How to manage a mental health condition during cancer treatment

Cancer is intense, but it isn't something you have to go through alone.

As a psychiatrist, I help patients with mental health conditions navigate the physical and mental aspects of their care.

Ahead, I discuss what patients with mental health concerns should know during cancer treatment.

When should I tell my doctor about my mental health history? 

If you have a mental health condition, you may be unsure when to tell your cancer care team. My advice is to do so as soon as possible – even during your first visit.

When your provider is taking your medical history, be sure to mention your mental health just like you would mention any other physical health conditions such as your cardiac history or diabetes. Your mental health is part of your medical history.

What sorts of mental health issues should I tell my doctor about?

Mental health issues to tell your doctor about include, but aren’t limited to: 

• Anxiety
  
• Depression
• Eating disorders
• Insomnia
• Mood disorders
• Phobias
• Post traumatic stress disorder
• Psychosis or schizophrenia 
• Past or current alcohol or drug use
• Past or current instances of self-harm or suicidal thoughts 
• Prior traumatic experiences 

Don’t be afraid to talk about your mental health with your doctor even if you don’t have a formal diagnosis or if you have had challenges with your mental health before but don’t anymore. Mental health struggles tend to flare up when we're under stress. Facing cancer diagnosis and treatment is really stressful, so whatever mental health challenges you’ve had in the past might flare up again. We want to be prepared and available to support you as best we can to either prevent them from reoccurring or catch them early so we can intervene as soon as possible. 

Are any mental health concerns too minor to mention?

No concern is too small to mention. There are things that we can help with that you might not even realize are related to mental health.

Many of my patients see me for very specific concerns. It's not always a major diagnosis. There might be just one piece of treatment that you need support to get through. For example, Psychiatry can help patients who:

• Feel claustrophobic in an MRI machine 
• Feel anxious while wearing a mask during radiation
• Have a fear of needles
• Have bad memories associated with past hospital visits

Your provider would rather have too much information than not enough. It is better for the provider to know about your mental health history so they can decide whether it's something that needs to be addressed than to not have known about it in the first place. 

Does an existing mental health concern affect cancer treatment?

Typically, a mental health condition will not change what type of cancer treatment a patient undergoes.

But that doesn’t mean your mental health history isn’t important. It's actually the opposite! During treatment, your provider will take your mental health history into account to ensure it doesn't make cancer treatment any more difficult than it already is.

Your care team will assess whether your mental health condition could interfere with your care. If it does, they will look for ways to minimize that risk. That way you can focus as much as possible on your cancer treatment. 

Can I keep taking my mental health medication during cancer treatment?

During treatment, a psychiatrist will monitor any mental health medication you are taking, such as antidepressants or anti-anxiety medications. 

In many cases, you won’t need to stop taking your medication. In the rare case that you do need to stop your mental health medication, we will recommend safe and effective alternatives. 

How does my care team monitor my mental health during treatment?

All MD Anderson patients fill out mental health screening questionnaires for depression, anxiety and psychosocial distress during treatment. 

Patients might get tired of answering the same questions, but these screenings help your care team monitor your mental health.

It also allows them to connect you with resources and support from other groups including:

Case Management: Case managers can help patients find mental health support in their community, if that is preferred.

Pain Management: This team provides resources for patients with treatment-related pain. 

Psychiatry: These professionals can prescribe medication, provide counseling and offer other coping mechanisms.

Social Work: Counselors provide resources, education and support to patients at all stages of treatment. 

Spiritual Care: Chaplains and pastors can speak with patients and guide them through spiritual concerns.

Supportive Care: This team helps patients and their loved ones navigate cancer’s physical and emotional challenges. 

How can psychiatrists help patients during cancer treatment?

Usually, your doctor will refer you to Psychiatry, but you can also ask to see a psychiatrist.

Psychiatrists can support patients in a variety of ways. We do this by first understanding what the patient is most comfortable with. Sometimes, this means prescribing medication, sometimes this means therapy; a lot of times it's both. A psychiatrist can also be a safe space to simply talk through what's been going on with you, your diagnosis and your treatment.

On the other hand, sometimes a patient might talk to us and decide neither therapy nor medication is something they are looking for. That is OK, too.

We also meet with patients with a history of mental health struggles that they are currently managing well. It's a good opportunity for us to develop a relationship and talk about past struggles. Then we’re able to pick up on any signs that a mental health concern might be creeping up again; we can nip those things in the bud early on before they become more difficult.

Request an appointment at MD Anderson online or call 1-877-632-6789.