I don’t know the exact statistics, but from talking to people within the cancer community, I’m guessing that most people who are going through cancer treatment, or who’ve finished cancer treatment, suffer from some form or other of mental health problem at some point along the way. The spectrum of mental health problems ranges in severity and intensity: some of these problems have specific labels like anxiety, depression, panic attacks and PTSD. But for many people, labels are irrelevant – all they know is that they are struggling on an emotional level and they don’t know what to do about it. They feel tired, unhappy, scared, anxious, overwhelmed, fearful, sad, confused, hesitant… the list goes on.
To mark Mental Health Week, I’ve done a bit of research into some techniques and strategies for helping your mental health during/after cancer treatment. I’ve also set out signposts to plenty of excellent online resources. These techniques and strategies won’t work for everyone and they will not miraculously sort out all your problems. I’m certainly not trying to minimise what you’re going through, but some of these might help you, so perhaps they’re worth trying.
I am no expert where mental health is concerned (I’ve only got my own experience and research to go on) so I’d just like to reiterate that everyone should speak to their medical team (oncologist, breast care nurse or GP) if they are struggling.
Mindfulness is worthy of a blog post all of its own (and luckily, I’m going to be posting on this topic some more later in the week). But here’s some advice that was given to me when I felt at my worst when I reached the end of my treatment. You might not notice anything the first or second time you do this, but the more you do it, the more effect it has. I found this incredibly helpful and it’s still my go-to technique for whenever anxiety or fear raises its ugly head:
- Sit somewhere quiet where you won’t be disturbed, maybe facing a window or even do this outside. Turn off your phone.
- Put your hand on your tummy.
- Take a few deep breathes in and out, focusing on your breathing.
- Look around you – what can you see, smell, hear and feel? Name four things you can see, hear, feel and smell.
- Remind yourself that you are here in this moment, in the present. Remind yourself that everything is okay right now. You are here. If you are NED or NEAD, remind yourself of that.
- Don’t think about the past – you can’t change what has happened.
- Don’t think about the future – what is the point in worrying over something that might or might not happen in the future.
- Bring yourself into the present and focus on the here and now.
You can do this whenever you feel overwhelmed, worried, panicked or fearful. Just take 10 minutes to yourself and bring yourself back into the present.
Talking about what has happened to you and how you are feeling can help to bring the anxiety and other unpleasant emotions out of your head and your heart and out into the open. The old saying, “it’s better out than in” definitely has something to it. So, who can you talk to?
- To a counsellor, therapist, support group or other people who’ve been where you’ve been.
- Ask your breast care nurse for a recommendation of whom you could to talk to. The hospital may be able to refer you for counselling of some description, either in the hospital or to a local support centre. Don’t be embarrassed about asking.
- There are plenty of people on social media who are in the same position as you, and who are all talking to each other: giving support, advice and encouragement. Twitter and Instagram are good place for chatting to like-minded people – just do a search for ‘breast cancer’ and you’ll be faced with a huge array of people to follow and chat to. And if you’re under 45 years old and based in the UK you can join the Young Breast Cancer Network Moving On Group on Facebook.
- There are plenty of local support groups at local cancer centres (Macmillan, Breast Cancer Haven, Maggies, Penny Brohn and lots of independent local centres that your hospital and breast care nurse will be able to tell you about). In addition to offering one-on-one therapy sessions, these centres often offer group sessions. These may not sound as appealing as a one-on-one session, but if it’s an option, then it’s worth trying it out. You may find that being around others who’ve been through the same things to you is actually a benefit.
- Talk to your GP. If you’re not getting anywhere with getting referred by your breast care nurse, don’t hesitate to go and talk to your GP.
In the same way that talking can help to get something off your chest, writing can also help. And with writing, you don’t need to rely on another person to be around when you feel the need to express your emotions – you can keep a notebook to jot down thoughts at any time of day or night, or you can keep a detailed journal about your feelings. Express your inner feelings of anger, sadness or fear by writing them down. You could even write on pieces of paper that you burn (very carefully) or rip up onto tiny shreds, in order to give yourself some sort of release from those thoughts.
On the other hand, you could write about what happened to you and/or your feelings about it, and share it with others who are going through the same thing. Not only are you lifting the weight of your shoulders by doing this, you’ll also be helping others who’re going through the same thing. Lots of places welcome these personal stories – here at tickingoffbreastcancer.com it’s important to me to post these personal breast cancer stories. Or you could contact Mission-Remission who post personal stories from people who’ve finished their cancer treatment. A number of the cancer charities also like to post personal stories (Breast Cancer Care, CRUK, Macmillan) so you could get in touch with them.
Exercise, keeping busy and getting fresh air
All of these things are apparently known to help with helping the mental health of a cancer patient or someone who is trying to move on after the end of treatment. It makes sense – the more time that you are distracted by exercise or keeping yourself busy, the less time you have to think about cancer. Of course, this won’t cure all mental health problems, but it might help.
- If you’re not much of an exerciser already, start off with some gentle walks building up the distance over time and perhaps introducing running if you are comfortable with that – you might want to take professional advice if you’re keen to start running (walking and running have the added bonus of fresh air and vitamin D).
