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Your feelings

Many people are bewildered when they hear that they have cancer, and wonder why this has happened, or feel sad, angry or afraid. It is very common for people to experience huge swings in emotions ranging from cheerful optimism to the darkest thoughts. These swings in feelings can be made more dramatic by the impact of the cancer treatments. The important thing is to remember that these feelings are normal, and that many others feel this way too.

It is a good idea to think about whom you want to know about your diagnosis, and what you wish to share. Discussing these wishes with your closest friends and family will ensure that you maintain control of your information. It can also be helpful to indicate to friends and family how you wish to be contacted. Do you want friends and family to contact you, or do you want to do the contacting. Would you rather a close family member be a contact point or would you welcome all the support and encouragement you can get?

Deciding when and how to talk to friends and family is unique to you. Evidence shows that it is a good idea to talk. It can help you understand your situation more clearly and can help you to crystallize your thoughts and preferences for the days ahead. Their questions and input can help too. However sometimes you may not want to talk about how you feel or about how others are feeling. You might like to think about how you would deal with days like this, and prepare a stock phrase. Something like "Usually I am OK to talk about it, but today I'm not feeling up to it. I'm sure you understand."

When is low too low?

As we have said, it is natural to have all sorts of emotional reactions to cancer, and these can vary throughout the journey. However being diagnosed with and receiving treatment for cancer is an incredibly stressful experience, and may lead to clinical depression. What should you and your family look for?

• If you are feeling overwhelmed
• If you are feeling depressed, sad, hopeless, discouraged, or "empty" almost every day for most of the day
• If you have lost interest or pleasure in activities that were once enjoyable
• If you notice a change in your eating habits (eating too much or too little), or have weight loss or gain
• If you have changes in your sleep patterns (are unable to sleep, wake up too early, or sleep too much)
• If you find that others notice that you are restless or "slowed down" almost every day
• If you have decreased energy or fatigue (severe tiredness) almost every day
• If you have feelings of guilt, worthlessness, and helplessness
• If you have trouble concentrating, remembering, or making decisions
• If you have thoughts of death (not just fear of dying) or suicide, or make attempts at suicide
• If you notice wide mood swings from depression to periods of agitation and high energy

Cancer treatment may cause some of these symptoms. But, if you have the first two symptoms on the list above, along with three or more of the other symptoms, you may also be depressed. If these symptoms last for two weeks or longer or are severe enough to interfere with your normal functions, an evaluation by a mental health professional is recommended. It's important to be honest with your GP or Nurse Specialist and let them know that you are feeling particularly low.