How to ask for help if cancer is affecting your mental health
Dr Clare Jacobson and Dr Mark Groves, Highly Specialist Clinical Psychologists at Guy’s and St Thomas’ NHS Foundation Trust in London, talk us through why it’s normal to experience difficult thoughts and emotions about cancer, and share tips on asking for help if cancer is affecting your mental health.
Being diagnosed with cancer can bring up a lot of feelings. Many people can feel a mixture of worry, sadness, anger, guilt, frustration, and shame. Psychological distress, such as feeling worried or low, might not feel ‘normal’ to you but it is understandable in the context of a diagnosis of cancer.
Cancer doesn’t just affect your body – it affects your mind, thoughts, emotions, relationships, and the roles we carry out such as work or family roles. We are not robots, we are living, breathing, thinking, feeling human beings. If you stubbed your toe on the door then you would feel pain. This does not feel pleasant, but it is a completely normal reaction to what has just happened. This is the best way of thinking about your thoughts and feelings about cancer and its impact.
Try not to avoid your thoughts and emotions
Although these feelings are completely understandable, they don’t feel nice. Therefore, our natural instinct is to try hard to avoid them. We can do this in all kinds of ways, such as putting on a brave face, avoiding people, criticising ourselves when we feel emotional or have difficult thoughts, or by using alcohol or drugs.
Although this often helps in the moment, it can feed into longer term problems, as it can start to have an impact on our wellbeing, relationships, and ability to do the things that matter to us.
Emotions and thoughts are not therefore something to avoid and try to get rid of. Psychological pain is telling us something important. Sometimes it’s useful to have a space to let someone else be in that distress with you, sometimes it’s useful to process and make sense of the distress and why you are feeling it, and sometimes it’s helpful to learn some techniques to stop the distress getting in the way of the things that matter.
Why distress can feel overwhelming
The thing about some types of distress, like anxiety and low mood, is that they can grow quite quickly. When distress grows and feels overwhelming, it can shut down our thinking, making it harder to see ways around it.
If low mood had a voice, for example, it would tell you unpleasant judgements about you, others and the world. It would tell you that you are different to everybody else, others are coping better than you are, there is no hope of things getting better, and it would want you to withdraw socially and stay alone in your room. This is how it feeds itself, as withdrawing from others is likely to make our mood stay low, and those negative thoughts keep coming.
Comparing and worrying are natural
Us humans are very good at comparing ourselves to other people. This goes right back to when we were cavepeople and our minds had to compare us to our group to make sure that we were fitting in and were not at risk of being kicked out and eaten by a lion! In our modern world, social media means that we can easily compare ourselves to others and convince ourselves that others are happier and coping better. This is not the case.
We just can’t see what others are feeling on the inside, so we end up comparing our insides (thoughts and feelings) to other’s outside (what we see them do). Think about when you have felt worried or upset but pretended to others that you were fine. It’s very likely that others are doing the exact same thing.
Our brains are wired to look for things that could go wrong and take a ‘better safe than sorry approach’. This means that all humans have anxiety wired into them. Feeling emotions such as anxiety is therefore not your fault. You did not design your brain or choose which brain you got!
Who you can talk to if cancer is affecting your mental health
It’s so important to try to get the right help as soon as you can to prevent low mood and anxiety getting too comfortable and sticking around for longer than you would like. There are lots of different ways you can do this.
Firstly, ask if there is somebody in your life that you feel able to talk to. This could be a family member, friend, girlfriend or boyfriend, a teacher or tutor, or a member of your church or other groups you belong to.
Sometimes talking to your Youth Support Coordinator (YSC) or Clinical Nurse Specialist (CNS) is helpful because they understand a lot of what you might be feeling and they have worked with lots of young people who have felt similarly. They are also really good at knowing other things that could be helpful, for example seeing a psychologist.
There are lots of weird and wonderful ideas around about what psychologists do. We don’t read minds, or make you lay on a couch and only talk about your childhood or dreams. We don’t judge or analyse you. Seeing a psychologist doesn’t mean that you are ‘mad’ or ‘weak’. Far from it. It takes real courage and strength to seek help.
Athletes have psychologists to help them optimise their training and performance for what they put their bodies through. Psychologists are trained in lots of different ways of helping people with their thoughts and feelings, and also with building up their strengths and connecting more with what matters to them.
Usually if you mention to your YSC or CNS, or anyone you feel close to in the team that you think some talking therapy could help, they will be able to refer you to someone who can help. You can also ask your GP for a referral to your local talking therapies service or you can google this yourself by typing in ‘talking therapies near (enter your GP’s postcode)’ and there is usually a button to click on to self-refer.
Asking for help can feel scary – that’s normal
Asking for help can feel very scary. This is normal. See if you can make space for the fear, it is just trying to protect you from something that feels scary. But you don’t have to let it stop you – take the fear with you to your first appointment. It is very normal.
Similarly, we all are given messages about emotions growing up, from lots of different sources such as our family, friends, school, church, culture, society. We can learn to label asking for help in an unhelpful way e.g. ‘I should not feel like this’, ‘I’m different’, ‘I’m weak’, ‘It’s not okay to ask for help’. This makes asking for help even more difficult and emotions can become scarier. See if you can take these thoughts with you to your first appointment and not let them stop you in your tracks.
We hope that this page gives you another perspective to these common thoughts. Having difficult thoughts and emotions about cancer is normal. It just may not feel normal to you. It’s not your fault that you think and feel these things, it is just how our brains are wired. If you are thinking about asking for help, you are strong and courageous and this is a big step, so reward yourself for this.
Asking for help can feel very scary but most people find that it does not turn out as bad as they thought. We usually don’t think twice about looking after our physical health by brushing our teeth, washing, eating and drinking, etc. Your emotional health deserves the same. If you think that it might be helpful to have some emotional support, speak to somebody.
If you’re a young person going through cancer and you feel you’re struggling with your mental health, please do speak to your clinical team, Teenage Cancer Trust Nurse or Youth Support Coordinator. They’ll do whatever they can to help you, which may include referring you to specialist support.