Mood & Emotions
Receiving a cancer diagnosis can be an intensely emotional experience. These emotions cycle in different ways for different individuals and can range from terror to anger, guilt to shame, despair or sadness, and feeling emotionally numb. Anxiety can be high because of the fears of the unknown, feelings of threat to life, worry about yourself, the treatment, loved ones, family, and more. Cancer can also trigger previous traumas or grief or feel like a PTSD experience from the diagnosis itself. It is essential to find ways to safely process these intense emotions as they come up in a healthy and nurturing way. Often, cancer will also provide an opportunity for a life review, clarifying life's purpose, exploring the quality of relationships, and may make you more keenly aware of who you are and what you need, allowing a deeper focus on your true authentic self. Surprisingly, some people even feel a deep sense of calm.
Anxiety and depression are common in cancer patients. It is not surprising that getting a cancer diagnosis provokes these changes in mood. Anxiety in cancer patients is not always identified or treated in a medical setting. It's important for you to share the feelings you are experiencing and ask for help if you are experiencing heightened depression and/or anxiety.
Unaddressed negative emotions precipitate a physical stress response that can impact prognosis negatively as well as interfere with relationships and experiencing joy in your life. Identifying your feelings and working with them takes time but is rewarded by freedom as you reconstruct your life and find your new normal. Who is the "New You"? Searching for ways to improve mood and promote emotional wellness should be an ongoing process and an important part of treatment goals.
Fatigue-Pain-Depression Cycle
Cancer related fatigue affects 80% to 90% of people undergoing cancer treatments such as chemotherapy and radiation and overall affects 40% of all people diagnosed with cancer. Even after treatment and remission, as many as 30% may have ongoing fatigue. Depression is also a frequent concurrent problem when fatigue is unresolved and impacts quality of life. Poor sleep can promote fatigue, worsening depression as well as chronic pain. It is difficult to be in a good mood when there is pain or significant fatigue, a cycle that can impact quality of life. Conversely, feeling depressed can promote fatigue and worsen pain. It is important to rule out reversible causes such as medication side effects, hypothyroidism, anemia, organ dysfunction (e.g., heart failure, pulmonary issues), poor sleep quality, pain, depression, or menopausal symptoms. After addressing medical reasons for fatigue with a health care professional, there are still many ways of reducing fatigue and improving mood using integrative therapies. Regular physical activity has been shown to improve sleep, decrease fatigue, reduce depression, and improve chronic pain, thereby improving overall quality of life. It is the most effective treatment for the fatigue-pain-depression cycle. There are several additional lifestyle or integrative approaches to address these symptoms.
Integrative Approaches
Beyond using prescription medications for mood, there are many effective strategies that you can safely use to promote healing and vitality. The key is to choose one or more of these to enrich your life, make positive connections with others, and examine negative moods that affect your decision-making process and quality of life. Using integrative strategies builds hope, hardiness and resilience, and allows you to create a brighter and more healthy future.
Acupuncture
Acupuncture is safe and useful for a variety of symptoms and health-related conditions. Acupuncture might improve mood by reducing:
- pain (specific and generalized)
- insomnia, fatigue
- hot flashes
- depression and anxiety
For best outcomes, a series of treatments are required. See more about Acupuncture
Aromatherapy
Essential oils can be used to both support healing and promote health and well-being by:
- Improving mood (depression, anxiety)
- Promoting relaxation, reducing stress
- Enhancing sleep, reducing fatigue
- Decreasing pain
- Strengthening immunity
- Supporting palliative care
Art Therapy
Art therapy relies on creative/expressive arts to manage a variety of conditions, including coping with illness, improving anxiety and depression, addressing stress, enhancing self-esteem, and providing a healthy way to explore emotions.
It is important to note that no artistic talent is needed to benefit from this therapy. An openness to try things will enhance the success. Art therapy can be used with children, adults, and the elderly.
Finding a properly trained therapist is important. They should have a minimum of a Master's degree. If they have ATR after their name, it means they are registered with the Art Therapy Credentials Board (ATBC). ATR-BC means they passed an examination and are board-certified by the ATCB.
If you choose not to work with a certified art therapist, or do not have access to one, focusing on your own creative projects and exploring your inner artist can still have many benefits. Coloring, drawing, design, or creating crafts can calm the mind, help release emotional or traumatic experiences, and decrease anxiety. You do not have to be an established artist to make art. We all have this potential.
