Scientists have long known that unpredictable circumstances increase stress. Sometimes we seek excitement and the unknown, reveling in the stress of an action-packed movie or a roller coaster at the fair. But when that loss of control is thrust upon us unwillingly, it’s experienced as stress. A mouse in a maze feels greater stress when the shocks come at unexpected intervals or are initiated by unpredictable events, than when they are foreseeable and negotiable. Dealing with a temperamental boss or spouse is more stressful than when life proceeds as expected, even if that predictable life is far from perfect.
For many of us, cancer is a stressful event in large part because it is so unpredictable. The diagnosis comes out of the blue, throws our lives into chaos and commands full attention as we cede control over life to the disease and its treatment. The fear of death is overwhelming as we face the possibility that we might not survive this ordeal. This fear becomes an underlying stress that can take years to disappear, even as we learn to put up a brave front and try to move on with whatever comes next. But the unpredictability of the disease and our response to treatment means the uncertainty and stress continue to build as we try to wrest back control over an interrupted life. Will my cancer come back? Can I work through treatment? Will my job still be there when I finish? How will I pay for it all?
As challenging as this is during normal times, the incremental uncertainty imposed by COVID further heightens the stress. Is it safe to get treatment? Is it safe to delay treatment? How will I pay for treatment now that I have lost my job and insurance? How can I get to treatment or scans or medical appointments without normal transportation options? Is my immune system strong enough to accommodate going out to get groceries? Can I safely hug my child who has been outside to play? When will things be normal again?
While we all struggle with the uncertainty of COVID and its ongoing implications for our lives, the double whammy of cancer during COVID steals away every last bit of control we thought we had over life. Although some may try to convince us that control is an illusion anyway, for many of us, that loss of control and self-determination is highly stressful. And that stress makes us grumpy, angry, sad, even depressed. We don’t know when the pandemic will end, when the local area will open up, when we can safely resume our normal lives, or even what “normal” will mean when the pandemic recedes. It may be months, or even years, before we do.
Talk to Your Doctor
You and your doctor can best weigh the risks of how and when you receive medical attention during the pandemic, and what activities may be safe for you in the meantime. And you can initiate the dialog by calling the office and requesting a phone appointment to discuss your concerns. But, you can’t control when the doctor will get back to you or what the outcome of the conversation will be when she does, so set your expectations accordingly. As Christina told me while she was being treated for her second cancer, “I can’t control this situation. I can keep my house tidy, I can do the laundry, take care of my plants. I can control what I do, but I can’t control the outcome of those actions.”
Despite our limitations, there are some things that experts recommend to help us regain a sense of control over our lives, in some small way, and reduce the stress we feel.
Set Some Goals
Make a To-Do list each day, setting achievable goals and checking items off when accomplished. Anything from making the bed to making a loaf of bread counts. But remember, it’s actions that you can control, not results. The sense of accomplishment that comes with looking at a completed list at the end of the day can help create a feeling of satisfaction and control.
If you relinquish control of things to others, you no longer feel compelled to control them yourself, further reducing stress. Remember driving with a map and trying to find the best route to a new location? Now Google Maps does that for us, and we can just relax and enjoy the ride. Ask others to pitch it. Assign grocery shopping or meal prep or other stressful tasks to family and friends and cross them off the list of responsibilities. It may not turn out exactly the way you would have done it, but sometimes the results are are a pleasant surprise.
Get absorbed in something that focuses your mind and takes you out of the constant state of worry. Not only does it help the time pass, but researchers have found that all sorts of meditative activities actually lower blood pressure, reduce cortisol levels (the hormone that stimulates the body and initiates the fight-or-flight reaction) and reduces stress. While formal cognitive behavioral therapy programs are designed to help you reprogram the brain, any repetitive activity that requires focus and encourages you to break your normal thought pattern will do the trick. Try deep breathing, knitting, meditating, praying, listening to music, singing, Qi Gong, Yoga, Tai Chi, massage. The options are nearly endless, and the benefits palpable.
Change Your Chemistry
Use your body to change your brain. Exercise. Generate some physical fatigue. Exercise releases neurotransmitters in the brain that elevate mood and the relaxation that comes with physical fatigue can help reduce stress hormones. Laugh. Watch a stupid cat video or a silly sitcom. Hug. Get tickled. These activities release oxytocin, the chemical that helps mothers bond with their new babies and creates a sense of calm. Go for a walk in the woods. Inhaling the scent of trees, especially pine and other aromatic trees, a custom referred to as “Forest bathing” in Japan, also helps lower stress hormones in the brain. And if a forest isn’t an option for you, remember even a walk in the park or aromatherapy can help.
Unfortunately, we can’t control the external forces affecting our lives today. But making some small changes in our daily routines can influence how we respond to those forces and help us cope.
Learn more about how you can become more resilient in the face of cancer and COVID stress.