long as they don’t put you at any medical or immunity related risk. For example, avoid hobbies that require you to be a part of large in-person groups to reduce the risk of infection when your counts are low.
Multiple clients of mine have found this extremely cathartic. Some have since converted their journalled experiences into small booklets to share with other patients and/ or caregivers. This gave them a renewed sense of purpose through the cancer experience.
During stressful and/ or low periods, visualize a calming and safe space for yourself. This safe space can be different for everyone.
You can be yourself at a support group for cancer and openly discuss any of your fears with no judgment, knowing that everyone is going through a similar situation and can relate to you and you with them.
Go for music, dance, expressive art or yoga therapies as they can help you gain a sense of control over the situation while working on other concerns. I have found music therapy to be extremely beneficial with clients, including those who are resistant to traditional forms of therapy.
Ask your oncologist for a referral to a psychologist/ psycho-oncologist. They will help you work through the multitude of thoughts and fears racing through your head. A psycho-oncologist is concerned with the psychological, social, behavioural, spiritual, and ethical concerns of your cancer experience. These concerns tend to vary based on a number of factors, such as the type and stage of cancer, the treatment plan, side effects and difficulties experienced thus far, and the pre-existing concern that may influence the disease process.