- Resources
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Cancer Research UK: Art Therapy
Provides info about Art therapy, Finding an art therapist, research related to cancer, expenses, and much more.
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Cancer.Net: Art Therapists in Cancer Care
Hear from a board certified registered art therapist and licensed mental health counselor on Art Therapy for folks with cancer.
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Psychology Today: Art Therapy
A broad explanation of what it is, when it's used, and professional training.
Botanicals and Supplements
Botanical and dietary supplements use must be discussed with your primary care or integrative medicine trained provider as these may interfere with cancer treatment (chemotherapy or radiation therapy) or other medications you are taking. Exploring the use of these with your provider is worthwhile, as they may be useful additions to your care. Teas are generally safe and can be a soothing way to manage anxiety and improve sleep. Chamomille, lemon balm, valerian, passionflower, and magnolia have all been shown to have soothing properties and can be found in tea form. Some companies sell soothing or "sleepy time" teas that contain a mixture of these herbs. It’s important to purchase supplements from a reputable company that adheres to Good Manufacturing Practices to ensure the product is free of contaminants and contains the correct herb and dosage.
Working with a trusted integrative provider can help you tailor your supplements to ensure safety and reduce risks of drug- or herb- interactions. Please do not attempt to use all these supplements at once.
The following nutrients and herbs have been shown to help with fatigue, depression, anxiety, and pain:
Fatigue/Lack of Sleep
- Melatonin can help with fatigue if your lack of energy is due to poor sleep because it is considered a natural sleep aid.
- 5HTP can also help with sleep and it has been shown to enhance mood as well, which is important when you are lacking energy.
- The herb guarana contains a high amount of caffeine, even more than a cup of coffee, so it can obviously help with fatigue; however, it should only be used early in the day and not by people who are sensitive to caffeine.
- Carnitine is a nutrient that plays a vital role in energy production on a cellular level so it can help enhance energy, but it does not act as a direct stimulant.
- Like carnitine, CoQ10, works on a cellular level to enhance energy and has also been shown to help with cancer-related fatigue.
- Ginseng is an herb that has also been shown to help with cancer-related fatigue and can enhance general energy levels as well.
Depression/Anxiety
- In addition to helping with fatigue, many adaptogenic herbs such as ashwagandha, rhodiola, bacopa, and chaga, can help with depression and anxiety as well.
- L-theanine has been studied primarily as a stress reliever, however, in addition to anxiety, it can also help with depression and sleep issues.
- Saffron and lavender are herbs that have been shown to help with both depression and anxiety.
Pain
- Curcumin is the active compound found in the spice turmeric and has been shown in several studies to help alleviate chronic pain.
- Boswellia is also an herb that helps alleviate pain and is sometimes combined with curcumin.
Communing with Nature
Spending time in nature has been shown to provide several benefits. These include connection to something larger than us and stepping away from our daily stress. Fresh air, sun, and the beauty of nature is good for the spirit and the body. Time in nature has been found to improve sleep, elevate mood, activate the immune system, and decrease pain. You might use your time in nature as an opportunity to practice contemplation or mindfulness, or as a chance to get some gentle physical activity. Most people find that even just sitting outdoors, listening to the various sounds of nature such as birds or the wind, and feeling the elements such as the warm sun or a light breeze, can be comforting and nurturing. Make time every day to be outdoors if you can, and if you can't, be sure to open windows to bring natural light into your room. Natural light has many benefits, including improving natural sleep by increasing your body's melatonin levels.
Counseling
There are many types of therapy that can be useful along the cancer journey. Cognitive Behavioral Therapy (CBT) is a "problem-focused" and "action-oriented" form of counseling that helps to identify thought distortions which results in anxious or depressed behaviors. Acceptance and Commitment Therapy (ACT) uses mindfulness philosophies to help you just notice, accept, and embrace all of your emotions, including the negative ones. Cognitive-Based Compassion Therapy (CBCT) is a practice of increasing compassion for yourself and others through the development of a contemplative practice.
Therapy is not generally a one-size-fits-all approach. It can take time to find the right therapist or right approach to therapy, but it is worth the effort. Many studies have confirmed that therapy or counseling, used by itself, or in combination with medications or other treatments, can reduce symptoms of depression and anxiety. A trusted therapist should have at least a Mater's level of training/education.
Energy Medicine
Everyone has an electromagnetic field on a large and small (cellular) scale. This has been described over millennia by many independent cultures as Mana, Prana, Chi, Qi, and other culturally relevant terms. The energy field can be directed and enhanced with the use of intention and breathwork to promote healing of self or others.
