Being diagnosed with breast cancer instantly sets off an emotional crisis. When we are experiencing a crisis, we instinctively shift to a survival mode. Our thoughts, behaviors and emotions all reflect our drive to live beyond the attacking threat. We become hyper-focused on not letting the cancer win. Our bodies produce more adrenaline to help us keep up with the extra demands on our mind and emotions. Some of us use the adrenaline to try to fight the life-threatening situation and others try to flee by running from it. Both approaches take a great deal of energy, regardless of whether or not you are trying to battle it or frantically repressing the panic by keeping your head in the sand. The longer we stay in survival mode, the more likely we are to stress our immune system, which weakens our natural defenses and leads to physical depletion. In other words, it wears us out and we become fatigued. Surgery, radiation treatments, and chemotherapy all cause fatigue, so it behooves us to try to manage our emotions in a way that doesn’t add to the physical drain.
A simple way to interrupt a self-defeating pattern is to learn how to manage your fear. Fear is the basis of worry. Fear in the moment can be a life-saving warning signal that you are in imminent danger, such as your response to a fire in your home. Your initial fear response to learning that you have cancer is helpful because it makes you take it seriously and take immediate action to try to get rid of it, however, fear becomes a problem when we bring it into the future in the form of worry. Thinking about the future and making a plan of action for your goals is good problem-solving. Thinking about all the possible ways that things can go wrong is counter-productive worry.
How We Are Glued Together
Our emotions such as fear, anger, sadness and joy, are a physical response to our thoughts. Your mental interpretation of a situation will determine how you will feel about it. If a good friend moves away, and you tell yourself you are going to miss that person, you will feel sad and your body will want/need to discharge that sadness through tears. Your tears keep you from wasting precious energy to repress the feelings and from having tight, painful muscles from holding the feelings. Now, I am not suggesting that you can spare yourself from feeling sad by lying to yourself, but if you continue to only tell yourself you are going to miss her, instead of also telling yourself you can e-mail, talk on the phone, visit each other and make new friends, you will continue to only generate sadness instead of also feeling joy and peace.
Don’t Be Hard On Yourself
I want to caution you to not be too hard on yourself for your tendency to have fear-based, negative thoughts. It is how we, as human beings, are wired. Our most important function is to survive, so fear is very instinctive. We don’t need to be happy to survive, but we do use fear to keep us focused on surviving. The problem is that we can get into a bad pattern of thinking and acting like survival is always the situation at hand, when, in fact, it is the exception, even with breast cancer.
Minimize Your Vulnerability and Loss of Control
Fear-based worry is most likely to occur when we are most vulnerable and have the least amount of control over the situation. Knowing this suggests that we can keep our level of fear/worry to a minimum by finding ways to take control over the situation. As is often said, “Knowledge is power.” The more you learn the facts about your type of breast cancer, the stage of your disease, treatment options and outcomes, and how much flexibility there is in how and when you receive your treatment, the more you will find ways to take back control of your life. It is amazing how empowering it can be to know we have asserted ourselves in at least a small detail of our treatment plan. Too often, women in our culture, especially middle-aged and senior women, still have a difficult time identifying their needs and asking for them. Something as small as requesting a quieter chemotherapy room, or even a blanket, can make a big difference in our comfort level and sense of control. This is a prime opportunity to decide you have intrinsic worth as a person, instead of playing out the old script of unworthiness. The staff is getting paid to serve you. If you weren’t their patient, they wouldn’t have a job, so validate their professionalism by making your needs known. It is a lot better than worrying if the room is going to be too cold at your next chemo treatment and if you will be able to endure it.
Besides what happens with your medical providers, there are many other areas where you can refocus on the present to give you more control over your life. Attending to the details by getting organized with lists, a doctor appointment calendar, a weekly supper menu and pre-cooked meals for the freezer, make such a difference in creating a sense of control. I have often been reminded how structure provides freedom when I return to more organization. It is such a relief to know that I have supper figured out and the meat is already cooked and stored in the freezer. Each week I buy a meat that is on sale, such as chicken breasts or pork chops and cook them while I am putting away the rest of the groceries. I individually wrap each piece of meat and freeze it. When I first started this approach it took me about 6-8 weeks to get set up by adding a different kind of meat each week, but now I have a variety to pick from. If your friends ask how they can help, ask them to bake or broil and freeze your meat for you.
Stabilizing Your Mood
It is not uncommon for cancer patients to feel moody. You may not have a full blown depression, but find yourself irritable and short tempered. If your doctor has made an assessment of your level of depression and has determined that you are experiencing a major depressive episode (biochemically based depression) it will need to be treated with an antidepressant. Individual therapy and support groups are excellent ways of helping you cope, but treating a chemical imbalance with only talk therapy is like treating strep throat with talking when an antibiotic is needed; it can actually make you feel worse. Gaining insight and getting suggestions from therapy, but not being able to follow through when you know what you are supposed to do, can make you feel more despairing and depressed. If you are just moody, exercise and diet can help your body make more mood neurotransmitters to prevent a full-blown depression. Exercise can be helpful for your overall sense of well being even if you are battling fatigue, but you will need to listen to your body and rest in addition to the exercise. Don’t overdo it, just try to get your heart and lungs moving to stimulate a healthy metabolic response and reduce your muscular tension and pain.
Try to go for healthier food choices such as fresh fruits and vegetables, lean meat, nuts, whole grains and avoid processed foods. Carbohydrates like sugar and refined white flour will reduce your energy, but healthier carbohydrates like fresh fruit will be calming. Protein like lean meat will energize you and improve your concentration, but salty processed meats can cause fluid retention and lead to muscle cramps. If you are trying to get off of sugar, you need to know that during the first two weeks you will experience an increase in carbo cravings, but then your cravings will go away. If you want to really get gung-ho about changing your diet, check with the American Cancer Society for their cancer-preventing dietary suggestions.
Panic after Treatment
It is extremely common to feel like you are sailing along okay during your treatment time, but to feel a sudden panic when the treatment is over. Having something to do to get rid of your cancer makes you feel more in control. When that is over, it can feel like you are a sitting duck just waiting for it to return, with nothing to do about it. This is the time to work hard at staying in the present. We are not our mind, we have minds to use to our liking. Obsessing or worrying is a choice and so is not obsessing or worrying. You get to decide what you want to think about. It won’t work to merely tell yourself not to think about something. While you are awake, your mind is always going to be active, so if you try to not think about something, it will just pop right back. To shift your thinking you have to consciously replace one thought with another. If you start to relive a memory of what it was like to go through treatment and dread doing it again if the cancer comes back, you can decide it is not in your best interest to keep that type of thing going. You can decide to use your mind for something else, like planning the week’s menu or your next vacation. Decide to use your mind to read an entertaining book or recall a fun memory you have of being with someone special. There are endless, positive things we can decide to think about. You also can break the negative cycle by simply picturing something neutral like an apple. See yourself touching, tasting, smelling and biting the apple to hear the crunch. Several years ago, when I went through a period of negative, worrisome thinking, I trained myself to quickly see the smiley face that my daughter had when she was a baby. I still use her face or picture the smiley face of a pansy, my favorite flower, when I find myself obsessing about something.
There are so many things we have no control over and it is easy to feel fearful and powerless if we don’t remember to stay in the present and manage what is right in front of us. Turning our worries over to God/fate and redirecting to what we can control is the best we can do. Luckily, when we do that, it seems to work out quite well.