How to Manage Your Anxiety

What is anxiety?

Anxiety can cause a range of symptoms. Anxiety may:

• make you feel nervous, worried and fearful
• range from mild to severe
• come and go depending on what is happening with your cancer
• cause many different symptoms in your mind and body, such as:
  • uneasiness, feelings of doom, or even panic
  • restlessness, tense muscles, and stress
  • trouble sleeping
  • shortness of breath
  • dizziness and nausea
  • chest pains or heart palpitations (a fast, fluttering or pounding heart)

Feeling anxious is normal for people who are coping with cancer.

What can cause anxiety when you have cancer?

• Medications, like steroids or some anti-nausea medications
• Depression or anxiety you had before cancer
• Side effects like nausea or pain
• Worry about your family, your future, and cancer coming back
• Worry about money, your job and other practical things
• Worry about suffering or death
• Waiting for results
• Loss of control over parts of your life

How is anxiety treated?

It is important to get help when you have anxiety.

While feeling anxious is normal for people with cancer, your anxiety may need treatment if it:

• is moderate or severe
• lasts more than 2 to 3 weeks
• interferes with your ability to cope with daily life
• is combined with symptoms of depression like feeling down most of the time or losing interest in activities that you used to like

Counseling

A professional counselor can help you cope and learn to live well with your anxiety. It can help to talk about your feelings and your fears with someone you can trust.

Talk to your health care team about getting counselling from a professional, such as a:

• psychiatrist
• psychologist
• psychotherapist
• social worker
• nurse practitioner

Ask your cancer care team or your family doctor about coping or stress management group programs.

Medication

For some people, medication may be needed to help control anxiety.

There are two types of medication used to treat anxiety:

Anti-anxiety medications are usually taken for short periods of time to treat acute (severe) anxiety. They work quickly but need to be closely managed by your doctor.

Anti-depressants are often used to treat anxiety that lasts for longer periods, is more severe, or happens with depression. They may take many weeks to work. They also need to be managed by your doctor long-term.

What can I do to help my anxiety?

The following ideas may be used as part of your treatment plan to help lower your anxiety.

Get help and support when you need it

Your support system is made up of friends, family and community members who want to help you. When you are not feeling well, your support system can help you with daily tasks such as cooking, cleaning and shopping. People who care about you may also bring comfort in difficult times and lift your spirits when you are feeling anxious.

Reach out to your support system when you need them. People are often looking for ways to help.

Watch for signs of avoiding people or places

Anxiety can cause you to avoid people or situations that cause anxious feelings.

Different types of anxiety can cause you to avoid different things.

• Panic disorder can make you avoid crowds.
• Social anxiety can make you avoid interacting with people.
• Phobias can make you avoid things like needles or closed-in spaces, like MRI machines.

The more you avoid things that cause you anxiety, the more anxious you will become when you try to do them. Severe anxiety can even cause you to avoid medical tests, treatments or appointments with your health care team.

Keep your regular routine as much as you can

When you feel the need to avoid people and places, it is hard to keep your regular routine. But keeping your routine is important, even when you do not want to. Doing your regular activities can help your anxiety and change your thoughts and feelings for the better.

To help keep your routine, put all of your regular activities into a daily or weekly calendar. Complete the activities as planned.

Include things such as:

• things you enjoy, such as hobbies, watching your favourite TV shows or taking a warm bath
• social things like calling a friend or family member
• daily tasks that give your day routine and structure, like chores and appointments

Focus on things that make you feel better

Things that have helped you feel better during other difficult times may help you while you have cancer.

You may find it helpful to:

• focus your attention on the things and people that bring you joy
• spend time with supportive people who make you laugh
• try to avoid negative people and things that cause you stress

Try relaxing activities

Relaxing your mind and body can ease your anxiety and keep your mind calm. Many activities can be done online or on cell phone apps, with no equipment.

Here are some relaxation activities or treatments to try:

• Mindfulness meditation (a way to feel calm by paying special attention to your mind and body)
• Massage
• Yoga
• Acupuncture (thin needles put into different points on your body to relieve symptoms). Talk to your health care team before starting acupuncture.
• Music or art therapy
• Deep breathing
• Guided imagery (imagining yourself in a pleasant, calm place)

Get good rest

Feeling rested can help to improve your mood and give you more energy.

To sleep better:

• Go to bed and wake up at the same time each day.
• Turn off all screens (TV, tablets, computers, etc.) at least 30 minutes before going to bed.
• Choose relaxing activities like reading, meditation or listening to quiet music before bed.
• Get out of bed if you have trouble falling asleep. Only go back to bed when you feel like you may be able to fall asleep.

Move your body

Any kind of exercise or movement may help to improve your mood, anxiety and sleep.

To be more active:

• Choose a pleasant activity that fits your health and fitness level.
• Start slowly with light exercise and movement, such as walking. Even 10 minutes a day can help.
• Slowly increase the amount of time you move and make your movements more challenging.
• Track your progress. Consider wearing a step tracker if you have one.

Safety tips for exercise:

• You can exercise at any time during or after treatment
• Talk to your health care team about how to exercise safely
• Stop and rest if you feel a lot of pain, nausea or if you have trouble breathing

Eat well

To keep your mind and body working their best, eat three meals a day, and snacks when needed.

Choose the following as much as you can:

• Whole grains, fruits and vegetables, low fat dairy products and lean meat
• Foods with mood-boosting omega-3 fatty acids like fish, flax seeds and walnuts
• Drink 6 to 8 glasses of water or other unsweetened drinks every day (unless you have been told to drink less)

Limit the following as much as you can:

• Foods that are high in fat, sugar or salt (processed foods, sugary drinks and desserts, fast food, potato chips, etc.)
• Caffeine, which is in coffee, tea, cola and chocolate

Think about your use of alcohol and tobacco

Avoid or limit alcohol. Alcohol can make you feel sad, interfere with cancer treatments and make side effects worse. If you are struggling with drinking, Connex Ontario can help you find alcohol treatment services in your community. Visit Connex Ontario online or call 1-866-531-2600.

Think about quitting smoking. Quitting smoking is good for your overall health. Quitting can also help cancer treatments work better and help with side effects. Visit Smokers’ Helpline or Health811 for information or call 811 for support.

Key Points

• Feeling anxious is normal for people with cancer.
• Anxiety can cause many physical and emotional symptoms.
• If your anxiety is not going away or is interfering in your life, you may need treatment.
• Counselling and/or medication may be part of your treatment.
• There are many things you can do yourself to help your anxiety.

Where to get more information about anxiety

For more links to helpful information go to:

• Anxiety
• Anxiety Canada
• Canadian Cancer Society or call 1-888-939-3333
• Centre for Addiction and Mental Health