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Building better mental health

Mental health is as important as physical health. CanHOPE counsellor Jaime Yeo looks at how cancer survivors can manage their challenges after treatment.

Most people with cancer look forward to completing their treatment, which can be gruelling physically, mentally and emotionally, so that they can resume their lives. However, some may find that life after cancer treatment has its own set of challenges.

Research from a 2010 National Health Interview Survey shows that people who survive cancer may be more susceptible to psychological distress. This could be due to various challenges such as the fear of cancer recurrence, the need to resume or adjust to life roles, having to cope with the short- and long-term effects of cancer treatment, as well as a perceived withdrawal of social support from healthcare staff, family and friends*.

Here are some emotions you may experience even after completing treatment, as well as some tips on how you can cope with them:

Fear/anxiety over cancer recurrence

Feeling fearful or anxious about your cancer returning is very common. Even feeling unwell or a visit to the doctor, can trigger unpleasant memories of the first time you were diagnosed with cancer.

Some possible ways to manage such feelings include:

• Acknowledging your fear and anxiety.
• Talking to your doctor, staying informed and scheduling your regular check-ups.
• Recognising that there are areas in your life in which you can exercise choice and control (e.g. living a healthy lifestyle, maintaining meaningful relationships, etc.), instead of letting yourself be preoccupied with what you cannot predict or control.
• Making plans for yourself. Keeping as active as you can in activities that you enjoy and derive meaning from and have purpose in.

Isolation/loneliness

During treatment, you may often be surrounded by family, friends and a caring team of healthcare professionals. These support networks, however, may diminish when you complete your treatment.

To combat the sense of isolation or loneliness, you could:

• Stay connected with your healthcare team if they are able to.
• Connect with other cancer survivors. Having that shared experience of undergoing treatment will help you feel understood and supported.
• Volunteer and contribute your experiences in a support group. Knowing that there are others who can benefit from your sharing may give you a renewed sense of purpose.

Stress

Getting back to a routine of family or work responsibilities after cancer treatment can be overwhelming, especially when you still feel fatigued. You may also feel stressed about having to pay more attention to your health.

To de-stress, you could:

• Pace yourself and allow time for your body to recuperate. Gradually ease yourself into your routines and responsibilities instead of jumping in full swing.
• Find time for relaxing activities (e.g. exercise, walk by the beach, etc.).
• Try something creative like art, dance or journaling. These are good ways to express your feelings and release tension.
• Talk to family members, friends or co-workers so that they can understand what you are going through and can offer practical or emotional support.
• List down your tasks, prioritise and break them down into smaller, more manageable ones.

Loss in confidence

Cancer treatment can result in changes to your body. You may feel conscious about your physical appearance. This may affect your confidence in going out, meeting people or accomplishing tasks at home or work. Perhaps, you may be uncertain whether you will be able to live life as before, in your work, family or relationships.

Here are some ways that could help build your confidence:

• Acknowledge the physical changes, and take time to grieve over them.
• Find new ways to enhance your appearance. Try, for example, a change in style or a new haircut.
• Realise that your identity is more than just your outward appearance and remind yourself of your inner strengths and qualities.
• Focus on how your cancer experience has helped you grow to be a better person, such as making you more resilient and courageous.
• Set new goals for your life. Break them into small steps and celebrate the little accomplishments that you make along the way.

Depression

Having gone through a major illness may have been a huge shock and loss to you. You may find yourself contemplating more on existential issues. While it is common to feel some degree of sadness after going through cancer, sometimes it is possible to spiral into depression. You may feel a sense of hopelessness and despair, and are unable to cope with your everyday tasks.

Depression is serious because it can reduce your quality of life significantly. It may also complicate any post-treatment medication as you might feel too depressed to stick to the schedule.

It is important to recognise the signs of depression:

• You feel sad, empty or hopeless
• You lose interest in activities that you once enjoyed
• A change in appetite, weight and/or sleep patterns
• You find yourself irritable or restless
• You feel fatigued or lacking in energy
• You struggle with guilt, worthlessness, and/or helplessness
• You have difficulty concentrating or making decisions
• You have thoughts of suicide or have attempted suicide

If you have had these symptoms for a prolonged period (more than two weeks), you may be depressed. Do seek help from a mental health professional.

Treatment for depression does not always involve medication. In psychotherapy or talk therapy, a therapist or counsellor can guide and offer a way for you to voice and explore your emotions and experiences. They may also use appropriate therapy interventions to help you to understand root causes of your depression, learn coping skills and reframe your perspective.

Joining a cancer survivor support group can also be very helpful. It will give you a chance to open up to others about your experiences, hear from them their experiences, and share common challenges and ways to overcome them. Belonging to a group will give you a feeling of being supported and understood as you journey together in the recovery process.

The healing of the mind is as important as the healing of the body after cancer treatment. As you work towards improving your physical health, make sure that you also take care of your mental health.

Remember that going through and surviving cancer also open up many areas of emotional, psychological and even spiritual growth that can spur you to live life more fully and meaningfully.

*Naughton, M.J., & Weaver, K.E. (2014). Physical and Mental Health Among Cancer Survivors: Considerations for Long-Term Care and Quality of Life. North Carolina Medical Journal, 75(4), 283-286.