Managing stress (and mindfulness)

Stress is not good for people, physically or psychologically. Being diagnosed with breast cancer and having treatment can understandably increase your stress levels. The shock of diagnosis can increase your stress levels instantly, and the ongoing impact of treatment and recovery can keep stress levels elevated. This is called chronic stress.

Reducing stress where you can, can boost your self-confidence and your mood and improve your quality of life. There are techniques and support to help you reduce stress and cope better.

Stress and its impacts

Stress increases the adrenaline and cortisol levels in our body.

Adrenaline increases heart rate, elevates blood pressure and boosts energy supplies. Cortisol increases sugars in the bloodstream, enhances the brain's use of glucose and increases the availability of substances that repair tissues.

These chemicals can be useful in coping with an acute stress situation, but can be harmful if they remain elevated, disrupting our body’s normal processes.

Stress:

• saps energy
• decreases coping
• increases our tendency to react to situations in an emotional way.

As you go through your breast cancer experience, there are many factors that can cause stress and add to your stress levels:

• Telling family and friends about your diagnosis and managing their distress at the news.
• Making decisions about treatment.
• Sorting out your life as you prepare for and undergo treatment – what will you do about work, study, managing the household and caring for your family, finances and other life commitments.
• Managing side effects of treatment.

And it’s not as if it all ends there. Finishing treatment can be a particularly stressful time as you look back on what has happened to you and reassess what you want from your life going forward. This stage, called post treatment adjustment, can last for a long time – at least two years and sometimes much longer.

Reclaiming your life, managing your expectations and those of the people around you, coming to grips with the next version of you, and learning to live with the fear that your cancer might one day come back, can all contribute to ongoing stress.

It would be wonderful if we could eliminate stress from our lived experience. But that’s just not a realistic expectation. Life has a way of delivering stress in many and varied forms, so it is more helpful to accept that and learn to manage it as best we can.

Strategies to manage stress

There are strategies for managing stress that can significantly improve your physical and psychological wellbeing.

These include:

• Exercise - regular physical activity such as a brisk walk or yoga, has been shown to improve stress and emotional wellbeing.
• Enjoyable activities - taking time to do the things you enjoy, focusing on things around you, or a hobby or interest.
• Time out – creating space in your life away from day to day stressors, such as a weekend away from it all; a break from work, chores, caring responsibilities. Small time outs are great too, like long walks or time spent in nature or by the sea.
• Boundary setting - being clear with others what you can and cannot do.
• Problem solving – this is a 3 step process: understand, strategise, implement. Problems come in all shapes and sizes. It might be about managing the needs of your family during treatment, or dealing with unrealistic expectations of others, or how to resolve an issue with your treatment team.
• Outsourcing – getting help from others to do tasks such as cleaning, mowing the lawn or keeping others updated on your cancer progress.
• Sleep – developing a good sleep routine, such as going to bed and getting up at the same time every day.
• Mindfulness meditation.

Mindfulness meditation

• Results from trials of mindfulness-based stress reduction (MBSR) programs for survivors of breast cancer show significant improvements in quality of life and psychological wellbeing, when compared to usual care.
• One of the benefits of mindfulness meditation can be an increase in the production of alpha waves. Alpha waves are one type of brain wave, and they are produced when our brain is in an idling or neutral mode, sometimes called ‘wakeful rest’. Alpha waves can reduce stress, make us feel more relaxed, calmer, and less anxious or depressed. In this mode, we are not asking our brain to focus on or address specific issues or problems.

It's up to you.

Managing our stress is not something we can rely on others to do. It comes down to us. Identifying your stress load, deciding if you would like to reduce it, and selecting and trialling one or two of the above strategies might be a good way to start.

Where to get help

If you are finding it difficult to cope with stress, you might want to talk to someone about how you are feeling. This may be someone in your treating team such as your breast care nurse or GP. They can advise if more specialist help may be beneficial to you.

Talking to someone who has had a similar experience may also be helpful. To connect with others join BCNA’s Online Network or a face-to-face breast cancer support group.

Acknowledgement
BCNA thanks clinical psychologist Dr Charlotte Tottman for her assistance in developing this information.