- Check out your local gym.
- Ask your local cancer support centre for suggestions about taking up some exercise.
- Try anything that keeps you busy and engaged, such as reading, taking up new hobbies (I’ve started to do a bit of pottery at a local studio) and gardening.
Life coaching is a little bit like talking to a therapist, but the focus is on actively taking steps to take back control of your life after cancer. This is something that you will often have to pay for (although some charities put on courses – see below). I’ve listed two organisations below that I personally like and I’ve spoken to both of them as part of my involvement in the cancer community. However, there are plenty of good free resources online and plenty of people who you can follow on social media for tips and advice.
- Return to Wellness
- Look around for a free course taking place near you. Some of the local cancer support centres put on moving on courses (for example, my local centre puts on a Hope course) and lots of the breast cancer and cancer charities provide moving on courses, for example,
Maggies Where Now course
Breast Cancer Care moving forward course
Relaxation techniques and affirmations
Again, relaxing is not going to miraculously cure all mental health issues, but using relaxation techniques on a regular basis can help your emotional state.
- Ask your local cancer centre if they offer things like reflexology, acupuncture, massage, reiki or yoga for free of charge. Breast Cancer Haven have a particularly good selection of courses to choose from. As do Penny Brohn who provide services in partnership with other centres despite being based in Bristol themselves (I had reflexology
in north London) courtesy of Penny Brohn. And I know that my local cancer centre (which is not affiliated to any of the well-known charities) offer all sorts of things like this.
- YouTube have a great selection of guided mediations and guided mindfulness recordings.
- Breast Cancer Haven have a superb selection of audio recordings on their website from guided meditation to yoga videos to relaxation visualisation. I thoroughly recommend you check out their website.
- Some people find it helpful to say daily affirmations to encourage positive thinking throughout the day. I think the attraction of affirmations is that they enable you to actively pursue a particular line of thinking. You can set your own affirmations like, “today I am grateful for X” or “I am healthy and happy“. Or you can look online for suggestions – for example type “affirmations for mental health” into Pinterest and it brings up loads of suggestions.
Getting enough sleep is essential to support your mental health. However, of all the times in your life when you want and need a good night sleep, during and after cancer is the time when it is sometimes really difficult to sleep. However, the research all points to the following ways as helping to get a better night sleep:
- Don’t look at your screens before bed.
- Try to have the same bed time each night.
- Avoid caffeinated drinks like tea and coffee for a good few hours before bed.
For more sleep advice, have a read of these three articles:
It’s a well-known fact that going through cancer can make you feel like you are not in control of your life. And feeling out of control can contribute to feelings of being overwhelmed and anxious. So, taking steps to regain an element of control in your life might help counter some of these unpleasant feelings.
- Take back control of home life by gradually doing more of the household chores at your own pace. If you suffering from fatigue or other physical side effects remember not to push yourself. A manageable to-do list might help.
- Take back control of your working life by returning to work if you haven’t been working throughout treatment. Speak to your employer about phasing you back in.
- Take control of your social life. If you’ve not been doing much socially during treatment, start to arrange a few meet-ups, coffees, early dinners out. Remember not to push yourself or do more than you can physically cope with. Just having a chat to a friend on the phone could make you feel better (and you don’t need to talk about cancer).
- Take control of what just happened. Go through your medical notes, make sure you diarise any follow up appointments or make a diary note of when you expect to hear about your next appointment so that you can follow up if you haven’t heard. This might also be an opportunity to familiarise yourself with what you need to look for in terms of your breast health and for future signs of secondary breast cancer. Yes, I know that this is absolutely terrifying, but fear can sometimes be fear of the unknown. If you’re aware of the signs then you won’t be expecting every ache and pain to turn into something sinister. If this isn’t a task for right now, maybe you could put it on a future to-do list. There is a wonderful infographic setting out the signs to be aware of, produced by the wonderful Jo Taylor of ABC Diagnosis.
It might seem like you’re never going to get over this. That you’ll always be feeling physically and emotionally bereft and that you’ll always have these mental health struggles. But that isn’t necessarily true. By getting the right professional support and/or implementing some of these strategies you will hopefully improve the state of your emotional well-being. I am no expert – but I know from my own experience that where I am now, is completely different to where my mental health was two years ago when I finished chemotherapy and was living under a black cloud of anxiety and having panic attacks.
Why am I feeling this way – what can I read about mental health and cancer?
Cancer Survivors: Managing your emotions after cancer treatment, Mayo Clinic article
Your Emotions After Treatment, Dana Farber Cancer Institute
Emotions After Cancer Treatment, Livestrong
After The Treatment Finishes, Then What? Dr Peter Harvey article reproduced on Working With Cancer website
Where can I read about how other people cope after cancer?
Breast Cancer Haven have lots of excellent resources on their website that you can use at home, for example, meditation and mindfulness audio files, yoga videos, visualisations and so on. Well worth checking out.
Mission Remission A website which publishes articles from people who have finished their cancer treatment and moving on.
Life after Lola This is Nikki’s personal blog in which she talks about moving on from breast cancer and provides some useful links.