If You Or A Loved One Are Cancer Survivors, You May Be Suffering From PTSD (Here’s How To Tell)

Although post-traumatic stress disorder (PTSD) is most often associated with war veterans and victims of assault, there's growing evidence that cancer survivors suffer from it, too.

Here's what you need to know about the effect of PTSD on cancer survivors.

What Is PTSD?

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that affects people who have experienced a traumatic event such as:

war or a combat experience
a violent assault (such as rape)
a natural disaster
a serious accident or illness (such as cancer)

Even though most people think of PTSD as a post-combat issue, it affects far more people than that.

It can affect anyone who has experienced a traumatic event, whether through first-hand exposure or even indirectly (such as the violent death of a loved one).

And women are twice as likely to develop PTSD than men are.

Regardless of the cause for PTSD, those affected by it have disturbing, intense thoughts relating to their traumatic experience that last long after the event occurred.

Until relatively recently, there hasn't been a lot of research relating to PTSD in respect to cancer survivors.

But that's starting to change, and there's growing evidence that life-threatening illnesses like cancer can precipitate the disorder.

Although it's still unknown how many cancer survivors are affected by PTSD, one study suggests that 1 in 5 cancer survivors suffer from PTSD six months after diagnosis.

The same study showed that about 6 percent of cancer survivors are still affected by PTSD four years after diagnosis, with over 34 percent of those people experiencing persistent or worsening PTSD symptoms.

So, can cancer survivors have PTSD? Unfortunately, yes — it's more common than you probably imagined.

From diagnosis and into remission, each state of a cancer survivor's journey creates physical pain and/or burdens and emotional and mental trauma.

It only makes sense that these would cause stress and anxiety.

Here are the 3 stages of a cancer survivor's journey and how the emotional trauma may contribute to the eventual development of PTSD:

1. Pre-diagnosis and diagnosis

When it comes to cancer survivors and PTSD, there's one unique aspect: The trauma doesn't necessarily occur at the time of diagnosis.

There's an insane amount of fear that accompanies the pre-diagnosis phase.

It comes from the fact that you're constantly being reminded you could have cancer.

You're spending an inordinate amount of time with doctors and at the hospital.

And you're being subjected to a number of tests that aren't normal, are uncomfortable, and might even scare you.

Case in point: I spent 3 full days at my local hospital going between my doctors and a number of tests to figure out what I had, how bad it was, and what to do about it.

One of those was an MRI, which I'd never been subjected to before.

I found out the hard way that they make me feel claustrophobic and very anxious.

The worst part of the pre-diagnosis phase is the loss of control over your life and your future.

This lack of control is exacerbated by the fact that you don't yet know what's going on — and that only increases the fear.

The entire experience is a recipe for trauma, high levels of stress, and serious anxiety.

And then there's the obvious emotional trauma caused by diagnosis itself.

2. Cancer treatment

Cancer treatment makes you feel like crap physically and leaves an emotional toll.

No matter what treatment you endure, it will zap your energy, have unexpected physical and mental consequences, and make you feel vulnerable.

The entire cancer journey batters your body and soul. It saps your emotional reserves and forces you to question yourself and your life in new, unexpected ways.

For example, during chemotherapy, you may endure extreme stomach pains and unbelievable physical exhaustion.

Some of these feelings and pains you'll expect, but not to the degree in which you experience them.

The lack of control doesn't go away after diagnosis.

If anything, it gets worse because of the questions popping into your head about what will happen that no one can answer.

3. Post-treatment triggers

Many cancer patients go through treatment yearning for the day when treatment ends.

But then that day comes ... and it's not the celebration they expected.

Your body, mind, and soul are battered during treatment. That doesn't just go away because treatment has ended.

Instead, you're now dealing with the long-term physical and emotional effects and trying to figure out your new "normal".

None of this is easy and all of it is stressful and even traumatic.

Moreover, even if you're cancer-free, the fear that cancer might come back will be ever-present.

And going back to visit your doctor for post-treatment appointments and tests can be stressful and might trigger an emotional response.

So how can you tell if you or a loved one has PTSD following a cancer diagnosis?

Here are 4 important signs of PTSD in a cancer survivor:

1. Avoidance

Avoidance is exactly what it sounds like: Anything that reminds you of cancer or the related traumatic experiences must be ignored.

You might avoid anything that brings upsetting memories.

Additionally, you might try to avoid talking about or remembering anything that triggers unwanted feelings.

Here are a few ways that avoidance might show up in cancer survivors:

Not wanting to talk about anything that reminds you of the diagnosis, treatment, or risk of recurrence
Skipping post-cancer doctor appointments
Resistance to talking about how you feel about it

2. Invasive thoughts

Invasive thoughts can come in several forms, such as through dreams, memories, and flashbacks.

They might be spontaneous or cued by something that reminds you of the event. They're distressing and relate to memories of the trauma itself.

These might appear as:

Recurrent dreams relating to your cancer experience or fear of recurrence
Mentally replaying traumatic aspects of treatment or diagnosis
Feeling profound psychological distress when visiting your doctors post-treatment

3. Reactive symptoms

Symptoms of reactivity and arousal are common among PTSD sufferers and include:

Angry outbursts
Reckless and/or self-destructive behavior
Difficulty concentrating
Being easily startled or having an exaggerated startle response
Being overly irritable
Having difficulty falling or staying asleep
Being constantly on guard or hyper-vigilant
Having panic attacks

These could show up in cancer survivors in various ways.

You might call your doctor every time you're tired or feel a bump due to your fear that it's a sign of recurrence or metastases.

Perhaps you internalize this fear and instead become irritable and angry much of the time.

4. Negative thoughts and feelings

These can include:

Distorted beliefs about yourself
Feeling detached or numb
Feelings of guilt, anger, fear, and/or shame.

You might believe your cancer is your own fault — and feel extreme guilt or shame over it.

Negative thoughts could also present as a persistent fear of recurrence that overcomes your ability to live normally.

Moreover, you might withdraw from being around family and friends or become numb to activities you previously enjoyed.

So what should you do if you see signs of post-cancer PTSD?

The symptoms described above can be experienced by many who have gone through something traumatic (including cancer survivors).

It's not PTSD unless you've experienced symptoms for at least one month and they're affecting your ability to function normally.

Most people with PTSD develop symptoms quickly after the traumatic event occurs — usually within a few months.

However, sometimes the symptoms can appear later.

Be aware of the symptoms and on the lookout — whether as a survivor or for family or friends who've been diagnosed.

PTSD is nothing to be ashamed of, and it's not your fault. The best thing you can do is to admit you're having trouble and get help.

And let me be clear: You don't have to live with PTSD.

Although your journey won't likely be linear, you can get better over time, but you're not as likely to get over PTSD without help.

If you feel that you might be suffering from PTSD (or someone you know might be), then ask your doctors or someone you trust for a referral to a specialist.

If you believe that you or someone you love is exhibiting signs for PTSD, there's hope. Please reach out and get help.

Heather Moulder is an executive coach, attorney, and founder of Course Correction Coaching who is also a cancer survivor. Connect with Heather for tips and strategies on how she can help you overcome the difficulties of a cancer diagnosis and get through your post-treatment PTSD.

This article was originally published at Course Correction Coaching. Reprinted with permission from the author.