In June 2017, I was diagnosed with metastatic sarcoma. I went from being a healthy, practicing therapist who worked three jobs while also caring for my two children and husband, to being afraid to move.
The impact of hearing the possibility of cancer was crippling, even at first. But once it was confirmed, in a matter of days my body began to fall apart as I lost the mental capacity to will myself to keep moving.
See, before I even knew something was wrong, I had already begun to feel that something was wrong. I was extremely fatigued, and each day my movements became slower. I became more irritated and unable to engage in regular activity with my children and husband. They all thought it was due to the hours I worked, as did I. But the reality was that my body was rapidly shutting down on me. Then, when I heard the word “cancer,” I mentally and emotionally broke! Everything that I had been doing was for the betterment of my family, but what was the cost? I could not believe I was on the brink of death without having first enjoyed my life. With my eyes on the prize, the so-called finish line, I had lost sight of the present and neglected my family. Now I wondered, “How do I get myself through this? How do I get my family through this? How do I prepare them for what is to come?”
The mental fatigue and the loss of bodily control that comes along with a cancer diagnosis can cause great stress. The components of the diagnosis and treatment regime can easily overwhelm a person. Any number of mental health issues may develop along with such an experience. Feeling emotions like sadness, uncertainty, even guilt is not uncommon, and these may become difficult to control. In some cases, denial and dissociation might also be present.
Challenging and difficult feelings can flood in at any time, unexpectedly, especially when in the “eye of the storm,” so to speak. Often, once an appropriate treatment regime is identified and begun, emotional displays may become less frequent. You might begin to feel more stable, even with the side effects that occur as a result of treatment. Fear of the unknown may begin to dissipate, and you may become more calm and sure of what is going on.
A Cancer Diagnosis’ Emotional Toll
Looking back and reflecting on my patterns of thought and behaviors, I believe I was experiencing what is classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an adjustment disorder with mixed anxiety and depressed mood. The DSM-5 specifies that symptoms of an adjustment disorder appear within three months of a stressful event (such as divorce, accident, loss, serious medical diagnosis, or any major life change). The symptoms usually dissipate after the effects of the stressors subside, unless the effects are chronic. More specifically, an adjustment disorder can be compounded with symptoms of depression and/or anxiety. In short, this diagnosis is typically characterized by a combination of alternating depressed and anxious mood symptoms that create difficulties for self/others with regard to daily function.
Although I did not meet the full criteria for a diagnosis of major depression or anxiety, I definitely felt symptoms related to both. Not only was I depressed due to the severity of my illness, I was anxious every time I had to go to the doctor, worrying about things like being late for my appointment. I had several incidents when having my port accessed, so I began to feel like there was going to be a problem each time, and whenever it was accessed I went into a state of panic. All I could do was imagine the pain and worry that something was going to go wrong and/or that my body would not respond to the medicine correctly. I even experienced a range of emotions when I thought of other people seeing me. I was afraid that others wouldn’t accept me, that I was I ugly without hair. My daughter cried and could barely look at me after I had to shave my head. I was devastated by her reaction and depressed at the thought of her not wanting to be around me when I looked the way I did, and I interchangeably felt both depressed and anxious.
Although my stressor was indeed traumatic, I did not experience avoidance or dissociation, necessary criteria for a diagnosis of acute stress disorder or posttraumatic stress. I knew had to attack the cancer like it was attacking me: aggressively. I had to attend doctor visits and be compliant with directives, no matter how scared or angry I became.
Coping and Acceptance
In accepting my diagnosis of cancer, many things ran through my head. My hopelessness was real, as was the lack of desire—and lack of ability—to engage in my usual activities. I quickly became overwhelmed by nervousness at the thought of surgeries, treatments, and the perceptions surrounding my changed appearance. While trying to make sense of the changes that have occurred, I found that maladaptive thought patterns were trying to take root. Even beliefs I recognized as irrational began to filter through with all the information I was trying to process.
Therapy is a positive and important step we can take to help counteract the emotional and mental effects of a cancer diagnosis.
I cycled through questions: “How do I fight this?” “Can I survive this?” “Why me?” “How will my family be affected?””If I can’t work, how will I pay my bills?” “What will I do next, once I beat this?”
These and many other questions loomed over me, and I didn’t have the answers to any of them. I knew I had to identity some coping strategies fast. Luckily for me, my support network assembled quickly.
A support network is everything! Without one, the emotional upheaval of a cancer diagnosis (or any other major illness) can be catastrophic. A support network is formed from a number of different individuals, including but not limited to:
- Family, immediate and extended
- A support group
- Religious leader and church community
- The organizations that exist to support people diagnosed with cancer by helping out with meals, beautification rituals, and babysitting or cleaning services.
Along with the physical support of health care and modern medicine, we also need emotional support. Having a good laugh, engaging in prayer or meditation, or even just sitting with a trusted person so we know we aren’t alone, is paramount. It can often help relieve some of the depression and anxiety that comes with the reality of a cancer diagnosis. While it’s important to allow ourselves to fully experience and sit with our emotions, a good support system helps to keep us grounded, which in turn helps minimize the development of maladaptive though patterns as we begin to cope with the reality of living with cancer.
Seeking support from a trained mental health professional, such as a therapist or counselor, can also be helpful. Therapy is a positive and important step we can take to help counteract the emotional and mental effects of a cancer diagnosis. Keep in mind that many people in our support networks are trying to cope with their own emotions surrounding our state of being. Sometimes, it may be hard for them to truly hear what we are feeling and engage with us. When your support system is unable or unequipped to handle our emotional state, a (trained) source of non-judgmental, outside support is beneficial. Therapy offers a safe space where we can be unapologetic and candid with what we are feeling and why.
As I moved forward, I realized the importance of creating and engaging in hobbies. When we are sick, we may have a lot of idle time. When idle, many of us tend to overthink a particular situation or fixate on distressing thoughts. In my case, I found that keeping myself busy, as much as I was able, helped keep thoughts of self-doubt and self-pity from settling in.
Currently, I am actively engaging in chemotherapy, and I still struggle with my cancer diagnosis. Holding on to past patterns of normalcy may be difficult or even impossible for some. I’ve found it’s actually easier to identify the positives of my situation.
By altering my expectations of self to reflect my present state of being, I have made hope easier to obtain. I believe life is not supposed to be the same experience it was five years ago. Every day we evolve, gaining and losing certain aspects of life as time goes by. I may have lost a job, a friend, or some health freedoms, but I have gained wisdom; love; and a greater appreciation of self, life, and family. It is all right to be different from your past self, and it’s all right to be comfortable in your new self. It’s also normal to feel sadness, fear, and anger as part of the grieving process of shedding the old.
This is a new chapter of my life, one that is not without great difficulty. But I’ve learned to lean on my support system (my village) to take the steps necessary to embrace what lies before me.
Maia Delmoor, a licensed counselor and GoodTherapy.org member who specializes in the treatment of trauma and addictions, was diagnosed with cancer in 2017.
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