MENTAL HEALTH PROBLEMS

This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.

A healthy lifestyle: taking care of your mental health

Living a healthy lifestyle means taking care of your physical and mental wellbeing. Overall, a healthy lifestyle can make you feel more energised, cope better with stress and have a more positive outlook on life. Repeatedly making healthy decisions can also reduce your risk of mental health problems such as anxiety or depression.

Taking care of your body can make you feel better mentally. And when you feel happier, it is often easier to make healthy choices for your body, too. This brochure focuses on the things you can do to take better care of your mental health. For more information on how to improve your physical health, please read: Health promotion.

Why is taking care of my mental health important for me?

Good mental health is beneficial for everyone. This includes people who have never had cancer treatment.

Experiencing cancer as a child may have an impact on your mental health. It is not unusual to feel upset, sad, angry or worried even years after completion of your cancer treatment. When these feelings affect your daily life and become a problem for you, you may want to seek advice. Dealing with a variety of emotions during and after childhood cancer can cause mental health problems.

Mental health problems include:

  • Anxiety
  • Behavioural problems, such as abuse of alcohol or drugs, uncontrolled anger or carelessness
  • Depression, mood changes
  • Post-traumatic stress, for example re-experiencing traumatic events
  • Suicidal thoughts

Anyone, including people who have never had cancer treatment, can develop mental health problems. However, we know that childhood cancer survivors may have an increased risk of having mental health problems later in life. That is why taking care of your mental health is extremely important for people who experienced childhood cancer.

What are symptoms and signs of mental health problems?

There are symptoms and signs that may suggest you could be experiencing mental health problems. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

These symptoms and signs may suggest that you have mental health problems:

  • Feeling persistently anxious or worried
  • Feeling persistently depressed or unhappy
  • Persistent changes in mood
  • Having trouble sleeping
  • Losing or gaining (a lot of) weight
  • Loss of appetite
  • Wanting to be alone all the time
  • Alcohol or drug abuse
  • Constantly feeling guilty or worthless
  • Suicidal thoughts

If you recognise any of these symptoms or signs in yourself, please focus on staying safe and talk to someone you trust and contact your general practitioner, psychologist/psychotherapist/psychiatrist or follow-up care specialist. If you experience suicidal thoughts right now, focus on staying safe and talk to someone. In your country there may be helplines you can call. For a list of suicide hotlines all over the world, please look at: https://blog.opencounseling.com/suicide-hotlines/.

I am at higher risk of mental health problems. What tests should I have and when?

If you are at higher risk of mental health problems, it is advised to see your general practitioner or follow-up care specialist regularly. Whenever you visit your follow-up care specialist, they may ask you about your mental health and whether you have been experiencing any symptoms and/or signs of mental health problems.

What happens if I have mental health problems?

If you have mental health problems, your general practitioner or follow-up care specialist will probably refer you to a:

  • Psychologist (healthcare professional specialised in mental health)
  • Psychiatrist (physician specialised in mental health)
  • Social worker (professional specialised in social problems)

The psychologist may do further testing and discuss different options with you. They will assist you in dealing with what you are experiencing.

What else can I do?

It is important that you are aware of the possibility of developing mental health problems and that you know the symptoms and signs. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.

There are several things you can do that may improve your mental health. For example:

  • Exercise, such as cycling, lifting weights and/or having an active lifestyle (for example gardening, going for a walk and doing housework). Exercise can distract you from negative thoughts and increase your energy levels. In addition, exercise reduces stress and encourages your brain to produce ‘happy hormones’.
  • Nutrition: Maintain a healthy body weight and eat
    healthy foods
    from each of the five food groups (fruits, vegetables, proteins, dairy and grains). Additionally, reduce sugar and salt intake.
  • Sleep 7 to 9 hours a night. The brain needs enough sleep to process emotional information. When you sleep too little, this can have a negative influence on your mood.
  • Connect with others. Spending time with family and friends protects against stress and increases happiness. It also creates a sense of belonging and purpose and boosts your self-confidence. You may also find it helpful to connect to other people with similar experiences through survivors groups or self help groups. Being part of groups like this can help you feel understood and part of a community of similar people.
  • Make time for yourself. Especially when you have a very busy work and/or social life, it is important to also take time to relax and unwind. You can use this time to take a bath, do some reading or other things you enjoy.
  • Reach out to family members or close friends when you experience negative emotions. Talking about your feelings with people you trust can help you process these feelings and reduces emotional distress.
  • Practise gratitude. Sometimes when we feel anxious, sad or stressed, we forget about the positive things in life. Refocusing on the positive can make you feel happier. You can do this by thinking about the things you are grateful for, or writing them down in a journal each day. This can be anything, such as a good friend or enjoying a good book.
  • Practice mindfulness. Mindfulness is the act of being fully present in the moment, while accepting your thoughts, feelings and bodily sensations. Mindfulness is proven to have positive effects on your mental health. For some exercises to practise mindfulness, visit: https://www.calm.com or https://www.headspace.com.
  • Using relaxation techniques. There are many exercises you can do that will help your mind and body relax. Relaxation exercises slow down breathing, lower your blood pressure and can help relieve stress. For some relaxation exercises, visit: https://www.calm.com or https://www.headspace.com.
  • Seek professional help. Often people find the advice above helps improve and maintain their mental health, sometimes however, it is not enough. In this case it is recommended to seek professional help. You may find it more helpful and easier to address your problems by receiving professional help from a mental health professional such as a therapist. If you think you may need professional help, you could either discuss this with your general practitioner or with your follow-up care specialist.

Where can I find more information?

You may find more information about mental health problems online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

  • Samaritans: Here you can find more information about receiving mental support in an immediate crisis in the UK
  • American Cancer Society: Here you can find more information about and advice for mental health problems after cancer treatment
  • NHS: Here you can find more information about mental health problems and tips for self-help

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the IGHG* guideline about “Mental health problems” [1].

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

*International Guideline Harmonization Group for Late Effects of Childhood Cancer

[1] Gilleland Marchak, J. et al. (2022) Recommendations for the surveillance of mental health problems in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Available at: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00750-6/fulltext