Mind, Body, and Soul

When patients battle cancer, not only are we waging a physical war, we are waging a mental war as well. For me, I have been struggling, from a mental health perspective, for several weeks now. Putting on the brave, strong face is very difficult for me right now. Recognizing that I am not in a good place, I started looking for a variety of strategies to help me get to a better head space:

• I signed up for a beginner yoga series starting the first Saturday in March
• I reached out to the Breast Cancer Resource Center in Williamson County, asking to hook up with a MBC support group
• I am looking to take advantage of free counseling offered to state employees as part of the ERS system.
• I am scheduling activities or get togethers with my good friends that "get it"
• I invested in CBD oil to help with anxiety (testing it out this weekend)

There is a great article from the mesothelioma group specifically about mental health. What I've copied is specific to the cancer patient, but they have information about care givers, how to deal with loss, etc. The whole spectrum of mental health issues associated with cancer. Please honor me and others you know facing a serious illness by reading the text below and educating yourself about the mental struggles many of us go through but rarely talk about. 

https://www.mesotheliomagroup.com/our-mission/resources/mental-health/

CANCER’S EFFECT ON MENTAL HEALTH

Any serious illness can impact mental health. For patients, caregivers, and their loved ones, going through cancer can be a devastating experience. Receiving a potentially fatal diagnosis, going through treatment protocols, and learning to live with limitations can cause depression in many patients, as can side effects from the treatment itself. Managing mental health needs is a crucial part of the treatment process, and may even impact prognosis.

How Cancer Impacts Mental Health

Some patients may lose the ability to be independent. Others find that energy levels plummet and activities that were once a source of enjoyment are no longer possible. Care must be given to allow the cancer patient to experience their disease in whatever manner is best for them.

Patients frequently experience a process similar to grieving after diagnosis and during palliative or end-of-life care2. There is evidence3 to support the existence of PTSD within both cancer survivors and cancer patients. This is a direct result of traumatic experiences associated with the disease, and because the potential for a fatal prognosis is high.

A study looked into the prevalence of mental health conditions diagnosed in cancer patients of working age; the study identified that nearly 30 percent of the patients in the study were diagnosed with a condition prior to the end of the study. As the national statistics for diagnosed mental health conditions is approximately 26 percent, this points to a noteworthy increase in patients.

Cancer treatments can also cause depression and anxiety. A side effect of chemotherapy known as chemo brain can cause fatigue, depression, mental fog, and other forms of cognitive impairment. An article by the American Cancer Society shows the link between depression and chemo brain, and identifies that both should be considered. Radiation can also lead to fatigue, nausea, and depression.

Treating Mental Health Conditions in the Cancer Patient

Treating mental health conditions in the cancer patient requires several special considerations5. Depending on the prognosis the patient has received, it may not be possible to simply encourage a positive attitude, and it may not be possible to remind the patient that it will eventually get better. This does not mean that treating cancer patients with mental health conditions is not valuable or necessary. Because mental health conditions are believed to be underdiagnosed in cancer patients, it is wise to take a proactive approach to detecting these conditions.

Common Conditions

The most commonly diagnosed comorbid mental health conditions for cancer patients are conditions that fall on the affective or adjustment scale6. This includes both anxiety and depression, as well as several different stress adjustment and coping conditions. PsychCentral has an article available that details adjustment disorders, and how they reduce the ability to handle traumatic situations.

Psychotherapy with an experienced therapist or psychotherapist can be helpful, even to patients who have not yet been diagnosed with a condition. A licensed therapist or psychologist who is trained to work with cancer patients will be able to provide guidance and a listening ear to the patient, right from the start.

Treatment Options

Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT) have both been used to treat mental health issues successfully. Each patient will require an assessment to determine which approach, if either, will work best for them. Basic self-directed mindfulness exercises are a large portion of Dialectical Behavioral Therapy. The website DBTSelfHelp details several such exercises for the public. Treatment strategies may include breathing exercises, discussion therapy, behavioral modification, medication for depression or anxiety, or even coping skills development.

Meditation may be an appropriate choice for some patients. Antidepressants and anti-anxiety medications can help to handle symptoms when they become overwhelming, although care must be taken to monitor the patient for interactions. Generally, medications are chosen if depression or anxiety is protracted and does not dissipate after two to four weeks. For depression, Zoloft, Paxil, Wellbutrin, and Prozac are commonly used. Benzodiazepines may be used to treat short-term anxiety or sleep issues, but they are addictive. Benzodiazepine drugs have also shown some ability to reduce the side effects found within chemotherapy.