If you are feeling anxious, sad, or stressed and see no improvement, then it may be a good idea to ask your doctor to recommend a counselor or therapist. Many cancer centers recognize that mental health is an important part of breast cancer care. Depending on where you receive treatment, you may be automatically referred to counseling.
Some people find that they benefit from various types of support at different times in their lives.
There are various ways to get mental health support. Some different types of therapy that you may want to consider include:
Psychoanalytic therapy focuses on changing negative or self-destructive behaviors, feelings, and thoughts by identifying their unconscious meanings and motivations.
Behavioral therapy focuses on changing learned thoughts and behaviors that are negative or self-destructive. Cognitive-behavioral therapy is a newer variation of behavioral therapy.
Cognitive therapy focuses on changing negative and self-destructive thoughts, which are believed to lead to negative emotions and behaviors.
Acceptance and commitment therapy is related to behavioral therapy that uses acceptance and mindfulness to help people accept experiences, become more mindful, and commit to behavior change.
Humanistic therapy focuses on a person’s positive accomplishments and ability to make rational choices and. The goal is to encourage self-discovery, healing, and fulfillment.
Integrative or holistic therapy combines different approaches to therapy depending on each person’s specific needs.
Many doctors use a combination of therapies tailored to meet each person’s needs. Research suggests that cognitive-behavioral therapy and acceptance and commitment therapy 1 can be especially helpful for people diagnosed with breast cancer.
Learn about different types of therapy at the American Psychological Association.
A number of licensed mental health professionals offer these various forms of counseling and therapy:
Psychologists. Psychologists have advanced training in assessing and treating complex mental health conditions. Both psychologists and psychiatrists offer psychotherapy. Still, most psychiatrists treat people primarily by prescribing medicine, while psychologists mainly treat people with psychotherapy.
Psychiatrists. Psychiatrists are medical doctors who can also prescribe medicine, in addition to diagnosing and treating mental health conditions. Some psychiatrists provide counseling and others focus primarily on helping people manage their medicine. Psychiatrists often work with other types of mental health professionals to support patients.
Psychiatric nurse practitioners. Psychiatric nurse practitioners are often referred to as NPs. These specialists are registered nurses with advanced training in mental health. Psychiatric nurse practitioners can diagnose conditions and prescribe certain medicines under the supervision of a doctor or psychiatrist.
Social workers. Social workers are experts in navigating the healthcare system, identifying resources, and setting up any additional services that people may need. Social workers usually have master’s degrees, are licensed to provide counseling, and often lead support groups or discussion boards. Social workers who specifically work with people diagnosed with cancer are also called oncology social workers.
Peer navigators. Peer navigators are people with a history of breast cancer who make themselves available at cancer centers and hospitals so they can help people who have been newly diagnosed. Your cancer care team can match you with one of these peer navigators. Organizations like Imerman Angels can also connect you or a caregiver with a mentor who has been through a similar experience. Peer navigators provide support by sharing resources, offering advice, or simply listening if and when you need it.
Psycho-oncologists. Psycho-oncologists are specially trained to provide mental health support to people who have been diagnosed with cancer. Psycho-oncology looks at the psychological, behavioral, emotional, and social issues that come up during cancer diagnosis and treatment.
Finding the right person to talk to is incredibly important. Here are some things you may want to consider when making your decision:
Pick a therapist who understands breast cancer. It is helpful to see someone who specializes in cancer care.
Find the right fit. The most important part of therapy is choosing someone who makes you feel comfortable.
Consider your options. You may want to try speaking to a few specialists on the phone first to help you choose the one who is the best fit. Many therapists offer a short, free consultation so you can get to know each other. It’s not unusual for people to see one or two therapists before finding the right one.
Choose the setting that works best for you. It’s entirely up to you whether you prefer in-person appointments or virtual visits.
The professional you choose can deliver therapy to you in a few ways:
Individual counseling. Also known as behavioral or talk therapy, you meet one-on-one with a counselor in a private setting to discuss your thoughts and emotions. Together, you can work on ways to manage your emotions and learn new coping skills.
Couples or family counseling. In couples or family therapy, you go to counseling with your partner or whole family. With the counselor as your guide, you discuss your feelings and how they affect each member of the family.
Group counseling. A mental health treatment that brings together several people who are experiencing similar situations or have been diagnosed with similar conditions, such as breast cancer. Group therapy is always led by a licensed mental health care professional. The goal of group therapy, according to some experts, is to help identify and change negative thoughts or behaviors.
Support groups. Similar to group therapy in that they bring together people with similar experiences. The key difference is that, although support groups can be led by mental health care professionals, they also can be led by someone who shares the group’s common experience. The goal of a support group, according to some experts, is to help people cope by offering them a safe place where they can vent or share their experiences.
