Mental Health and Mesothelioma
Caring for your mental health after a mesothelioma diagnosis can improve your quality of life and positively impact your physical response to treatment. It is natural to feel sadness and anxiety about your diagnosis, but with support, you can still experience purpose and joy as your condition progresses.
Medically Reviewed By:
Patricia Shelton, M.D.
Medically Reviewed By:Patricia Shelton, M.D.
If you have been diagnosed with mesothelioma, you may feel like everything in your life has changed. You may be overwhelmed by the side effects of treatment, having to tell people you have mesothelioma cancer, the effects of your condition on your family, and the fear of death.
Although mesothelioma treatment has traditionally focused only on physical interventions, many mesothelioma doctors recognize that mental health plays an important role in treatment outcomes. As a result, mesothelioma treatment centers often include mental health support in the treatment plan.
Mesothelioma symptoms and treatment can take a toll on your mental health, no matter how strong you are. Finding positive ways to cope is an important factor in your post-diagnosis quality of life, whether your condition worsens or improves.
Common Mental Health Conditions Associated With Mesothelioma
According to Epidemiology and Psychiatric Sciences, 35 to 40 percent of cancer patients experience a diagnosable psychiatric disorder, with higher percentages for patients with advanced cancer. Mesothelioma is a rare cancer that is often in an advanced stage at the time of diagnosis.
Depressive Spectrum Disorders
Approximately 25 percent of cancer patients experience major depression. It is normal to feel sadness in response to a mesothelioma diagnosis. However, when these symptoms last at least two weeks and interfere with normal functioning, you may have developed major depression.
Symptoms of major depression include the following, according to the American Cancer Society:
- Pervasive sadness, hopelessness, or emptiness
- Loss of interest in activities previously enjoyed
- Weight changes
- Difficulty sleeping
- Excessive sleeping
- Feelings of worthlessness or helplessness
- Suicidal thoughts
- Mood swings
- Difficulty concentrating
Side effects from mesothelioma treatment may mimic symptoms of depression. It is important to inform your health care provider if you experience these symptoms.
Anxiety and Stress Disorders
The American Cancer Society defines anxiety as feeling uncomfortable, worried, or scared about a real situation or a situation that might occur. It is normal to feel fear after a mesothelioma diagnosis, including fear about treatment, symptoms, dying, and what may happen to your loved ones.
However, if the following symptoms persist, natural anxiety may have developed into an anxiety disorder, for which treatment is available.
Generalized Anxiety Disorder
Symptoms of generalized anxiety disorder include the following:
- Uncontrolled worry
- Difficulty focusing thoughts
- Difficulty with problem-solving
- Muscle tension
- Restlessness or feeling “on edge”
- Dry mouth
- Short temper
You may experience post-traumatic stress, a condition similar to post-traumatic stress disorder, but not as severe, according to the National Cancer Institute. This can occur as a result of the diagnosis itself or in response to mesothelioma symptoms or treatment side effects.
Being diagnosed with mesothelioma involves multiple stressful events, beginning with receiving the diagnosis. Other stressful events include painful treatment, bad news following diagnostic testing, financial distress, and progression of symptoms.
Symptoms of post-traumatic stress include the following:
- Repeated frightening thoughts
- Difficulty sleeping
- Feelings of detachment from self or reality
These symptoms can be triggered by neutral events, such as a smell or sound that reminds you of chemotherapy. You are less likely to develop post-traumatic stress if you have the following:
Adjustment disorders are characterized by excessive distress. They affect 20 to 25 percent of cancer patients according to Epidemiology and Psychiatric Sciences. Distress is a strong emotional reaction to the multiple stressors associated with cancer. According to the American Cancer Society, distress can include the following emotions:
- Loss of control
- Crisis of faith
A mesothelioma diagnosis may cause you to feel weak, vulnerable, exposed, or unsafe. Some distress is normal. It becomes an adjustment disorder when you experience such symptoms as the following:
- An overwhelming sense of dread
- Sadness to the point of feeling unable to complete treatment
- Inability to cope
- Concentration and memory problems
- Pervasive hopelessness
- Non-stop thoughts about mesothelioma
- Crisis of faith
- Difficulty sleeping
- Feelings of worthlessness
One of the most important defenses against adjustment disorders is a supportive cancer care team that makes you feel safe. Even if you think your feelings are minor, you should feel comfortable expressing them to your health care providers.
