Having a cancer diagnosis is a highly significant moment in your life, so it is normal for you to feel scared and stressed. When treatment is finished people expect you (and maybe you expect you) to be getting on with your life. But often this is when you can feel the most anxious.
It can be helpful to think about it this way: imagine you are a young gazelle with not a care in the world. Then a lion comes along out of the blue and eats your best friend. From now on, you are going to be more vigilant. You are not just looking out for lions, but anything yellow will be worrying, the movement of grass, and even the time of day the incident happened could be a trigger for anxiety. This vigilance is natural. On the most basic level, it enables you to stay alive and avoid the lion coming to get you. This natural reaction (known as fight or flight) is really helpful in short bursts, making the body react more rapidly. While short bursts of anxiety can be manageable, even helpful to get things done, too much can be exhausting, overwhelming and debilitating.
During treatment, many people manage well. You will have had a clear sense of purpose – an aim (getting through treatment) and a plan of action (how you were going to get there, for example counting down chemotherapy sessions). However, when treatment ends, that structure drops away – you are no longer fighting, no longer have a routine and set of goals in the same way. There is now a loss of an obvious focus. You have also lost the regular medical support from your healthcare team; reassuring medical surveillance and the comfort of ‘something being done’. On top of all that, you may have lost some of your social support, as people around you get back to life as it was before, and assume you will too.
So don’t be surprised if, at a time when you are expecting to feel happy and relieved, you actually feel worse. You may feel an over-awareness of danger called ‘hypervigilance’. Essentially, with a new, heightened sense of mortality, you’re looking out for lions (or early signs of lions). Except that, of course, it’s cancer, or early signs of it.
Most people I see never resume the old ‘normal’ again. But here’s the good news. The 'new normal' can be better. It can bring a better perspective on what matters, and what doesn’t; a better appreciation for the richness of life.
Thanks to Dr Dominic Bray, Consultant Clinical Psychologist at the Southport and Ormskirk Hospital NHS Trust for answering this question
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6 November 2019