For example, there may be a difficult contrast between the positive emotions of others and what a patient is feeling about their current circumstances. A patient may be limited in their physical ability to travel or to take part in certain holiday traditions or activities. Some friends or relatives may even avoid contact because of anxiety about what to say or do.
Dr. Alan Bates, psychiatrist and Provincial Practice Leader for Psychiatry at BC Cancer, discusses these challenges and provides some advice for patients and their family, friends and caregivers.
What kinds of emotional challenges do cancer patients face during the holidays?
The holiday season can present a difficult contrast between the positive emotions of others, either in real life or as portrayed on TV or in movies, and how patients and family members are feeling about current circumstances. There can also be a difficult contrast to how they have felt in previous years and there may be losses of function or abilities that prevent long-time traditions from continuing.
For example, maybe a usual trip "home" for the holidays has been made impossible by medical circumstances. Also, it may become more apparent for someone that they are having a unique and personal experience of their cancer that people around them are not sharing. There may be an enhanced experience that others don't really "get" what they're going through as they celebrate the holiday season while the patient continues to experience very challenging emotions related to cancer. Some cancer patients may even find that they're not invited to events they would normally be invited to as friends and family might make incorrect assumptions about whether they would be willing or able to attend a particular function. Friends sometimes even avoid contact with patients because of anxiety about what to do or say around them.
Holidays can also be a difficult reminder of illness (e.g. "this is my first Christmas since being diagnosed") and recent or distant losses. When a previous difficult event such as a diagnosis, loss of function or loss of life occurred around the time of a holiday, the holidays sometimes become a difficult reminder of that loss. Memories of the loss may be accentuated to a greater degree than if the loss had happened at a more generic time of year.
What kind of advice do you offer to cancer patients in managing these challenges?
Validating their experience is very important. Whether enjoying the holidays more than they thought they'd be able to or suffering through greater isolation than they've ever experienced, they're far from the first person to feel either way about this time of year.
There are lots of reasons why the holidays can be particularly difficult. People often find they don't feel like socializing when they're depressed or anxious and the isolation often leads to worsened depression and anxiety. So, a rule of thumb is that we try to encourage people to push through that lack of energy or increased anxiety and get out and be around people. Exercise, even just a brief walk with a friend, and talking with people are very good things for everyone and socializing tends to feed into a positive loop including enjoying other people's support and company and others enjoying their company, which can lead to an improved mood.
What kind of advice do you offer to friends and family of cancer patients during this time of year?
Interactions with family and friends can be very positive, or very challenging. It can be a difficult balance between forcing oneself to stay engaged with friends and family in order to not become isolated and also setting appropriate limits with others around things like what activities you can and can't do, when you're feeling too fatigued and have reached your limit for the day, and minimizing time with people who, for whatever reason, seem to be purely negative influences on one's mental or physical wellbeing.
I suggest that family and friends continue to give patients the option of being involved in all the activities that they would normally be part of prior to a cancer diagnosis. Related to that, it's generally helpful to have open and honest discussions about what's happening, how each other are feeling about it and what's actually possible for this year. Also, BC Cancer counselors regularly work with family members of cancer patients and family members should know that this excellent resource is available to them when they need it.
To learn more about Patient and Family Counselling at BC Cancer, visit: www.bccancer.bc.ca/our-services/services/patient-family-counselling