From the psychologist's chair: Kate Willcox speaks about cancer and mental health

Sometimes people have questions about mental health, or psychology, that they may not have the opportunity to ask. So we'll be featuring interviews with some of our psychologists, answering some questions that may have sprung to mind for you too.

Our wonderful admin support, Megan, who is not a psychologist (yet!), will be our roving reporter, sharing her curiosity about the areas our Birch psychologists are interested in.

For this World Cancer Day on Sunday February 4, Megan asks Kate Willcox some of the things she, and you, may have been wondering about cancer and its emotional impact.

Megan: How did you end up working in this area?

Kate: I started my career working with young people in a mental health service, and loved working with this age group. When it was time for me to look for some different experience, I was fortunate to move into a role working with adolescents and young adults in a cancer hospital. This was my first professional exposure to working in oncology, and it was an incredibly rewarding experience. I loved getting to know the people I worked with, and their families, and seeing their strengths and resilience as they faced something that often no one in their lives had been through before. Many of the themes facing this age group are also relevant to someone of any age who has, or has had cancer. Since then I have been able to continue working with people with cancer across different settings, and continue to see it as my privilege to do so here at Birch.

Megan: What are the common mental-health issues experienced by people who have been diagnosed with cancer?

Kate: Nearly everyone will experience some level of distress throughout their experience of cancer. However there are many different types of cancer, which means different treatment experiences, different expectations of outcome, and of course every person is unique. Common emotional responses are sadness, fear, worry, grief, stress, and fear of the cancer recurring. Many of these feelings will be normal emotional responses. Humans are remarkable in the way we can adjust to the situations we face, and find ways to live with the challenges of a stressful situation – even though this often comes with some emotional upheaval. However for some people their experience of sadness or worry may be severe or persistent enough to meet the criteria for a diagnosis of depression or anxiety.

You can read more of Kate’s thoughts on the emotional impact of cancer here.

Megan:  Emotional distress is a common response to a cancer diagnosis, but this is quite a general term. What are the signs that somebody is facing a severe level of distress, and therefore might require professional support? 

Kate: It’s important to remember that emotional distress is normal. Almost everything about a cancer diagnosis, treatment, and follow up is stressful, and people may feel varying levels of distress at different times. Some indications that someone may be experiencing a more significant level of distress are:

  • Isolating themselves or withdrawing from people in their lives
  • Being more snappy or irritable
  • Feeling overwhelmed by everyday stresses
  • Being unable to stop thinking about cancer or other problems
  • Fluctuating moods
  • Feelings of panic or dread
  • Changes to sleep or appetite
  • Not engaging in or enjoying things they used to
  • Feeling hopeless or worthless
  • Difficulty making decisions

Megan: What aspects of cancer diagnosis, treatment, and aftermath, can a clinical psychologist help with?

Kate: The short answer to this is ‘anything!’ Cancer affects so many aspects of someone’s life, and often in interconnecting ways. So even though there may be one thing that prompts someone to ask for help, we usually find ourselves covering a whole lot more. Some of the common reasons people may want to seek help from a psychologist may be: fear of cancer coming back, changes in sense of identity – who you feel you are and your expectations of the future, body image during and after treatment, sexuality and intimacy, relationships, changes in mood, getting back to work, re-evaluating what life means, and adjustment to treatment outcomes.

Megan: Is it common for family and friends to seek professional support too?

Kate: Yes! Being the partner, family member or friend of someone with cancer is terribly distressing. This can also feel isolating, as people often describe feeling some guilt about finding the situation so hard, when it seems the person they care about is experiencing so much worse. Carers can often become over burdened and not look after themselves, only to ‘crash’ once treatment is over. It is not selfish to acknowledge that your life and emotional wellbeing has also been dramatically affected by someone close to you having cancer.

Megan: What are the sorts of mental health issues experienced by family and friends?

Kate: Again, there are as many emotional responses as there are people. And in fact more, as most people will experience a range of often confusing and conflicting feelings. Commonly, family and friends may experience feelings of depression, anxiety, grief, burnout, carer stress, isolation, guilt, helplessness, and anger.

Megan: Do you have any tips for family/friends supporting somebody through cancer?

Kate: Ask the person what they need – let them guide you on what you do or don’t talk to them about. Be flexible when that might change from day to day. Seek your own support so you have someone to vent to outside of the situation. And look after yourself.

Megan: Everybody is different, but is there any advice you find tends to be helpful for lots of people?

Kate: However you’re feeling is ok. Often people talk to me about how they feel they’re not coping – or how they should be coping better because so many people are worse off than them. I have had the privilege of many people sharing with me the things they are feeling and experiencing when going through cancer. It can be extraordinarily challenging, and there is no ‘right’ way to cope. Each person is coping in the only way they know how, and that is just fine. And every person can benefit from a space to talk about their feelings.

Megan: Finally, given it is World Cancer Day, what steps can the community take to better support people with cancer? What should the community know about cancer?

Kate: To understand that cancer affects every aspect of people’s lives, and that this can continue for some time even after treatment is finished and people look ‘better’. It would be lovely to think that people can feel less isolated or disconnected after cancer because the complexities of their emotional experience are more widely understood.

Kate has also written about strategies for coping while in hospital, or during medical treatment. You can read this here.