Sometimes it can be hard to recognize that we need help, especially when it comes to our mental health. Many of the cancer patients I counsel were surprised, or even confused, when their oncologist or nurse referred them to my practice for mental health support. It’s not uncommon for them say things to me like “Do they think I am crazy? But I was just having a bad day last time I was in clinic!”, “I have cancer, of course I am worried, isn’t everyone with cancer worried?”, or “This is how I have always managed my stress, why would I need help now?”

So, how can you tell that you need more support during your cancer treatment? If you answer yes to one or more of the signs below, then strongly consider making an appointment with a therapist.

  1. If you do not feel like your regular self, at all, for days on end. Or if you yell “like a crazy person” but are usually calm and thoughtful, then you may benefit from having an evaluation for irritability.  
  2. If you can’t manage a smile, even for your favorite people or beloved pet dog or cat, then you may benefit from having an evaluation for depression. Many people are sad, and tired, during cancer treatment, but the small, simple pleasures in life should still bring some sense of joy. A favorite song on the radio, a blossoming tree, colorful tulips, and little kid art projects are all simple joys in life – if you can’t sense any of that joy, then you may need more support during cancer treatment.
  3. If you can’t think about one future activity you are looking forward to, not even a fun movie, event, or visit to the mountains because you are always thinking about cancer, then consider getting an evaluation for anxiety. Cancer treatment can be all consuming, to the point of making you think there is nothing else in life except managing cancer. If you are so hyper-focused on medical care (symptoms, appointments, medications, results) that you can’t divert your attention from cancer for even 30 minutes at a time to think about life outside of cancer, then you may need treatment for an anxiety disorder.
  4. If it takes you 3 hours to go through your work email, when typically you can respond to work email in 20 minutes, or you normally have the kids’ backpacks organized and packed before breakfast, but you find yourself without the energy to even ask if they have a backpack, you may benefit from an evaluation of fatigue. Mental fatigue may come from psychological cancer distress as well as medications and medical problems, like anemia, that come with cancer treatment.
  5. If you don’t talk to single person about your cancer experience, then you may really need more support. Talking about stressful life experiences helps us all cope by diffusing the tension about the experience, problem solving about challenges, and gaining information that can be psychologically empowering (and lifesaving if related to medical issues). Denial, anger, or shame may stop people from talking about cancer, and these are exhausting and painful emotions. Yes, some people are more private and shy, but think hard about why you have not shared your cancer experience with a single person. Ask yourself if being silent really feels comfortable or does it worsen your mood and worry? Of course, when you do open up, be sure to choose the person wisely (a trusted, caring family member or friend, or a trained therapist) so that sharing your cancer experience feels helpful.