Psychological Issues That May Arise After a Diagnosis of Breast Cancer

Every year, over 230,000 women and 2,600 men get diagnosed with breast cancer.(1,2) Breast cancer is today the second most prevalent type of cancer and not just in developed countries, but it is equally prevalent in developing countries as well.(3)

In spite of the favorable survival rates in most developed countries, breast cancer still remains one of the leading causes of deaths in women in both developing and emerging countries. A diagnosis of breast cancer is one of the worst things that a person can hear. It is difficult to come to terms with such a diagnosis. After receiving this diagnosis, it is normal for everyone to feel a wide range of emotions – ranging from despair to rage.

Once the initial rage, confusion, and grief settles, many people end up developing a serious psychological health issue. After all, a diagnosis of breast cancer usually comes as a devastating surprise for most, and the emotional turmoil that follows is known to affect not just the physical health of a person, but their psychological well-being as well.

The first thing you need to know upon receiving a breast cancer diagnosis is that you are not alone in this condition. Research has found that women who get diagnosed with breast cancer usually go through depression that has an impact on their overall quality of life as well as their adherence to treatment.(4)

Here are some of the major psychological issues that a breast cancer patient may experience after receiving a diagnosis of this disease.

Psychological Issues of Breast Cancer

Emotional Distress

The first psychological impact a breast cancer diagnosis has is that it causes severe emotional distress. Of course, it is, but likely for people to experience distress upon hearing such devastating news. Severe emotional distress is the most common psychological issue amongst patients of breast cancer.

The National Comprehensive Cancer Network (NCCN) has taken out a questionnaire that is used by doctors as means of determining just how much emotional distress a patient is under and to what extent this emotional distress is affecting their life.(5) The questionnaire is known as the Distress Thermometer. The distress thermometer uses a 0 to 10 scale to reflect how much distress a patient is feeling currently and over the past week. Ten is the highest level of distress the patient is going through, and zero means no distress.(6)

Most cancer care teams use the scale of the distress thermometer to rate the distress of their patients in order to determine whether psychological help is required. If the patient’s response is four or above, then they are more likely to suffer from a moderate to a high degree of emotional distress.(7)

Your doctor and your cancer care team will then find out more ways to offer you the required psychological help.

Major or Clinical Depression

The biggest psychological issue that breast cancer patients face is depression. While sadness is a passing feeling of unhappiness, emptiness, or loss, but depression goes beyond that and is long-lasting. Depression is a mental health condition that is characterized by a depressed mood and an inability to experience happiness. There are a variety of psychological and physical symptoms that disrupt your daily life.

Feeling of depression is very common when patients and also their family members are coping with breast cancer. It is normal for all involved to feel grief and profound sadness. After all, their dreams, plans, and even the future suddenly seem uncertain.

Depression can be mild and temporary with bouts of sadness, but in some patients, this depression can be severe and long-lasting. This type of severe or long-lasting depression is known as major depression or clinical depression.

Major depression makes it difficult for a patient to function and adhere to their treatment plans. According to research, major depression affects around one in four cancer patients.(8,9)

A patient with major depression is likely to experience a variety of mental and physical symptoms, including:(10)

A General Feeling Of Unhappiness: You will be feeling sad and hopeless for the majority of the day

Negative Thoughts: Continuous feelings of hopelessness, and worthlessness about the future

Decreased Interest: There will be a drastic interest and lack of motivation in daily activities. Even the smallest of tasks may feel like a huge effort.

Decreased Concentration: A general inability to focus on even the simplest tasks or carry out conversations with people.

Social Challenges: You will find yourself avoiding others and lashing out at any well-wisher who tries to help you

Low Self-Esteem And Guilt: A persistent feeling that all your problems are your own fault and you that you are not good enough for anyone

Physical Symptoms: Noticeable weight loss or weight gain, loss of appetite or the opposite, trouble sleeping, headache, body aches with no particular cause being apparent

Suicidal Thoughts: Considering suicide or daydreaming about killing yourself – it is important to keep a close watch on a patient who is having suicidal thoughts as they may try to harm themselves.

Mood Swings: You may also experience wide mood swings that may range from depression to periods of high energy and agitation

Managing major depression in people with breast cancer include counseling, prescribed medication, or a combination of both. Sometimes doctors may recommend other specialized treatments as well. The focus of these different treatment plans works towards improving your depression, reducing the suffering, and helping patients lead a better quality of life.

Generalized Anxiety Disorder (GAD)

Anxiety is a common reaction to breast cancer. It is common for patients to experience anxiety while they undergo a screening test for breast cancer, wait for their test results, receive the diagnosis of breast cancer, and while undergoing cancer treatment as well. Furthermore, there is always lingering anticipation of whether the cancer is likely to return or if they are genuinely cured.

Generalized anxiety disorder (GAD) is a term used to describe the general feeling of fear or unease that is present in breast cancer patients. If you are suffering from GAD, then you are likely to spend most of your time worrying, often to the point where you become mentally exhausted and start experiencing physical symptoms such as irritability, restlessness, sleep disturbances, and muscle tension.

A study carried out by the Technological Educational Institute of Thessaly in Greece on 152 breast cancer patients found that around 32 percent of all the patients experienced GAD.(11)

Anxiety associated with breast cancer can lead to an increase in pain, interfere with the ability to sleep, cause nausea and vomiting, and an overall disruption of their quality of life.

People with breast cancer may find their feelings of anxiety increasing or decreasing at different times. For example, a patient may feel more anxious as the cancer treatment becomes more extensive or as cancer spreads. At the same time, the level of anxiety experienced by one patient may differ from the anxiety another patient is feeling.

