The Importance of Psychological Support in Breast Cancer
What is Cancer?
Cancer is a crisis process. But it can also be a chance on the other hand. During the illness, the individual may fall into a material and moral depression and may experience some spiritual awakening by thinking ‘I made a mistake, I did not pay attention to myself’.
It requires a holistic approach. Because the individual is a bio-psycho-social being. Because the disease affects not only the person’s body, but also all areas of his life. Therefore, even if the treatment is terminated, it is necessary to treat it as a chronic type of ailment that must be lived with.
Secondly, after going through such an experience, the person can find the opportunity to question the meaning of life, to think about what he wants to give importance to and what he wants to give up. They may decide for personal growth to transform something about themselves and their lives. Support is also important at this point.
Psychological Problems Experienced by Cancer Patients
– They react psychologically when they first learn about the disease. Personality changes are often seen.
– May experience adaptation difficulties.
– He attributes every complaint that he and those around him experience to the disease.
– Panic and anxiety disorder appear.
– The risk of becoming depressed increases when treatment begins.
Experiencing organ loss due to cancer exacerbates depression.
– Brain syndrome may occur in the temporary short, medium and long term in advanced cancer treatment.
The person involved in this process
They may experience losses in keeping their body, health and life under control.
Due to his increasing dependence on others, he may have to face the deteriorating balances in family-work-social life.
The person may experience confusion, problems with concentration – time-space orientation and memory.
Physical Complaints: Depending on the treatment, pain, hair loss, mucositis, loss of appetite, nausea, skin problems, insomnia, eye problems, neurological problems, weakness, fatigue may occur.
Psychological Complaints: Anger, hopelessness, sleep disorders, depression, anxiety, post-traumatic stress disorder can be seen.
Social Complaints: Lack of social support, lack of social connections, social isolation.
The moment of diagnosis: It is a time when psychological support is needed, as it can have a shocking-destructive effect on the patient. The patient experiences a process of shock and denial, most likely resulting from a negative and frightening perception of illness. First complete bewilderment and then disbelief that something like this had happened to him. First are the reactions. Many symptoms such as insomnia, anxiety, depressive mood, unhappiness, loss of appetite, crying, introversion, and not speaking, which are the most common symptoms in the shock period, are the onset and precursor of psychological problems.
- On the one hand, while making treatment decisions, on the other hand, the rising stress level is tried to be controlled.
- Medical factors: The patient’s ability to cope with stress, the type of cancer-stage-location-symptoms-predicting future stages,
- Psychological Factors: The person’s ability to adapt to previous illnesses, physical and psychological rehabilitation capacity, personality structure, capacity to cope with problems, age, gender, the meaning given to the illness by the person,
- Social Factors: Marital status, education, cultural-religious attitude, lack of emotional support, influence of the healthcare team
Meaning: People often feel that life is in control. When there is any situation that disrupts this feeling and emotion, the universal goals of the individual are shaken. In such a case, it can fall into a meaning gap. In this case, the individual enters the process of striving to restore the universal meaning. There is a period of meaning making.
Where does our need for interpretation arise? By nature, human beings are trying to understand and evaluate everything to the extent of their mental capacity. The main motive that drives this effort is getting rid of uncertainty and closure.
People want to understand and make sense of the events that happen to them or happen around them. As a result, people want to control their own life, direct events or at least predict what will happen.
As long as a person lives, he tries to internalize them in a way that will be beneficial for him by evaluating the physical, mental and social formations. Man is not helpless against the circumstances surrounding him. It has the potential to take a stand according to the current situation and the ability to change.
The individual who encounters a stressful situation or event first tries to understand what the problem is. In the first place, he looks at whether the problem is a danger or a threat to him. If the situation poses a danger or threat to him/herself, the individual seeks personal coping resources.
Most Common Psychiatric Problems in Cancer Patients
There will definitely be positive aspects of the therapy support to be received for all the psychiatric issues listed below.
- Adjustment disorder: It has a rate of 48% among all psychiatric diagnoses. What is adjustment disorder: When the symptoms become severe and begin to negatively affect the functionality and treatment of the person, it means that the psychological structure has difficulty in adapting to the current stressor and adjustment disorder occurs.
- Depression: It is the second most common disease after adjustment disorders among psychiatric diagnoses. The incidence in individuals varies in a wide range such as 4.5-58%. One of the most important reasons that increase the risk of depression in patients is severe pain. When the gender factor is evaluated, it is seen that women are 2 times more depressed than men. The age of experiencing depression is generally between 35-45 in women and 55-70 in men. Effective psychotherapeutic treatment for depression has been found to influence the course of cancer. From a medical point of view, psychotherapy often helps relieve pain by reducing anxiety and depression in people.
- Anxiety Disorders: The incidence of anxiety varies between 6-47% among people with cancer. An important point regarding anxiety is that anxiety often coexists in this disorder.
What causes anxiety?
Uncertainty about what will happen in the future
-feeling of inadequacy
– uncontrollable pain
– regrets about the past
– Being separated from relatives while lying in the hospital
-feeling of isolation from people
– feeling of loneliness
-lack of knowledge about the disease
– metabolic abnormalities (infection, low blood sugar)
-shortness of breath- insomnia
What happens as a result of anxiety?
-sadness
-thoughts of bad news
-diarrhea-
mouth tenderness
-difficulty focusing
-insomnia
– irritability
If hallucination-severe agitation is added to these symptoms, if the perception of place and time is disturbed, if feelings of doubt occur constantly, delirium should come to mind.
What Does Social Support Do?
- It acts as a buffer against stress.
- The person does not feel alone.
- Positive feelings such as Belonging, Self-Confidence, Self-Esteem etc. are positively supported.
- It really strengthens the immune system.
- It makes it easier to adapt to changing conditions.
With effective psychotherapy, medically psychological distress is reduced, and often pain is relieved, resulting in a reduction in symptoms and a lower cost of care, and positively affecting the course of the disease.
When cognitive reactivity begins in the core state, it jumps to the cognitive triad (worthlessness, hopelessness, helplessness). Chemotherapy and radiotherapy processes do not prevent psychological support.
Mindful awareness of climbing processes, reduction of ruminations, metacognition, that is, learning to control our thoughts about our thoughts. Support can be provided in reducing experiential avoidance, non-judgmental acceptance of experiences with exposure, regulating attention, and increasing bodily awareness.
