Cancer Caregiver Anxiety: How to Manage the Stress
Knowing a loved one has cancer adds a new kind of challenge — and often new responsibilities — to life. And this challenge is often reflected in a caregiver’s mental health. The National Institute of Mental Health reports that an estimated 19 in 100 U.S. adults had an anxiety disorder in the past year. Meanwhile, a study of cancer caregivers found that just over half showed signs of severe anxiety.
In fact, family caregivers sometimes have higher rates of anxiety than patients because they’re not ultimately in control of treatment decisions, says Jamie Jacobs, PhD, a Mass General Brigham clinical psychologist. She’s also a clinical researcher and the director of the Center for Psychiatric Oncology and Behavioral Sciences and the Caregiving Research Program at Mass General Cancer Center.
The lack of control combined with concerns about your loved one is a recipe for anxiety. Here, Dr. Jacobs shares the most effective ways to reduce anxiety and when to seek help.
Anxiety symptoms in cancer caregivers
Cancer caregivers may deal with physical and mental symptoms of anxiety. These symptoms often include:
- Dizziness
- Fast or irregular heartbeat
- Fatigue
- Headache
- Irritable mood
- Loss of appetite
- Nervousness
- Struggling to fall asleep or stay asleep
- Trouble concentrating
Anxiety often goes together with depression. Depression is more than feeling sad — it’s when a low mood lasts a long time and disrupts daily life.
As a caregiver, you may also have symptoms of depression, such as feeling you’re not doing enough to care for your loved one. You may also have little to no interest in activities you once enjoyed.
Caregiver anxiety has an impact on health
Anxiety is normal and healthy in the short term. But anxiety that’s excessive and long-lasting keeps your body’s stress response active. This can cause health problems.
“Staying in that state of stress response is a chronic wear and tear on the system. It’s one of the reasons we see caregivers struggle with their physical health,” Dr. Jacobs says.
Family caregivers tend to have an increased risk of:
- Cancer
- Diabetes
- Heart disease
- High blood pressure
- High cholesterol
- Infection
How cancer caregivers can reduce anxiety
Reducing anxiety can help caregivers improve overall health and mood.
The strategies Dr. Jacobs uses to reduce caregiver anxiety are rooted in cognitive behavioral therapy (CBT). While CBT is most effective with a qualified mental health professional, there are principles you can practice at home.
Here are 5 tips for using CBT for anxiety:
- Don’t ‘just think positive’
Dr. Jacobs gives family caregivers permission to ignore those who tell them to think positively. “The notion that one simply needs to ‘think positive’ is deeply unhelpful for individuals grappling with something as devastating as cancer,” she says.
Instead, she works with cancer caregivers to replace negative thoughts with balanced ones. A balanced thought avoids both worst-case and best-case extremes. “Our goal is to cultivate an accurate and realistic perspective,” Dr. Jacobs says.
For example:
- Negative: My loved one will die next month.
- Positive: My loved one will never die.
- Balanced: While my loved one may pass away sooner than I had hoped, we are following the recommended treatment plan and focusing on taking each day as it comes.
- Act when possible
An action-based coping strategy — confronting the problem that’s causing anxiety — can help you feel in control. You may not be able to solve the problem of cancer, but you can address other issues.
An action-based coping strategy might include:
- Asking for help from family, friends, and professionals
- Creating a calendar or reminder system to stay on top of appointments and tasks
- Deciding next steps
- Gathering information about treatment and support options
However, there are only so many actions you can take. So, it’s important to recognize when to shift to stress-reducing coping strategies to manage your emotions, Dr. Jacobs says.
Once you’ve acted, consider whether there’s anything else you can do. If not, it’s time to practice stress reduction techniques.
- Practice stress reduction daily
- Prioritize self-care
Self-care is challenging for caregivers. “They prioritize the patient’s needs at the expense of their own, and that’s a recipe for disaster,” Dr. Jacobs says.
Neglecting your own health often worsens anxiety. It can also lead to caregiver burnout — a state of emotional, mental, and physical exhaustion.
“Self-care is a basic way to prevent burnout,” Dr. Jacobs says. Key self-care strategies include:
- Eat a healthy, balanced diet
- Exercise daily
- Sleep at least 7 hours per night
- Visit your primary care provider (PCP) once a year
It can be challenging for caregivers to maintain a healthy diet and exercise routine. For this reason, Dr. Jacobs encourages them to set realistic goals. If you struggle to eat regular meals, focus on getting enough protein every day. If you don’t have the time or energy for a structured workout, at least aim to walk around the block.
- Seek cancer caregiver support
Caregivers tend to isolate themselves from friends and family. “They think they should be able to take care of their loved one on their own,” Dr. Jacobs says.
It’s okay to need your own support. Asking friends and family to help with caregiver duties or basic tasks at home can take stress off your plate. This gives you an opportunity to care for yourself, helping reduce anxiety.
Get help from a mental health professional if you’re overwhelmed with anxiety and depression. “If you can’t control worries or your sleep is really affected, it’s time to seek mental health care,” Dr. Jacobs says.
A mental health professional can teach you how to reduce anxiety and prescribe medication if necessary.
If you have thoughts of hurting yourself or others, call or text 988. Help is available.