Depression, anxiety, and stress may lead to suicide without treatment. The suicide risk in cancer patients was 4.4 times higher than in the general population in a study published in Nature Communications.
A study by the Journal of the National Cancer Institute found that the rate of suicide in cancer patients is decreasing. While the study could not directly link this to supportive care, it may be correlated. Cancer patients today have better access than ever to palliative care, symptom management, hospice care, and mental health care.
The fear of developing symptoms can cause symptoms to occur. For example, phobias related to chemotherapy may lead to induced anticipatory nausea and vomiting. Other somatic effects may include increased pain intensity and magnified disability. This can adversely impact treatment outcomes and decrease your quality of life.
The effects of somatization may include the following:
- Decreased treatment adherence
- Delayed recovery
- Poorer outcomes
- Reduced sense of well-being
- Exacerbation of other mental health symptoms
Delirium or confused states of mind are common as cancer progresses. This can also occur as a side effect of chemotherapy, commonly known as “chemo brain.” According to the Mayo Clinic, the effects of chemo brain may include the following:
- Difficulty concentrating or learning
- Mental fogginess
- Short attention span
- Short-term memory deficits
- Taking longer than usual to complete routine tasks
Demoralization occurs when you feel hopeless and helpless. It may accompany a sense of failure and an inability to cope. Symptoms of demoralization include the following:
- Higher levels of sadness
- Increased physical symptoms
- Reduced well-being
- Fewer leisure activities
- Increased worry and preoccupation with mesothelioma
- Loss of meaning
- Loss of hope
- Reduced dignity
- Sense of worthlessness
- Suicidal ideation
If you are experiencing demoralization, you should report your feelings to your health care provider and reach out to your friends and family for support.
Changes in sexual functioning affect 25 to 40 percent of cancer patients, according to Epidemiology and Psychiatric Sciences. This can stem from psychological and physical changes that occur as a result of your mesothelioma diagnosis. The psychological factors may stem from the following:
- Body image changes due to weight loss
Physical factors that may impact sexual functioning include the following:
- Effects of systemic chemotherapy and radiation on the reproductive tract
- Progression of mesothelioma
You do not have to resign to permanently reduced sexual functioning because of a cancer diagnosis. Many of the physical changes are temporary. The psychological factors can be addressed by having open discussions with your partner and your health care provider.
Grief Following a Mesothelioma Diagnosis
When you are diagnosed with mesothelioma, you may experience a feeling of loss of the following:
- Bodily functions
- Future plans
The natural human response to loss is grief. Grief occurs in stages as your brain’s method of protecting you from experiencing too many overwhelming emotions at once.
According to the University of Rochester Medical Center, grief occurs in five stages. These stages do not always occur in order, and you may vacillate between stages throughout the process.
Stage 1: Denial
The first stage of grief is denial. Denial is a defense mechanism in response to an overwhelming loss. This can manifest in the following forms:
- Emotional numbness
- A refusal to believe it
Eventually, the reality of your diagnosis will set in, and the denial will give way to an emotional response.
Stage 2: Anger
You may feel anger that you developed mesothelioma. You may be angry that it happened to you. This is a healthy, natural response, and you have a right to feel angry. Asbestos exposure is nearly always to blame for a mesothelioma diagnosis, and this occurred because an asbestos company sacrificed your health without your consent in a relentless pursuit of profits.
You may not know how you were exposed to asbestos. You may feel confused about where to direct your anger. Whether or not you know the source of your exposure, you can process your anger in a healthy way by doing the following:
- Use exercise or physical activity to release extra energy brought on by the anger.
- Talk to your mesothelioma care team and the people who care about you about your anger.
Stage 3: Bargaining
During the bargaining stage, you may look for ways to make the disease go away. For example, you may make promises to a higher power in exchange for a cure. You may feel haunted by questions of why this happened to you. You may feel a need to regain a sense of control. This can lead to feelings of guilt as you convince yourself that you deserve your mesothelioma diagnosis.
