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How to manage always feeling on edge?

Page last modified on: September 8, 2009

Question from Sally: Since my diagnosis, I often get very strong startle responses to ordinary things. I am also often very irritable and "edgy." I can't seem to handle the daily stresses of life. Is this normal and what can I do about it?: Answers —Mitch Golant, Ph.D.: I think it's back to a little of what Roz was saying earlier, that tapped out feeling that diagnosis and treatment of cancer is a multiple, traumatic event. As said earlier, there's the diagnosis, the treatment, the side effects of treatment, and recurrences or threat of recurrences, all of which are distressing. You are describing a stress response to the diagnosis and treatment of cancer. Receiving support, counseling, therapy, or joining a support group may help. But you probably would also want to talk to your doctor about any potential anxiety or depression.; Rosalind Kleban, L.C.S.W.: I think that we have omitted something very important. While we both agree that all of the emotions mentioned tonight are not only normal but to be expected, among the many things that can be helpful such as therapy and support groups we've neglected to mention the appropriate use of medication. In many cases, either antidepressants or anti-anxiety medications can be very helpful. One of the more eminent oncologists at my center has often suggested that we put Prozac in candy dishes in the waiting room!

Editor's Note: If you are taking tamoxifen, talk to your doctor about which antidepressants are safe for you to take. Some antidepressants -- including Paxil, Wellbutrin (chemical name: bupropion), Prozac (chemical name: fluoxetine), Cymbalta (chemical name: duloxetine), and Zoloft (chemical name: sertraline) -- interfere with the body's ability to convert tamoxifen into its active form, preventing you from getting the full benefit of tamoxifen. For more information, please visit the Tamoxifen page.; Mitch Golant, Ph.D.: Actually, a side effect of the treatments of cancer themselves may create the anxiety or depression, so treating it medically is incredibly important, at least to investigate.

On Wednesday, April 29, 2009, our Ask-the-Expert Online Conference was called Managing Fear and Anxiety. Mitch Golant, Ph.D. and Rosalind Kleban, L.C.S.W. answered your questions about dealing with fear and reducing the stresses that can accompany breast cancer.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Mitch Golant, Ph.D. is a health psychologist and senior vice president of research and development for the national office of The Wellness Community, which provides free psychological and emotional support to help people with cancer on their path to recovery. His research focuses on the benefits of online and community support groups for women with breast cancer.

Rosalind Kleban, L.C.S.W. is administrative supervisor for psychosocial programs at Memorial Sloan-Kettering Cancer Center's Lauder Breast Center in New York City, where she leads weekly support groups for women with early and advanced breast cancer.