Mental Health and Breast Cancer - Advice & Guidance

We have recently talked to the team at 'Talking Change' about mental health struggles related to a cancer diagnosis. Find useful tips, advice and guidance on mental health difficulties:

A bit about ‘Talking Change’:

Talking Change is a mental health service in Portsmouth. We are a team of therapists and researchers that specialise in the treatment and understanding of common mental health difficulties, providing free and confidential support.

Talking Change is part of the NHS service: Improving Access to Psychological Therapies (IAPT).

Find us online:

Website: https://www.talkingchange.nhs.uk/

Youtube: Here

 

Why is mental health important?

According to the latest research*:

  • Worldwide, 1 in 4 people will struggle with their mental health at some point in their lives
  • About 450 million people are currently struggling and mental health is one of the major threats to our wellbeing worldwide
  • Over the past week in England, 1 in 6 people had a mental health problem
  • Across the UK, 2 out of 3 people who suffer from a long-term physical health condition struggle with their mental health

*Reports published by the World Health Organisation, the British Mental Health Foundation and the British Department of Health and Social Care

 

What mental health concerns can come up after a cancer diagnosis:

Following a cancer diagnosis, it is normal to experience common mental health problems such as anxiety and depression. Causes of common mental health problems can include: difficult or stressful life events, difficult family dynamics, changes to our physical health, and changes in hormones. All of these are things we may be experiencing after a cancer diagnosis.

Depression is a prolonged sense of sadness and low mood and its symptoms include feeling hopeless, low self-esteem, irritability, tearfulness, and lack of motivation or interest in things. When facing a cancer diagnosis, we may experience a change in role and lifestyle, and a sense of loss, which may contribute towards feeling low. To read more about Depression please see the NHS link below:

https://www.nhs.uk/conditions/clinical-depression/

We all may feel anxious at some point in our lives, especially when facing a cancer diagnosis. We may be left feeling uncertain about the future, whilst juggling changes in ourselves both physically and in our day to day lives. It is when this feeling of anxiety becomes constant and starts to take over our daily lives however, that it might indicate an anxiety disorder. To read more on Generalised Anxiety Disorder, please see the NHS link below:

https://www.nhs.uk/conditions/generalised-anxiety-disorder/

 

How can someone living with breast cancer help themselves if they are struggling?

Here are some tips for looking after your mental health if you are struggling:

  • Make some time for yourself to do something you enjoy. Scheduling even a small amount of time to do something we enjoy, whether that is a relaxing bath, painting, watching our favourite TV show, or whatever it may be, can have a positive impact on our mood.
  • Gentle exercise. Evidence shows that exercise can have huge benefits for our mental health, reducing our stress and increasing our mood. Even a short walk or gentle yoga session can have a positive impact to how we are feeling.
  • Breathing exercises. Slow, rhythmic, breathes can help us to feel calm and reduce our anxiety. There are lots of mediation apps, or breathing videos on YouTube, to help guide you with this. We recommend searching for ‘square breathing’.
  • Talk to someone. Sometimes it can really help to talk. If you have someone in your life that you feel is a good listener, being a family member, a friend, or even a colleague, sharing how you are feeling can help you with coping.
  • Seeking support. It is okay to ask for help. Whether it is support with your mental health, or more practical support, there are services out there to help you. It might be worth having a conversation with people involved in your medical care as they may be able to signpost you to local services.
  • Reduce social media use. Social media can be a great way of keeping in contact with people, but it can have its downsides. It can be very easy to compare ourselves and our lives with others which may have a negative impact on our mood. Reducing the time we spend on social media can help to limit this.
  • Be kind to yourself. You are going through something extremely difficult and you may be feeling a whole range of different emotions. It’s understandable if you are finding things hard.
  • Get writing. Writing down how you feel, can be a great way of processing how you are feeling and getting your thoughts out of your head and on to paper. Once you have done this, you may want to show it to someone to help express how you feel, you might want to keep it private, or you might even want to just destroy it which can be just as beneficial.

 

What signs should I look out for that someone isn’t coping well and might need help?

It can sometimes be hard to tell if someone isn’t coping well but some things to look out for are:

  • Starting to withdraw or spending more time on their own
  • Finding less pleasure in activities they previously enjoyed, often resulting in avoiding these activities altogether
  • They may be more restless and fidgety than usual, or they may have lower energy and find it hard to do day to day tasks.
  • Changes in mood, for example being more irritable than usual or crying more
  • Changes in sleep pattern, either sleeping more than before or finding sleep difficult

These are just some general indicators, but if you suspect that someone is struggling then the best thing to do is just ask them how they feel and allow them space to talk. Let them know you are there for them.

 

How can I help a friend or a member of family who is struggling?

