Emotional health

People who’ve just been diagnosed often encounter the well-meaning friend or loved one who says that a positive attitude is necessary to get through a cancer diagnosis and treatment. But if you’re not feeling especially positive about your situation, this can feel unnatural and alienating. It can even feel like pressure. Instead of trying to feel a certain way, allow yourself to experience your true range of emotions. And if you need to, ask your care team about getting emotional support from a licensed counselor to help process emotions in ways that are healthy for you.

If you’re looking for ways to feel uplifted or find a sense of empowerment during uncertainty, think about things that might feel helpful. Some people find that getting exercise, talking with a friend, relaxation techniques (such as meditating, deep breathing, or taking a hot bath), or finding a support group is what they want to do. Others choose to focus on gathering information about their diagnosis, pursuing a second opinion about treatment choices, or organizing medical records and healthcare contacts. Often a combination of practical steps and self-care can help bring back a sense of control.

Each person's emotional response to diagnosis is different. At first, it may be hard to grasp the news or to believe it. Whatever you may feel — scared or calm, angry or numb, overwhelmed or ready to act — see if you can accept your feelings and just be there with them. Over time, feelings change, and some feelings might be easier to manage than others.

As you experience different emotions, know you could feel all of them at the same time or at different times. Or you might find that your priority is to put your feelings aside in order to concentrate on making treatment decisions and moving forward. There is no right way to process your diagnosis.

It can also help to look back on times that you faced a crisis in the past. How did you get through it? Remembering the skills you may have picked up then can help you access an inner source of strength. The shock of a diagnosis can sometimes make it easy to forget skills and strength you already have — and that you can use those skills again now.

Talking about your feelings can also help. In addition to confiding in trusted individuals in your personal life, you can also talk to a nurse or social worker at your hospital or ask for a referral to a support group. If your circumstances don’t allow for in-person support, there are still ways to connect with others in your situation, whether it’s over the phone, through email, or through online support groups. All of this can help you gain helpful information and reduce any isolation you might feel.

After the initial shock of diagnosis, some people ask questions such as “Why me?” “How could this have happened?” or “What did I do to deserve this?” Some even feel embarrassed or blame themselves for the cancer.

You didn’t do anything to cause breast cancer. Still, after a diagnosis, some people have an immediate reaction of feeling punished for something they may have done. Maybe it’s a feeling of “I didn’t eat right,” or “I didn’t exercise enough.” But there’s no way to know this, and in a way, thinking about “could haves” and “should haves” gives a false sense of control over a situation. It can also trigger feelings of regret or guilt instead of allowing you to focus on next steps. Wanting to look back and make sense of breast cancer is normal, but it’s important to focus on what you need to feel supported in the now.

If someone else in your life makes a comment that seems to imply that you did something to cause your diagnosis, feel free to remind them, and yourself, that millions of other people with circumstances similar to yours did not get cancer. Unfortunately, some people seek to reassure themselves by deciding on a “reason” why someone is diagnosed. Try to see this as how others manage their own anxiety about a potential breast cancer diagnosis and  while it may feel helpful to them, it has nothing to do with you.

The end of primary treatment (also called active treatment) for early-stage breast cancer — surgery and possibly treatments such as chemotherapy and radiation therapy — is commonly viewed as a time for celebration. And you and your caregivers may feel understandable relief that you’ve made it through all of those appointments, procedures, and physical demands. Many people also report that going through treatment has changed their general outlook for the better as they move toward the future.

But sometimes, this can be a period of new challenges. Some people find that emotions they did not have the energy to process during active treatment come to the surface at this time. Others feel vulnerable because they are not seeing their medical team as often.

Worries about new aches and pains can sometimes raise fears of cancer recurrence, especially when you’ve only recently completed primary treatment. And if you’re taking hormonal therapy for several years as a follow-up measure, it’s common to feel concerns about their possible side effects.

