Receiving a diagnosis of an illness can cause many complex emotions to surface, especially when it comes to cancer. These patients may experience anger, fear, anxiety and even depression, which often deepens a sense of loneliness. These are normal reactions to have, but in 2020 they are further complicated by COVID-19. Currently, cancer patients - whether they are just learning of their diagnosis or have been receiving treatment – are also trying to cope with a pandemic that requires them to socially distance from family and friends.
“This pandemic is not tangible. We can’t grab hold of it and organize it in a way that makes life easier,” explained Samarea Lenore, Ph.D., Clinical Health Psychology Fellow at McLaren Flint, who also sees patients at Karmanos Cancer Institute at McLaren Flint. “There is continued uncertainty around the coronavirus. This further stimulates anxieties with patients already struggling with complex medical concerns that feel out of their control.”
This could mean, increased feelings of panic, doubt, fears and frustration. These can be added stressors to the loneliness that a cancer patient may already be feeling, further increasing the risk of depression and further compromising physical health.
“Depression is anger turned inward. It’s that constant thinking about ‘if onlys’, reflecting back with grief, regrets and nurturing self-doubt,” said Dr. Lenore. “Over the last few months, there has been an increase in feelings of anxiety and fear in our patients who have been receiving treatment for cancer, because of the added risks of infection from COVID-19.”
Dr. Lenore says these complicated risks can trigger a deep sense of loneliness which can lead to clinically depressive symptoms. The American Cancer Society (ACS) and the National Cancer Institute (NCI) list some signs and symptoms of depression as:
- Ongoing and daily sadness or hopelessness;
- Feelings of guilt or worthlessness;
- Loss of interest in activities the person usually enjoys;
- Changes in eating, major weight loss or major weight gain;
- Changes in sleeping habits, unexplained tiredness;
- Trouble focusing, remembering, or slow physical and mental responses;
- Mood swings;
- And more.
According to the NCI, cancer patients may have weakened immune systems due to treatments. A weakened immune system could increase a person’s risk of having severe illness if they contract COVID-19. It is very important to socially distance from those loved ones who have cancer if you do not live in their household. If you do live with a cancer patient, it is important to be safe when in public.
“When we began social distancing and staying at home in the early months of the pandemic, it was interesting to hear people talk about the value of social interaction. People all over the world began to realize the mental health consequences of social isolation,” said Dr. Lenore. “People seemed to begin to understand that a lack of interaction can lead to profound consequences in moods, such as depression and anxiety, which can then impact physical health.”
With the holidays around the corner and the recent increase in COVID-19 cases, the Michigan Department of Health and Human Services has ordered certain businesses to close and has placed restrictions on other businesses and activities, as well as restricted household gatherings.
Dr. Lenore believes we will learn how to adapt to the changes that are needed, as we have done earlier this year.
“Resilience tends to outweigh over time – that’s just inevitable. People nurture hope. There are opportunities for creativity in how we overcome. We’ve seen this already early on with people bonding and reconnecting by sharing videos of people singing together on their balconies in places like New York City. It will be exciting to see who we will be as a society as we become more aware of the value of human connection.”
When it comes to adapting to social isolation while going through cancer treatments, Dr. Lenore suggests patients work to do two things:
1. Be nice to yourself.
This sounds simple, but it can be very difficult for those who are experiencing exhaustive treatments for cancer. Dr. Lenore describes this step as making peace with the uncertainty one may have with their disease and the pandemic. So how does one do that?
“Learn how to talk about it and share your vulnerabilities with family members and friends,” explained Dr. Lenore. “As individuals, we tend to be resistant to revealing vulnerable feelings or experiences. This often stimulates feeling of loneliness, resentment, and depression. If we can find the courage to trust others with our vulnerability, it could dramatically improve our relationships and our health. If you can reveal to someone that you’re scared, it’s an opportunity for them to say, ‘I’m scared, too.’”
For family members or friends of cancer patients who want to help their loved one communicate more about what they may be experiencing, Dr. Lenore suggests the following message to help present that opportunity:
“I’m scared, because I don’t know how to talk about this. I’m scared to talk about it, because I may say the wrong thing and it may hurt you. But I see you’re scared, too. I don’t want you to be feel alone with this illness. I want you to know I’m by your side. How can we navigate this together with mistakes along the way?”
2. Nurture hope.
According to the NCI, cancer patients may feel lonely because they feel that others may not understand what they may be going through. Dr. Lenore says there are two ways to find hope if experiencing loneliness.
Faith - Some people nurture faith through religious practice and their own personal interactions with church, prayer, congregation, or various other practices that support a personal faith in a higher being. Many religious organizations offer sessions online to help minimize the spread of the virus. If your faith is something that helps you get through tough times, Dr. Lenore suggests attending some faith-based virtual services or support groups.
Relationships - Having family members and friends around, even if they may not fully understand, helps with nurturing hope.
“Fostering relationships is key. To have, at minimal, one consistent person with whom you can share a vulnerable space can increase physical and mental health outcomes,” explained Dr. Lenore. “When we suppress and ignore our emotional experiences, it worsens our physical and mental health. But if we learn to find the courage and be willing to practice communicating our vulnerabilities, loneliness will disappear.”
There are many ways to virtually continue to foster relationships with family and friends from a social distance, especially if you do not live with them. Dr. Lenore encourages phone calls and video chats to help feel that closeness to one another.
For cancer patients who would like someone to talk with, behavioral health specialists are available at McLaren Flint. Dr. Lenore is also available at the hospital, the Karmanos Cancer Institute at McLaren Flint and the McLaren Proton Therapy Center. To schedule an appointment with Dr. Lenore, contact Hannah Ardelean, BSN, RN, OCN, oncology nurse navigator at (810) 342-4848.
Karmanos and the McLaren Proton Therapy Center offer support groups for cancer patients and those touched by cancer. This includes the monthly Cancer Support Group, Music Therapy and Art Therapy. All support groups are offered online at this time. Find out when the next support group meets and register, by visiting karmanos.org/flintcancersupport.