If you identify that someone is struggling, then there are a few things that you can do:

  • Listen. Providing them the space to be heard without judgement can make a difference and help them to realise that their feelings are valid and that there is someone there for them.
  • Ask. Ask how you can help and what they need from you to feel supported
  • Signpost. There are plenty of services available that may be able to provide support, whether that is therapeutic, practical, financial etc. If you struggle to find services yourself, then don’t be afraid to ask someone involved in your care as they may be able to direct you to someone that can.

 

What sort of services are available if I feel like I am not coping?

If you feel like you are not coping, then it is okay to ask for help. Sometimes it can be easier to talk to someone separate to the situation that can offer you support and a non-judgemental space to talk. The following services may be able to provide support:

Macmillan

IAPT

NHS IAPT services offer treatments such as Cognitive Behavioural Therapy and Counselling for individuals with common mental health problems such as anxiety or depression. More information and guidance on finding your local service can be found on their website: https://www.nhs.uk/service-search/find-a-psychological-therapies-service/  

At the moment, IAPT is only available in England. The following services are available for other parts of the United Kingdom:

Scotland -  Visit https://www.nhs24.scot/our-services/ to see the services provided and how to access them.

Wales – You will need to contact your GP for a referral to NHS counselling services.

Northern Ireland - Through calling Lifeline on 0808 808 8000 you can talk to a trained counsellor who will help you to identify the support you need. Visit lifelinehelpline.info for more information

 

I am worried about how my family will cope with my diagnosis:

It is completely normal for your friends or family to face a wide range of emotions in relation to your diagnosis. It is a tough situation for everyone involved. They may feel shock, fear, anxiety, anger, loss, sadness, exhaustion, to name a few. Talking about both how you feel, but also how they feel can help you all to understand how it is affecting you.

The same services available to people with a cancer diagnosis, also tend to provide support for family members and carers. Encouraging them to seek support can help them to have their own space to process how they are coping with your diagnosis.

 

I am a bit overwhelmed with all the information I have been given:

Whilst being given a lot of information can be helpful, sometimes it can feel like too much and it is hard to know where to start. Some useful ways of dealing with this are:

  • Prioritise what you need to know first. You aren’t expected to know everything all at once. It may be that some things might not be relevant right now and could be read further down the line. Try to seek out what you need to know, first of all, and work through it gradually.
  • Break it down in to manageable pieces. Breaking things down in to smaller chunks can make things seem less daunting. Maybe limit yourself to one or two leaflets/sites/pages of a book a day and let yourself process that information before moving on to the next thing.
  • Share the load. Ask someone you trust to go through the information with you. This also may help loved ones to feel more involved and support you better.
  • Speak to your GP or a specialist. Ask them if they can help to break things down for you. 

 

I feel angry that I was diagnosed – WHY ME? Are there any tips or tricks that can help me cope better with this?

Anger is a completely normal emotion when facing a cancer diagnosis. For example may be angry at what it means to your life and the changes you may have to make, the reactions of others, or the symptoms you experience. Anger is not shameful and there are healthy ways to cope with it. Some tips for this include:

  • Stop. Step back. Observe. Take a moment to pause and notice what is happening. What are your thoughts, your physical sensations, emotions and images? Notice how you’re interpreting these and what that means. Notice the unhelpful thoughts and what you are reacting to in that situation. Is there anyway you can look at this differently?
  • Practice Mindfulness. Mindfulness can be a useful way of helping us to focus on the present moment and calming our reactions. There are several apps available for this such as Headspace or Calm. There are also lots of videos available on YouTube.
  • Breathing exercises. As with mindfulness, our breathing can have a powerful impact on our mood and reduce our feeling of anger.
  • Physical exercise. Whether it is a gentle walk, or something more vigorous, exercise can help reduce expel and reduce our anger
  • Changing “why” into “how”. Sometimes we can get stuck in moments of rumination, thinking over and over about negative situations, thoughts, or feelings. We might be stuck in a loop of asking “why?”. To help us catch these patterns it can be useful to ask ourselves the following questions:

 

  1. Have I made any progress towards solving a problem?
  2. Do I understand something about a problem (or my feelings about it) that I haven’t understood before?
  3. Do I feel less self-critical or less depressed than before I started thinking about this?

If the answer to all three of these is NO, then the chances are you are ruminating. If this is the case then it can be helpful to reflect on how you can turn that “why” into a “how can I do something about this?” Is there something you can do differently that might help your mood? Is there a problem that is bothering you that could have a solution?

  • Problem solving. Applying a structure to solving problems can help make it more manageable. Start by defining what specifically the problem is. Once you have done this then you should try to think of ALL the possible solutions, feasible or not, don’t discount anything. Then you can move on to choosing the two most likely solutions and assess the pros and cons of both. Once you have chosen your solution you can plan it and put it in to action. Afterwards it can be useful to review it, is there anything I could have done differently?
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