Exercise
Physical Activity is one of the best ways to help treat depression, fatigue, or chronic pain. Yoga, Tai Chi and other movement therapies are helpful in reducing fatigue, improving balance, and improving mood.
For most people with cancer, exercise is both safe and important to wellness and recovery. It may even promote longevity. In addition to improving health and increasing fitness, exercise has been shown to improve many side effects of cancer including:
- Fatigue
- Mood
- Sleep
- Pain
- Stamina
- Balance
- Muscle strength
- Lymphedema
- General body function (e.g., after surgery)
- May increase lifespan
- Improves quality of life in many other ways
Journaling
Therapeutic journaling can be used daily to gain perspective and reveal hidden emotions and feelings that can then be processed. Journaling can help you cope with a cancer diagnosis and the challenges of treatment. There are many different types of journaling practices and activities. Some people prefer free journaling, while others use a designed or prescribed approach (like a gratitude journal). Nobody has to read what you write, and you don't have to re-read it. Much of the healing is in the process of journaling itself.
Read more about contemplative practices (including journaling)
Healing Power of Laughter
Who doesn’t love to laugh?! But did you know that the actual act of laughing has significant mental, emotional, and physical health benefits? The old saying is true that laughter really is the best medicine.
The research regarding laughter as medicine is no joke. There are several ways laughter enhances health. The act of laughing reduces the stress hormone cortisol and increases feel-good neurotransmitters like dopamine. Laughter has even been identified as a potent “longevity” medicine as it can reduce the risk of several chronic illness associated with aging including cardiovascular disease, diabetes, and cancer.
The best part of laughter medicine is that it’s natural, free, and fun to focus on.
The two types of laughter are spontaneous and self-induced with the most common form of self-induced laughter being laughter yoga. Research shows that both forms of laughter have health benefits.
Spontaneous laughing can be encouraged by viewing funny movies or television shows, reading or telling jokes, and hanging out with funny friends. You can find free laughter yoga classes online or in your local area.
Hypnosis
Hypnosis is a healing modality facilitated by a trained therapist that induces a trance-like state, allowing for heightened focus and concentration. It is a safe and effective tool that can be self-administered or with a professional trained in the practice.
Hypnosis works well for
- Insomnia
- Depression
- Pain control
Seek this therapy only from someone who is working as or under a licensed clinical practitioner.
Meditation or Mindfulness Practice
Mindfulness means keeping your thoughts and your heart in the present moment. What brought you to this moment is less important than the fact that it is what it is.
Mindfulness…
- Means being aware and living your best right now.
- Means using all your senses plus being aware of what you feel and think.
- Means less pain from the past or worry about the future.
- Can be related to prayer but is not religious.
- Is backed by a great deal of good research.
- Can be learned by practice.
Meditation is a type of mindfulness practice. Meditation prior and during chemotherapy can decrease anxiety by 46%. Meditation can be used individually with audio, video, or phone apps, or in group settings. Start a daily practice for yourself. It is best done in either the early morning or before bedtime.
Mindfulness Based Stress Reduction (MBSR) is an 8-week program that has been shown to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer according to one large analysis.
Massage
Massage is generally considered safe in people with cancer. There are many studies that have examined various types of massage and found benefits including: improved mood and sleep, increased energy, decreased anxiety and depression, as well a improvements in pain and even nausea. Massage can also be deeply relaxing and nurturing.
Read more about Massage
Music Therapy
Music is used in many cultures and traditions to trigger emotional experiences and to promote healing. Using music in a specific way, for the purpose of healing and emotional processing can be very therapeutic and is collectively referred to as music therapy. Music therapy has been shown to relieve anxiety and depression, as well as provide a distraction from pain and distress. Music therapy sometimes involves the process of creating music, while other times the music is played by others using live instruments, or on an electronic device to trigger a pleasure response.
Even if you can't find a certified music therapist in your community, you can experiment with different types of sounds or music that may help you with deep relaxation or sleep, deepening meditation, processing grief, or promoting joy. Music can be playful and can also help bring about lightness and elevate mood in the home.
Support Groups
Sharing your experience, learning from other cancer patients' journeys, and receiving love and support from others with a cancer diagnosis are all valuable benefits of being part of a support group. Additionally, professionals facilitating the group often educate about lifestyle changes, ways to process grief and other emotions created by your cancer journey, and other important topics.
Many of the support groups also extend services to family, friends and caregivers as well.
