How to look after your mental health when you have cancer
13th May 2019
Clinical psychologist and award-winning writer Dr Frances Goodhart shares her tips for taking care of your mental wellbeing following a cancer diagnosis.
How to cope with a cancer diagnosis
For some people, a cancer diagnosis can feel like an earthquake. It shakes your foundations, your world can crash down around you. The landscape that was familiar is suddenly damaged, altered, very very different. You may feel crushed, trapped under the rubble of the pressure of diagnosis.
I think the first thing to say is, no wonder you have moments when you may feel helpless – it's completely natural that you're going to be shocked, confused, and really struggle with your thoughts and feelings through the experience.
At the point of diagnosis, try to prioritise taking care of your very basic needs. You've got so much to be processing, so many decisions to be making. Try to make sure, as far as you can, that you are eating as well as you can, that you are sleeping enough, or at least resting when you have the opportunity.
Write things down. Thoughts that are in your head become clearer if you can write them down – they're moved out of your head, they're on paper. Make lists: of questions you want to ask your treatment team; of things you have or want to do; of thoughts that come into your head.
Look after yourself, as well. Try to be kind, be compassionate to yourself at such a difficult time. Work out what soothes you, what helps you to relax and then do it. Don't see this as self-indulgent, it's actually a really core strategy for coping.
How to talk about cancer
I've had many, many people talk to me about the loneliness of receiving a cancer diagnosis or going through cancer treatment. I think opening up to your family and friends for some people is really difficult. It can be hard to find the right words, it can be hard knowing that what you are saying is upsetting for your loved ones to hear. You're then watching the impact that this information, that your experience, is having on the people you're closest to.
My first tip for talking to family and friends is not to rush into it straight away. Give yourself a little bit of time to process and get to grips with it yourself.
Try not to have definite expectations about how people will react. People react in very different ways and it may not be in the way you had expected or hoped. But don’t forget that they may be very upset or shocked or confused and they might say “the wrong thing”. It might be that they too need time to deal with the news – and if they can come back to talk to you again then the next conversation might be better.
Keep channels of communication open, don’t expect there to be one conversation that answers all the questions that you have… Don’t feel that you have to have all the answers. You can always direct them to Bloodwise or other services where they can seek out information for themselves.
I think a lot of people have a concern that if they start talking they will be ‘opening a can of worms’. So sometimes they don’t begin talking because they don’t know how to stop talking. So think about a way of finishing conversations before you start them...
Have a few phrases up your sleeve that you can bring out when you think you've covered enough. It might be something like, I think we've probably covered enough for today, thank you for listening, can we come back to this? I'd love to talk a bit more later.
How to deal with anxiety when you have cancer
Anxiety is a normal human response to threat, to a sense of danger. It's our high alert and anxiety is really important in many situations, like if you're crossing a road and you see a car speeding towards you – you want an anxious response to speed you up across the road, to get you out of danger.
Anxiety triggers the ‘fight flight' reaction. It's normal, natural and helpful in certain situations.
The trouble is that in a sense we haven't evolved as quickly as society has moved on. That 'fight flight' reaction is the response we needed if we were cavemen and the threats were from another tribe or a wooly mammoth at the door of one’s cave. The modern threats to us tend not to be ones that we can so easily respond to, either through fighting or running. Anxiety becomes problematic when it lasts for a long time and when it isn't easy to respond to or to turn off that high alert system.
I talk to people about anxiety having four components to it. There's the feelings – the emotional aspect to it. But there are also thoughts, behaviours and physical sensations. These all interact and psychologists quite often talk about it being ‘like a hot cross bun’ in that all four of those elements are interconnected. Most people find that tackling the physical sensations first – muscle tension, racing heartbeat, rapid breathing is their preferred starting point. The most immediate way of doing that is through relaxation strategies.
How to use slow breathing techniques
Slow breathing techniques are really simple. If you can make your out-breath longer than your in-breath, you start to actually manage some of those physical sensations. One of the classic ways is to do it via counting: taking a breath in, one, two, three, hold it, then breathe out, one, two, three, four, five. Another way is to imagine you're breathing out through a straw because if you're breathing through pursed lips, you actually can't do that rushed out breathing. Notice as you do that, the feeling of relaxation flowing through, your shoulders dropping, your muscles loosening and unwinding.
Another way is to tense your muscles and then release them and again, to talk yourself through that feeling of noticing the muscles loosening and unwinding. Hunch your shoulders up towards your ears, clench your fists, pull your elbows into your sides. Feel the tightness and tension, hold it for a few moments and then slowly release the tension and let yourself notice the relaxation flow into the muscles of your arms and shoulders, neck and chest.
Like any skill, if you practice it, you become better at it. It may not work every time, but don’t lose confidence – the more you practice it the easier and more natural it becomes.