The Psychological Impact of a Breast Cancer Diagnosis

A diagnosis of breast cancer is one of the most devastating things a woman can hear. After such shocking news, it is normal to feel a range of emotions, from despair to rage. But for some patients, even once the initial confusion and grief have dissipated, a serious mental health issue may develop.

Your Emotional Symptoms After Breast Cancer Diagnosis

The first thing to know is that you are not alone. Researchers have found that women who are diagnosed with breast cancer frequently experience depressive symptoms that impact their quality of life as well as adherence to treatment. 

Some of the conditions that a breast cancer patient may experience include:

1. Severe Emotional Distress

Severe emotional distress is the most common mental health issue among breast cancer patients. A simple questionnaire known as the "Distress Thermometer" has been endorsed by the National Comprehensive Cancer Network (NCCN) as a way to determine whether emotional distress is significantly affecting your life.

2. Major Depression

Depression goes beyond a passing sadness or brief feelings of emptiness or loss. It is a mental illness in which a depressed mood and the inability to experience pleasure occur along with a variety of mental and physical symptoms that interfere with your daily life. While someone with clinical depression may not experience every symptom, it is important to check with your healthcare provider if you experience any the following:

• General unhappiness: Feeling sad or hopeless most of the time
• Negative thoughts: Continuous feeling of worthlessness, hopelessness about future
• Reduced interest: No motivation; even smallest tasks or feel like a big effort
• Reduced concentration: Inability to focus on simple tasks or even conversations
• People problems: Avoiding others, lashing out when others try to help
• Guilt and low self-esteem: A feeling that problems are all your fault or that you are not good enough for anyone
• Physical problems: Trouble sleeping, noticeable weight loss or gain, head or body aches
• Suicidal thoughts: Daydreaming about death, considering suicide

3. Post-Traumatic Stress Disorder (PTSD)

PTSD may affect individuals who have suffered a traumatic event in which bodily harm was experienced or threatened. Often associated with war veterans and victims of violent crime, PTSD can be just as severe in cancer patients, who similarly struggle with questions of their safety and mortality. One German study found that most (approximately 80%) newly diagnosed patients with breast cancer experience PTSD symptoms. Symptoms to watch for include:

• Reliving the moment: Intense distressing memories of the time around your diagnosis
• Avoidance: Going to lengths to stay away from places or people that remind you of the traumatic experience of your diagnosis.
• Increased arousal: Feeling easily startled or angered; being unable to sleep or concentrate as though danger is imminent

4. Generalized Anxiety Disorder (GAD)

A study of 152 breast cancer patients found that approximately 32% experienced GAD, an anxiety disorder in which a general feeling of unease or fear is present, despite little or no threat. GAD sufferers spend most of the day worrying, often to the point of mental exhaustion, and experience physical symptoms such as restlessness, irritability, muscle tension and sleep disturbances.

What To Do - Seek Emotional Healing After Breast Cancer Diagnosis

If you are experiencing any of the symptoms in the conditions described above, remember that they are common and that you do not have to continue to struggle alone. There are some important steps to help address your symptoms and concerns:

• Reach Out To Others. Lean on trusted friends and family members. Ask your clergyman to put you in touch with others of the same faith who have been treated for breast cancer. Find support groups in the community; usually, hospitals that specialize in breast cancer treatment sponsor these types of groups. Your healthcare provider should also have information about support groups.
• Talk With Your Healthcare Provider. Your mental health is important to successfully treat your physical condition. It is important to tell your healthcare provider about anything that is continually troubling you. Ask for a referral to a mental health professional if you would like more help.

Learn About Medications

The medications often prescribed for these conditions include antidepressants such as SSRIs (Prozac, Zoloft and Celexa among them). 

Be aware that there is a potential for drug interactions that could endanger your treatment; for example, some antidepressants can reduce the effectiveness of tamoxifen. Be sure your mental health provider and your oncologist know about any medications you are taking.

Finally, remember that antidepressant medication may take some time to provide relief. Do not stop taking the medication without consulting your healthcare provider if you don't feel better right away.

Know Which Symptoms Require Immediate Help

Call your healthcare provider or local hospital immediately if you experience any of the following:

• Thoughts of suicide or continuing daydreams about death
• Reckless behavior, such as drinking to the point of blackout or driving erratically
• Inability to eat or sleep for several days
• Severe trouble breathing or calming down from anxious feelings

I am OK ... I Think

If you do not believe you are suffering from any of the above conditions -- but you do not feel quite yourself -- you still may find comfort by reaching out to others.

Find support online. Sites like CancerCare can provide information on coping with cancer and the whirlwind of emotions cancer survivors experience. They also have information on online support groups, where you can connect with people who are experiencing some of the same things you are.