Mental Health is an Important Part of Survivorship Care

Taking care of your emotional well-being is as important as looking after your physical health.

Mental health care can help childhood cancer survivors throughout their lives, says Sunnye Mayes, PhD, ABPP, a University of Michigan psychologist and researcher who cares for childhood cancer survivors at U-M Health C.S. Mott Children’s Hospital.

While anyone may experience mental health challenges, childhood cancer survivors have specific needs shaped by their medical history and the long-term effects of cancer treatment, Mayes says. 

While most survivors cope well, they are at risk for emotional difficulties, such as anxiety and depression. Survivors may also have specific anxiety about medical test results (scanxiety) and/or fear of their cancer coming back. While these experiences are relatively common, mental health services can help survivors find more helpful ways to address them.

If you are having mental health challenges, you are not alone. Many survivors experience similar struggles, and there are resources to help. By focusing on your emotional well-being, you can improve your quality of life. Whether it is finding a therapist, joining a support group, or practicing stress management, small steps can make a big difference.

“It is important to be aware of the challenges and how to get the coping and emotional support needed to stay hopeful and manage the ups and downs of life,” Mayes says.

Mental health care – what it means

It is normal to feel sad or anxious sometimes. That is human. When people hear the phrase “mental health,” they often think of a serious mental health issue. But that is not always the case. Mental health care supports a person’s social and emotional health and their overall well-being. Mayes encourages childhood cancer survivors to pay attention to how they are coping and consider support options as needed.

Mental health services may provide support, ways to cope, or another point of view that can helpful in stressful times. These services can help you handle the challenges of life after cancer. Effective therapy involves working toward goals and measuring progress to achieve them. Not all therapy is long-term and sometimes people may find great benefit from a few sessions to help with specific coping skills or management strategies.

A mental health care provider may use different kinds of therapy to help. Two common types of therapy are cognitive-behavioral therapy and acceptance and commitment therapy. Cognitive behavioral therapy helps people to identify and change unhelpful thinking patterns. Acceptance and commitment therapy can help people develop greater flexibility and consider new perspectives for coping with stressful events.

Help for those in serious distress

Some survivors may face more serious mental health challenges. If that happens, they may need extra support, including more in-depth therapy or medicine to help them feel better.

“Cancer is always hard,” Mayes says. “Everyone experiences distress in their lives. What separates normal distress from a mental health diagnosis is something we call functional impairment. A functional impairment can be greater intensity or severity of symptoms, a longer duration of symptoms, impacts on relationships, or effects on ability to function in typical roles at school or work.

These problems may show up in various ways. A person may have a lot of anger, depression, anxiety, or be very irritable. There may be problems managing frustration, difficulty focusing on schoolwork, or completing tasks that are part of their job. A person may not feel or act like they usually do. Their family members or friends may notice a change in behavior, attitude, or emotional response. Or they may have changes in their relationships with parents, siblings, or romantic partners.

“People may move away from doing things they previously enjoyed,” Mayes says. “Things they did to get through difficult situations may no longer help. They may no longer feel like themselves.”

More serious signs that mental health services are needed are when a person has thoughts about harming themselves, other people, or other thoughts about death and dying. If this happens, they should seek mental health resources right away to help restore their loss of hope.

If these signs are present, it is important that you get help by calling or texting the 988 Suicide & Crisis Lifeline operated by the Substance Abuse and Mental Health Services Administration. 

Finding mental health resources

Often, the hardest step toward healing is taking the first step. Speak up if you need help or would like more information. If you have worked with a mental health provider before, try contacting that provider again if possible. If that person was not a good match for you, then seek another provider who might be a better fit.

If you do not know a mental health provider, then a good place to start is a visit with a primary care provider, such as a doctor, physician assistant, or nurse practitioner. They can often provide a referral to therapists and other mental health resources.

“Asking about mental health care is not a full commitment to treatment,” Mayes says. “You’re just getting more information and trying things out.”

In some cases, you may also be able to have an online virtual visit with a counselor. It is OK to try a few options and find the best fit.

For some people, support groups can provide a way to connect with others who have had similar experiences. It is important to see whether a group meets your needs and goals.

Other tips for maintaining good mental health

Mayes also stresses the importance of other health behaviors, such as eating healthy foods, sleeping well, and getting enough exercise. Keeping up with health care appointments and taking medications as prescribed are also important. Make sure to spend time doing healthy things you enjoy, such as walking, travel, or spending time with supportive friends and family members. Plan these activities and make them a regular part of your life. Being intentional about doing things you love gives you something to look forward to and will help to maintain or work toward a positive outlook.

During times that are extra stressful, increase the activities that give you joy, Mayes says. She also recommends that you stay in contact with your important, special people, and have gratitude for positive things in your life. Combining these tips with the right therapy and therapists can go a long way to help you lead a more hopeful, fuller life.