If you joined a support group during your primary treatment, it may become more important to you as you move into this new phase. If you didn’t join one, you might consider joining a group of others who’ve finished primary treatment and may be having similar feelings as they move forward. Visit our support group page or talk with your doctor or hospital social worker about finding a group that works for you.

This may also be a good time to boost your physical and emotional well-being through exercise. The Livestrong Foundation partners with the YMCA to offer a free or low-cost 12-week course designed to help people who’ve been diagnosed with cancer ease back into fitness routines. Some YMCA branches are currently closed due to COVID restrictions, while others have re-opened. See what’s available near you and ask about online classes if you’d prefer to take classes at home for now.

Depending on your diagnosis and treatment plan, treatment can sometimes continue for a while — weeks, months, or years. If you’ve been diagnosed with metastatic breast cancer, you will likely be in ongoing treatment to keep the cancer under control.

If you’ve recently been diagnosed with metastatic breast cancer, it’s understandable if you’ve experienced anxiety, depression, or both as you process the news. Anxiety is a stress response of fear and uneasiness. Depression can be a combination of sadness, despair, and loss of energy that interferes with daily life.

It makes sense that research shows people in long-term treatment may be more likely to feel depressed or anxious. Stress about the diagnosis, worry about loved ones, uncertainty about the future, and other concerns can all lead to anxiety and depression. These feelings can also surface in uncertain situations, such as when a treatment is no longer working and it’s time to try a new one.

In addition, anxiety and depression may develop as side effects of breast cancer treatment itself. Some medicines may trigger these feelings directly. Medicines can also indirectly lead to anxiety and depression for some people if they cause pain, fatigue, or changes in appetite.

The good news is that there are many strategies for feeling better, so you can continue staying connected to the people and things that mean the most to you. LBBC offers strategies for managing depression and anxiety after a metastatic breast cancer diagnosis and ways to take care of yourself. Many people find that complementary therapies such as acupuncture, expressive writing, guided imagery, and art therapy can help them feel connected and supported.

With so much to learn and understand, it’s normal to feel overwhelmed and uncertain about your future. Many people diagnosed with breast cancer wonder how to make decisions about their next steps.

Consider how you coped with uncertainty in the past. Did you seek out all the information you could about the situation, or did you want to know only what was necessary to understand at each step? When you faced enormous challenges in the past, what resources did you use? Were there people you trusted? Call on these supports now to help you process and cope with this new diagnosis.

As you gather information, talk with your care team about what you learn. Make a list of questions before you see your doctor, nurse, or other member of your team. If one care team member’s answer to a question doesn’t address a particular concern, ask the question in a different way. It often helps to take a trusted friend or relative to your medical appointment. That person can take notes or, with your doctor’s permission, record the conversation. This allows you to focus on the appointment while it’s happening and review the notes later.

Finding ways to address your feelings and get needed support is important. Sometimes, immediately after diagnosis, this may mean coping just well enough to do what is needed, until you have more time to sit with and work through your emotions. And that’s okay.

Here are 10 things you can do right away that can help you cope with a new diagnosis:

1. Think about what you need most right now, and write it down.
2. Make a list of your doctors and their contact information.
3. Think about which of your trusted loved ones feel safe for sharing how you’re feeling, and talk with them.
4. Make medical appointments.
5. Write down questions and other information in a notebook or journal, or keep notes on your tablet or smartphone.
6. Learn about second opinions, and decide whether you want to seek one.
7. If you work, decide whether you want to take time off from work; talk with your employer about options.
8. Take good care of yourself: Get some exercise, catch up with a friend, take a relaxing bath, or seek a support group online or through your hospital’s social worker. Maintain structure in your life to the extent that you are able. Mealtimes, bedtime, daily routines. Structure helps with anxiety.
9. Seek information about breast cancer from trusted sources; you can start in Recently Diagnosed.
10. Keep track of your medical records. Start a folder or binder, and make copies of everything you receive. Being organized can help reduce feelings of overwhelm.