It is essential to understand that by learning more about breast cancer and the treatment options available, patients can reduce their anxiety levels.

Post-Traumatic Stress Disorder (PTSD)

PTSD is another common psychological issue that affects breast cancer patients. Post-traumatic stress disorder is also a type of anxiety disorder that is brought on by a traumatic event in a person’s life. While it is usually associated with war veterans or victims of abuse or violent crime, PTSD can also severely affect breast cancer patients, who face a similar struggle with questions related to their own safety and mortality.

For example, a German study found that nearly 80 percent of newly diagnosed patients of breast cancer experience symptoms of PTSD.(12)

Some of the PTSD symptoms you should watch out for include:

  • Avoidance: Going to great lengths to avoid people or places that remind you of the trauma you went through when you were diagnosed.
  • Reliving the diagnosis moment: Feeling intense emotional distress and having distressing memories of the time period around your diagnosis.
  • Increased aggravation or agitation: Feeling easily angered or startled; being unable to sleep or concentrate and always feeling like danger is lurking around you, and something is bound to go wrong at any minute.

Steps to Seek Help After Diagnosis of Breast Cancer

If you are experiencing any kind of psychological issues along with the symptoms described above, then the first and foremost thing to remember is that you are not along, and these symptoms and feelings are common amongst most cancer patients. There is no need to struggle through the sea of emotions alone. There are many people you can reach out to for help.

Here are some essential steps you can take to help address your psychological issues and other concerns:

You have to reach out to others and take the support of trusted friends and family. If you belong to a religious group, then you can always ask your clergyman to get you in touch with others of your same faith who have earlier undergone treatment for breast cancer.

There are many support groups in various communities and even online that specialize in providing breast cancer treatment support.(13) Doctors and hospitals also have information about such support groups.

Conclusion

Your psychological health is equally as crucial as your physical health, and it is also essential to the successful treatment of your breast cancer.

This is why it is so important to tell your doctor about anything that is troubling you. If you are struggling with psychological issues, then make sure to ask your doctor for a referral to a mental health professional to get the help you require and deserve.

References:

  1. https://www.apa.org. 2020. Breast Cancer: How Your Mind Can Help Your Body. [online] Available at: <https://www.apa.org/helpcenter/breast-cancer> [Accessed 14 March 2020].
  2. Cancer.Net. 2020. Breast Cancer In Men – Statistics. [online] Available at: <https://www.cancer.net/cancer-types/breast-cancer-men/statistics> [Accessed 14 March 2020].
  3. Cancer.org. 2020. [online] Available at: <https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2017-2018.pdf> [Accessed 14 March 2020].
  4. Avis, N.E., Levine, B.J., Case, L.D., Naftalis, E.Z. and Van Zee, K.J., 2015. Trajectories of depressive symptoms following breast cancer diagnosis. Cancer Epidemiology and Prevention Biomarkers, 24(11), pp.1789-1795.
  5. Nccn.org. 2020. Managing Stress And Distress. [online] Available at: <https://www.nccn.org/patients/resources/life_with_cancer/distress.aspx> [Accessed 14 March 2020].
  6. VanHoose, L., Black, L.L., Doty, K., Sabata, D., Twumasi-Ankrah, P., Taylor, S. and Johnson, R., 2015. An analysis of the distress thermometer problem list and distress in patients with cancer. Supportive care in cancer, 23(5), pp.1225-1232.
  7. Van Lander, A., Tarot, A., Savanovitch, C., Pereira, B., Vennat, B. and Guastella, V., 2019. Assessing the validity of the clinician-rated distress thermometer in palliative care. BMC palliative care, 18(1), pp.1-7.
  8. Chochinov, H.M., 2001. Depression in cancer patients. The lancet oncology, 2(8), pp.499-505.
  9. Trask, P.C., 2004. Assessment of depression in cancer patients. JNCI Monographs, 2004(32), pp.80-92.
  10. Breastcancer.org. 2020. Depression: A Side Effect Of Treatment. [online] Available at: <https://www.breastcancer.org/treatment/side_effects/depression> [Accessed 14 March 2020].
  11. Tsaras, K., Papathanasiou, I., Mitsi, D., Veneti, A., Kelesi, M., Zyga, S. and Fradelos, E., 2020. Assessment Of Depression And Anxiety In Breast Cancer Patients: Prevalence And Associated Factors. [online] Journal.waocp.org. Available at: <http://journal.waocp.org /article_63340.html> [Accessed 14 March 2020].
  12. Voigt, V., Neufeld, F., Kaste, J., Bühner, M., Sckopke, P., Wuerstlein, R., Hellerhoff, K., Sztrókay‐Gaul, A., Braun, M., von Koch, F.E. and Silva‐Zürcher, E., 2017. Clinically assessed posttraumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study. Psycho‐oncology, 26(1), pp.74-80.
  13. Ww5.komen.org. 2020. Support Groups For Breast Cancer Survivors. [online] Available at: <https://ww5.komen.org/BreastCancer/SupportGroups.html?cl=direct&utm_campaign=rkd_fy20&utm_medium=cpc+grants&utm_source=google&attr=rkd_search_grant&gclid=CjwKCAjwxt_tBRAXEiwAENY8hV9fSF-5EhqPmVWgBY5vcg0wS_m13SJGdYqlpSxBL8AkY3ogWRBP0xoCcpcQAvD_BwE> [Accessed 15 March 2020].

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