Shock and Numbness
Most people are completely unprepared when told they have cancer. Despite the fact that you may have attended for cancer screening or repeated investigations for niggling symptoms – a cancer diagnosis is simply incomprehensible. When given the news by your doctor you can feel stunned – as if watching a movie or witnessing something that’s happening to someone else. And this can be true for partners and loved ones. You might nod and ask polite questions and yet the doctor’s words just float by – without properly registering. It’s as if the world as you know it has been turned upside down.
Numbness is a natural psychological reaction to the trauma of a cancer diagnosis. In fact it is the brain’s way of filtering information in order for you to keep on functioning.
Then Comes the Rollercoaster
After this initial period of shock (that can last up to several days) your brain’s defences relax a little and you are likely to experience waves of overwhelming distress. In those next few weeks you may find yourself gripped with bouts of despair and overwhelming anxiety. This can translate into feeling physically uptight, losing your appetite or experiencing other gut symptoms, being agitated and unable to sit still, having difficulty concentrating and remembering, being unable to sleep and being caught up in a spiral of negative thoughts about the future. And yet you may also have periods of feeling tremendously thankful that the cancer was detected and that you have the option of first class care and a renewed gratitude for life and for loved ones.
When on a rollercoaster of very strong emotions it is easy to feel as if you are going crazy.
The Negatives of Staying Positive
It is likely that well-meaning friends and family, in their efforts to help you feel better, have been urging you to “look on the bright side” or to “stay positive”. You might also have taken the message from popular literature that you need to stay positive to get the best possible treatment outcomes. And yet feeling upbeat all of the time is nearly impossible – so your distress about the cancer can quickly become compounded by your distress about your distress!
In fact, although there is research to suggest that persistent severe depression can take a serious psychological and physical toll, there is no evidence that fluctuating periods of high stress impacts negatively on cancer outcomes. Furthermore there are many studies that show that, for most people, the initial panic and despair will quite naturally subside to more normal levels within the first 12 months after diagnosis.
So not only is it unrealistic and unhelpful to put pressure on yourself to feel positive, the roller-coaster of negative emotions will generally start to level out without you having to do anything at all.
Adjusting to Cancer is not plain sailing
If you’re reading this to try to make sense of your emotions, you can take heart from the fact that periods of overwhelming distress are not only common, they are part of normal adjustment to a genuinely threatening life event – in this case, cancer.
Of course this doesn’t mean that dealing with the aftermath of cancer is plain sailing; after the initial hurdle of diagnosis it is likely that your anxiety will spike again when faced with new cancer challenges such as starting treatment or attending for follow-up appointments. And if you are younger, have a history of depression or anxiety, have experienced other losses, are in the midst of horrible treatment effects, are experiencing relationship difficulties or other stressful life events – you may be at risk for more serious depression and anxiety. And this holds true for partners and other family members, many of whom travel a similar journey but with the added burden of feeling helpless about how best to provide support.
Cancer is a traumatic life event and, as with other traumas, we all differ in our recovery.
Take Heart, Help is at Hand
Whether your distress feels like a bump in the road or you are feeling totally overwhelmed by negative thoughts and feelings, there are ways of coping that can help.
First of all, take the pressure off yourself to feel calm and in control. In the initial aftermath of cancer this is not only unrealistic – it is just one more thing over which you have little control.
Secondly, depending on your needs and circumstances you might benefit from reading self-help materials or tapping into the range of practical and emotional support services offered by the Cancer Council and other cancer organisations dedicated to helping people following a diagnosis.
And finally, clinical psychologists who specialise in oncology (cancer) are uniquely equipped to help you with individually tailored, evidence-based ways of coping that can be especially beneficial for those with persistent distress.
In summary, no matter how unsteady you are feeling now, it is likely you will start to feel better over time. Judging yourself or putting pressure on yourself to think or feel any particular way is not only unnecessary, it will likely add to your burden. In the meantime there are tried and true ways to navigate the journey forward.
The Cancer Wellbeing Centre is a recent initiative of Lilley Place Clinical Psychology and is serviced by clinically trained psychologists who have expertise and experience in the specialist field of psychology and cancer.