Grief counseling. Grief counseling may be beneficial for people diagnosed with metastatic breast cancer. Grief counselors are mental health professionals who specialize in end-of-life considerations and use a variety of tools, including pain management, meditation, and talk therapy. Family members and friends are often part of this process.
Nearly any type of therapy can be delivered virtually — over the phone or as a video visit.
People who are interested in connecting with others who are experiencing similar situations may be interested in online discussion boards. For example, you can join the conversation with members of the Breastcancer.org community as often as you’d like and take a break if you need to. Here are a few additional safe spaces where you can share stories, find resources, and ask for advice:
Cancer Survivors Network
Virtual Community Meetups, where you can talk with members of our community
Young Survival Coalition
In addition to counseling, there are medicines that can help ease mental health issues.
It’s important to remember to speak with your oncologist before starting any new medicine. It also may make sense to check with a pharmacist you trust. Either your oncologist or trusted pharmacist can confirm whether any over-the-counter, herbal, or prescription medicines might potentially interact with the breast cancer treatment.
Some common medicines are:
Antidepressants. Depression occurs when there is a chemical imbalance in the brain that affects mood and emotions. Antidepressants work by balancing these chemicals. Unlike anti-anxiety medicine, which can be taken as needed, antidepressants are taken every day for a certain period of time. It may take six weeks or more for antidepressants to noticeably improve mood. Antidepressants also can improve the quality of sleep and help reduce some breast cancer treatment side effects.
Anti-anxiety medicines. These are typically prescribed for short periods of time to reduce intense feelings of anxiety, fear, or worry, and to calm racing heartbeats and breathing rates.
Medical cannabis. Although further research is needed, some studies have shown that medical cannabis may help reduce anxiety, pain, stress, and insomnia. It’s important to remember that each state has different laws surrounding the use of medical cannabis. 2
Some herbal and vitamin supplements are supposed to help boost people’s moods. Still, it’s important to know that certain supplements can interfere with breast cancer treatment. If you’re interested in taking herbal or vitamin supplements, your oncologist can let you know whether it’s safe for you to take them.
Additionally, if you’re having difficulty sleeping, it can affect your mental health. Although there are sleeping aids that your doctor may recommend, there are ways to treat insomnia without medicine.
Complementary therapies (also called alternative therapies) can help some people better manage the stress and anxiety over a breast cancer diagnosis. If you’re interested in exploring complementary therapies, it’s important to let your medical care team know before you get started.
Some complementary therapies that have been shown to be effective include:
biofeedback (teaches people to understand how stress affects the body and how to control basic functions, such as heart and breathing rates)
progressive muscle relaxation
Some of these complementary therapies require a practitioner. The others can be self-taught or done alone after a few sessions with a certified instructor.
After a breast cancer diagnosis, some people find that making even small lifestyle changes can help improve their overall well-being. Some of these adjustments include:
Eating nutritious foods. A healthy, well-balanced diet and keeping properly hydrated can strengthen your body and mind.
Getting good sleep. Most adults need at least seven hours of sleep each night. Still, people who’ve been diagnosed with breast cancer may need more hours of sleep. Emotional health can have a big effect on how much and how well someone sleeps. It’s a good idea to talk with your doctor if you are having trouble falling or staying asleep or feel excessively tired in the morning when you wake up. Some people are successfully able to improve their sleep with self-help strategies.
Keeping your body moving. According to the American Psychological Association, more research is needed to see if there is a link between regular exercise and brain chemicals associated with stress, anxiety, and depression. Still, many psychologists recommend regular exercise because it can lead to other healthy habits, like eating nutritiously, socializing with others, and getting a good night’s sleep — all of which can improve mood. Research also shows that people diagnosed with breast cancer who exercise may have a lower risk of recurrence. 3 It’s important to remember to talk to your doctor before starting any exercise routine.
Quitting smoking and limiting alcohol. Drinking alcohol and smoking cigarettes can actually make anxiety and symptoms of depression worse. If you would like to cut back on drinking alcohol or smoking, it makes sense to talk with your doctor.
Any type of therapy, whether it’s an individual or a group session, is confidential. It’s absolutely up to you whether you want to tell family and friends that you are getting therapy.
Written by: Carolyn Sayre, freelance writer
American Psychological Association. Acceptance and Commitment Therapy. Available at: https://www.apa.org/pubs/books/4317286
American Cancer Society. Marijuana and Cancer. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/complementary-and-integrative-medicine/marijuana-and-cancer.html
Cannioto RA, Hutson A, Dighe S, et al. Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival. Journal of the National Cancer Institute. 2021. 113(1); 54-63. Available at: https://doi.org/10.1093/jnci/djaa046
— Last updated on August 24, 2022, 9:25 PM
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