Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is an anxiety disorder that can be brought on by experiencing or witnessing a traumatic event, such as:
war and combat
a violent crime
a serious accident
a natural disaster
a breast cancer diagnosis and breast cancer treatment
PTSD can make it difficult for people to function and manage everyday tasks. Mental health specialists, often a psychiatrist or psychologist, categorize symptoms into four different types:
re-experiencing: when a person relives a traumatic event through intrusive and distressing recollections, flashbacks, and nightmares
avoidance: when a person becomes emotionally numb and avoids places, people, and activities that are reminders of the trauma
hyperarousal: when a person has difficulty sleeping and concentrating, feels jumpy or frightened, and is easily irritated or angered
negative changes in mood and awareness: when a person feels cut off from other people and experiences negative changes in mood, ways of thinking, or remembering
PTSD also can lead to self-destructive behaviors such as drug or alcohol abuse, as well as other mental health conditions, including:
rapid breathing or heart rate
Certain breast cancer-cancer related factors can trigger PTSD, such as:
the diagnosis itself
pain or discomfort from the breast cancer or its treatment
testing and imaging
hospital stays
fear of the cancer returning
completing treatment and seeing your cancer care team less often
For some people, certain sights, sounds, smells, places, and feelings can lead to vivid flashbacks of the breast cancer experience:
pink ribbons
ads for breast cancer medicines or treatments
foods they ate or avoided during breast cancer treatment
stories about other people’s breast cancer experiences
hospitals, doctor’s offices, and imaging centers
aches and pains (which can lead to fears that the cancer has returned)
People with cancer may not necessarily have all the symptoms of PTSD, but rather some of them — a condition often called cancer-related post-traumatic stress.
There are also some factors that can increase the risk of post-traumatic stress, such as:
a personal history of anxiety or depression
a metastatic breast cancer or triple-negative breast cancer diagnosis
not having a strong support system of friends and family
having to cope with many stressful situations at the same time (worrying about infertility, money, or having to take time off work)
not having a good understanding of the breast cancer diagnosis
feeling like you’re unable to communicate with your cancer care team
PTSD symptoms typically appear within three months of a traumatic event, last longer than a month, and can severely affect daily life. In some cases, symptoms may reappear after many years or may not appear for the first time until years after a traumatic event.
Post-Traumatic Stress Disorder After a Cancer Diagnosis
Mar 21, 2020Managing PTSD
If you have symptoms of PTSD, it’s important to ask your cancer care team for a referral to a mental health professional, such as a psychiatrist, psychologist, therapist, or counselor. A mental health professional can offer you tools to manage your feelings and stressful episodes to help ease PTSD symptoms.
Some ways of managing PTSD include:
deep breathing
mindfulness-based stress reduction
mind-body relaxation techniques, such as progressive muscle relaxation and grounding techniques
individual counseling (also known as behavioral or talk therapy)
anti-anxiety medicines, such as Xanax and Niravam (chemical name: alprazolam), Valium (chemical name: diazepam), Ativan (chemical name: lorazepam), Librium (chemical name: chlordiazepoxide), and Klonopin (chemical name: clonazepam)
antidepressant medicines, such as Paxil (chemical name: paroxetine), Prozac (chemical name: fluoxetine), Zoloft (chemical name: sertraline), and Effexor FR (chemical name: venlafaxine)
Certain antidepressants can interfere with tamoxifen. If you’re taking tamoxifen, it’s essential to ask your doctor which antidepressants are safe for you.
Your doctor can work with you to figure out which medicine relieves PTSD with the fewest side effects. Typically, you begin taking a lower dose at first and, under your doctor’s guidance, increase it if and as needed until the symptoms improve. Anti-anxiety medicines pose some risk for addiction, so doctors prescribe them for short-term use. Doctors prescribe antidepressants for longer periods of time because it can take up to six weeks for the medicine to improve symptoms. Still, although doctors don’t consider antidepressants to be addictive in the traditional sense, it is possible to become dependent on them.
Support groups, one-to-one peer support, or Virtual Community Meetups (where you can talk to members of the Breastcancer.org community) also can connect you with others who can share ways they’ve eased PTSD symptoms.
According to the American Psychological Association, exposure therapy helps people face and eventually control their fears. People are gradually exposed to the trauma they’ve experienced by recalling it, writing about it, or eventually visiting the place where the trauma happened. Exposure therapy’s goal is to make the trauma less intense.
In eye movement desensitization and reprocessing (EMDR), a type of psychotherapy, people are encouraged to recall a traumatic memory while making back-and-forth eye movements or listening to alternating left and right beeps or tapping. EMDR’s goal is to make the traumatic memory less vivid and less emotionally charged. 1
Additionally, some complementary therapies that have been shown to ease anxiety, stress, fear, and depression include:
Some of these complementary therapies may require a practitioner.
Helping yourself while living with PTSD
Patience with yourself is important. It can take some time for symptoms of PTSD to improve.
Depending on the severity of the PTSD, some people find the following strategies helpful:
maintaining their normal routines as much as possible
getting enough sleep
being physically active every day, say walking for 30 minutes a day
avoiding alcohol and caffeine
doing something they enjoy, such as reading, painting, exercising, or listening to music
Written by: Kristine Conner, contributing writer
Pomeri AP, La Salvia A, Carletto S, et al. EMDR in Cancer Patients: A Systematic Review. Frontiers in Psychology. 2021. Available at: https://doi.org/10.3389/fpsyg.2020.590204
— Last updated on June 4, 2024 at 10:39 PM
