The shock of a breast cancer diagnosis, followed by the dizzying days filled with doctor’s visits, endless procedures, chemo, radiation, and surgeries might do more than rock your world. Once you’ve come out on the other side, you could be left feeling anxious, insecure, exhausted, and as changed mentally as you may be physically.
“After breast cancer treatment I definitely experienced post-traumatic stress,” says Melanie Young, author of Getting Things Off My Chest: A Survivor’s Guide to Staying Fearless & Fabulous in the Face of Breast Cancer, who was diagnosed with stage 2A breast cancer in 2009. “I was unprepared for the deep sadness and sense of feeling stuck between my pre-cancer life and my future after cancer.”
Post-traumatic stress symptoms after a breast cancer diagnosis are not unusual, and they’re something researchers are increasingly focused on, says Susan David, PhD, a psychologist on the faculty at Harvard Medical School and author of Emotional Agility. “There are both the terror of moving forward and the terror of ‘what if it comes back?’” she says. “It’s relief mixed with anxiety and fear.”
One study of more than 3,000 Danish breast cancer survivors found that one in five of the women reported experiencing “severe” post-traumatic stress symptoms three months after surgery. And a 2016 German study of 166 breast cancer patients found that more than 80 percent experienced some level of post-traumatic stress symptoms early on, with the number dropping to 57 percent one year after diagnosis.
So now you’re cancer-free. But after spending so much time with little-to-no control over what was happening in your life, how do you reclaim a sense of control post-treatment? How do you build up psychological and spiritual strength? Where and how can you find new sources of inspiration going forward? What kind of support do you need? Indeed, how do you transition from “survive” to “thrive?” These steps may help.
1. Harness your feelings: “It may take time, but to build up psychological strength, I encourage you to lean into your experience and give yourself compassion and space to truly feel,” says David. She suggests acknowledging your feelings (they’re normal!) and practicing letting them go. True, you don’t know what the future will bring, but you’re a breast cancer survivor, and that’s something to celebrate today. Mindfulness—the act of being present in the moment—may help, David says. Focusing on the here and now rather than ruminating on the past or fearing the future may help you push negative emotions to the side—even if it’s just for a few minutes. And you can build on that.
2. Pick up a pen: Or get in front of a keyboard. David says that writing about the traumatic aspects of your breast cancer experience—even for just a few minutes at a time—may go a long way toward helping you feel better. “Applying words to emotions can be a tremendously helpful way to deal with stress, trauma, and fear,” she explains. In Emotional Agility, David details years of research on this subject—with study participants now numbering in the thousands—showing an increase in physical and mental well-being after people engaged in “emotionally significant writing.” Even months after their writing sessions, they had lower blood pressure, better immune function, and fewer doctor’s visits.
One study in the Journal of Health Psychology found that participants who wrote about their traumas for just two minutes a day for two consecutive days reported fewer health complaints four to six weeks after the last session. “You don’t have to write your memoirs,” she says. “And no one else has to read it. But the power of honestly facing your experience and the emotions attached to it may surprise you.”
3. Develop a mantra: With your diagnosis and treatment behind you, take the time now to find a short mantra to say out loud every morning as soon as you wake up, says Marisa C. Weiss, MD, director of breast health outreach at Lankenau Medical Center near Philadelphia, chief medical officer of breastcancer.org, and a breast cancer survivor. “It might be, ‘Thank God, I’m alive,’ or ‘I’m happy to be alive,’” she explains. “Next, say, ‘I’m going to do the best I can to be as healthy as I can today.’ These could be small but meaningful ways of shifting your perspective and reclaiming a sense of control post-treatment.”
4. Start moving: There are few better ways to recover mentally from breast cancer than resuming or rebooting an active lifestyle. “Physical activity may help with feelings of fatigue and sadness, especially if you’ve got a friend who wants to do things with you,” says Corinne Leach, PhD, MPH, MS, director of cancer and aging research for the American Cancer Society’s Behavioral Research Center. “That friend also helps keep you accountable for staying active.” Weiss considers physical activity to be too valuable to be optional. “Your health depends on exercise and so does your quality of life,” she notes. “Not just your breast health but your heart and bone health and your sleeping and mood, too.” One positive way to approach movement: Celebrate it, especially if your breast cancer treatment made physical activity difficult. And there are so many choices for healthy activity, says Weiss. “Mix it up, make it social, and use exercise as a way to connect, something that will really help if you feel hopeless or anxious.”
5. Try (or return to) yoga: Adding yoga to a regular program of aerobic exercise and resistance (aka strength) training may be of particular benefit to the mental health of breast cancer survivors, according to the American Cancer Society’s guidelines. A meta-analysis of 10 studies exploring yoga’s potential benefits for cancer patients showed that regular yoga practitioners experienced “significantly greater improvements” in feelings of anxiety, depression, distress, and stress than those who used only support groups or did nothing. Even though the studies reviewed were small and more research is needed, isn’t it worth a try?
6. Create a game plan: To regain a sense of control over your health going forward, Leach’s advice is to find out what’s coming your way post-treatment. Being in contact with everyone on your medical support team and understanding—in detail—what to expect might help prevent any stressful surprises. A partial list of things to consider: Follow-up appointments with your oncologist, surgeon, and other caregivers; any scans that need to be scheduled; what you should be doing at home to monitor your progress and health. It also helps to be aware of any potential “late effects” of cancer treatment. “There may be cardiac issues, extreme fatigue, lymphedema (swelling of the lymph nodes in the upper arms), or neuropathy (numbness and tingling) that can happen later,” Leach says. “If you aren’t aware that these might occur, these symptoms can be concerning and might prompt you to worry needlessly about recurrence.”
7. Connect with others: Sometimes the best advice is simply to call a friend, says Weiss. Or it might be even more helpful to join a support group of like-minded people who could truly relate to what you’re going through in the days, weeks, and months following a breast cancer diagnosis. In the end, you might just want to pick up where you left off with your knitting group, poetry workshop, or stand-up comedy pals. “Your goal: To find and embrace all the things that give you pleasure and inspiration,” Weiss explains. And consider this: It’s not just possible to have the life you had before your diagnosis—it’s possible to have an even better one.
Learn more about how to live a healthier post-cancer life, here.