Anxiety, Fear, and Emotional Distress
Anxiety (a feeling of worry or unease), fear, uncertainty, anger, and sadness are common feelings that patients and families sometimes have when coping with cancer. They are normal responses to the many stresses of cancer.
You may have trouble with your family duties and the loss of control over events in your life. Changes in the way you look, or simply the shock of finding out you have cancer might lead to feelings of fear or anxiety. Many people feel uncertain about the future and worry about suffering, pain, and the unknown. It’s normal to mourn changes in your body, and maybe losing the healthy future you wanted. Fears about loss of independence, changes in relationships, and being a burden to others can be too much to deal with all at once.
Family members may have these feelings because they, too, are uncertain about the future or maybe even angry that their loved one has cancer. They may feel guilty and frustrated at not being able to “do enough” as they care for the patient and family. Or it might seem like it’s too much to do everything they now have to do. Many caregivers feel stressed trying to balance work, child care, self-care, and other tasks, along with this extra work. All of this is on top of having to worry about and take care of the person with cancer.
Sometimes, a person with cancer may become overly anxious, fearful, or depressed and may no longer cope well with day-to-day life. If this happens, it often helps the patient and family to get help from a mental health therapist or counselor.
What to look for
- Feeling anxious, swamped, or overwhelmed
- Trouble thinking, solving problems, or making decisions (even about little things)
- Feeling agitated, irritable, restless, or panicked
- Feeling or looking tense
- Concern about “losing control”
- An uneasy sense that something bad is going to happen
- Trembling or shaking
- Being cranky or angry with others
- Trouble coping with tiredness, pain, nausea, and other symptoms
- Problems sleeping or restless sleep
What the patient can do
- Talk about feelings and fears that you or family members may have − it’s OK to feel sad and frustrated.
- Decide together with your family or caregiver what things you can do to support each other.
- Do not blame yourself or others when you feel anxious and afraid. Instead, look at your thoughts, concerns, and beliefs about what has been going on in your life.
- Get help through in-person or online support groups.
- Think about asking your cancer team to refer you to a counselor or mental health professional who can work with you and your family.
- Use prayer, meditation, or other types of spiritual support.
- Try deep breathing and relaxation exercises several times a day. (For example, close your eyes, breathe deeply, focus on each part of your body, and relax it, starting with your toes and working up to your head. When you’re relaxed, imagine yourself in a pleasant place, such as a breezy beach or a sunny meadow.)
- Cut down on caffeine (coffee, tea, energy drinks). It can make anxiety worse.
- Talk with your cancer team about medicines for anxiety.
What caregivers can do
- Gently invite the patient to talk about their fears and concerns.
- Don’t try to force the patient to talk before they are ready.
- Listen carefully without judging the patient’s feelings – or your own.
- Talk with the patient to decide what you can do to better support each other.
- For severe anxiety, it’s usually not helpful to try to reason with the patient. Instead, talk with the cancer team about the symptoms and problems you notice.
- To reduce your own stress, try suggestions from the list for the patient, or use other stress relievers that have worked for you in the past.
- Consider getting support for yourself through groups or one-on-one counseling.
Call the cancer team if the patient
- Has trouble breathing
- Is sweating or flushed, with a fast or pounding heartbeat
- Is feeling very restless
Note that some medicines or supplements can cause or worsen anxiety symptoms. If anxiety gets worse after starting a new medicine, talk with the cancer team about it.
See Depression for more on this.
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Last Medical Review: June 8, 2015 Last Revised: June 8, 2015