The truth is that no one deserves a mesothelioma diagnosis, and you are not to blame for your condition. You developed mesothelioma because the greedy asbestos companies colluded to conceal the dangers of asbestos from the public so they could continue to profit from the toxic substance.
Stage 4: Depression
Depression is a natural part of the grieving process that is not necessarily unhealthy. It becomes unhealthy if you become mired in this stage. Depression during the grieving process feels like overwhelming sadness. You may experience difficulty sleeping, changes in appetite, and loss of interest in social activities.
It is important during this stage to resist the urge to withdraw. This is a time when you need to stay connected with your care team and the people who love you. You can cope with depression in a healthy manner by talking to any of the following:
- A counselor
- A health care provider
- A family member
- A friend
- Your caregiver
- A support group
Stage 5: Acceptance
Acceptance occurs when you have accepted the diagnosis and incorporated cancer into your life. It does not mean you will not experience other emotions. However, you are better able to manage once you reach this stage.
Coping with a Mesothelioma Diagnosis
When you have been diagnosed with mesothelioma, you will need help coping with your condition. While your physical health will be the primary focus of treatment, your mental health is an important component of the success of your treatment.
According to Psychology Today, healthy coping mechanisms can drastically improve your quality of life while you undergo treatment.
One of the most important early steps you can take to cope with a mesothelioma diagnosis is to obtain emotional support. You can accomplish this by choosing the right health care provider, joining support groups, seeking individual counseling, and relying on your loved ones.
Choose the Best Health Care Provider
If possible, choose a treatment center that has a mesothelioma program. Most mesothelioma treatment centers provide a multidisciplinary health care team that treats you as a whole person rather than only treating the disease. This includes mental health services, palliative care, and hospice care.
Palliative care focuses on keeping you as comfortable as possible while you are receiving treatment. This may include alternative mesothelioma treatment that can help ward off side effects and manage symptoms. Popular alternative treatments include meditation, acupuncture, and biofeedback.
Hospice care is similar to palliative care. The primary difference is that hospice care is offered when curative treatment is no longer available or desired.
It is important that you feel comfortable talking to your health care providers about your emotions throughout treatment. If you are uncomfortable openly communicating with your care provider, it is okay and even advisable to find another provider.
When you are facing a mesothelioma diagnosis, you may feel alone. Your loved ones cannot completely understand how you feel, and you alone are facing the pain and prospect of dying of cancer. Cancer support groups provide a confidential environment where you can share with others who are faced with similar circumstances.
If your health care provider is a specialized mesothelioma center, it may offer a mesothelioma-specific support group. Support groups are frequently offered virtually for the benefit of patients who cannot attend in person. Support groups for caregivers and family members are also available.
Individual counseling techniques can help you retrain your mind to think differently about your illness so you do not become overwhelmed with negative emotions. According to the Association for Behavioral and Cognitive Therapies, education and behavioral therapies are effective methods in reducing anxiety and helping patients complete treatment.
Education about mesothelioma, treatment options, side effects, and the medical system may decrease the adverse effects of treatment and make them more manageable.
Behavior therapies include relaxation training and cognitive behavioral therapy. Relaxation training teaches patients how to relax muscle groups or use biofeedback to reduce chemotherapy side effects. This has been proven effective in reducing anxiety, nausea, and stress before and after therapy.
Cognitive behavior therapy is a process of identifying negative thoughts and beliefs and replacing them with more rational ideas. This can help patients find serenity in the midst of their diagnosis and reduce the fear of death.
Mindfulness is the practice of learning to be present in the moment. It is a disciplined practice of witnessing your own thoughts and emotions without judgment. This is often achieved through meditation or yoga. Mindfulness can help you regulate your emotions. It has been proven to significantly reduce anxiety, depression, distress, insomnia, and fatigue in people with cancer.
Staying connected with loved ones is one of the most important coping mechanisms you can adopt. Resist the urge to withdraw, and consider reconnecting with loved ones with whom you have lost contact over the years.
You are not alone in your grief. The people who care about you are also grieving. This may trigger feelings of guilt, but know that your loved ones treasure every moment they have with you. Make the most of these moments. This will enrich your life and theirs.