Cancer-Related Post-traumatic Stress

Post-traumatic stress disorder (PTSD) is the inability to get over a traumatic event. It is characterized by living in fear of re-experiencing the trauma, accompanied by intrusive thoughts, nightmares, or flashbacks of the traumatic event.

Though cancer is a traumatic stressor, not everyone who experiences this stressor gets PTSD; the disorder often goes hand-in-hand with depression and anxiety.

In addition to cancer, PTSD can be caused by:

• Serious injury to oneself or others
• Death of a loved one
• Relationship issues (divorce or breakup)
• People who have experienced
  • Military combat
  • Natural disasters
  • Violent personal attack
  • Other life-threatening stress

Cancer-related post-traumatic stress disorder (PTSD) can develop due to:

1. Accepting the reality of cancer
2. Pain or other physical problems caused by cancer
3. Undergoing regular and frequent tests and treatments
4. Receiving upsetting test results
5. Extended hospital stays or treatments
6. Cancer relapse or fear of relapse

Certain people with cancer are more likely to develop PTSD, such as those with the following:

• Another mental health condition
• Single or living alone
• Minority women who are highly stressed
• Use of drugs or alcohol
• No complete formal education
• Low or no income

Cancer survivors may have some symptoms of traumatic stress even if they do not have full-blown post-traumatic stress disorder (PTSD). Symptoms may emerge shortly after a diagnosis or appear after months or years.

An upsetting event may trigger symptoms of cancer-related PTSD. Neutral triggers (smells, sounds, and sights) that occur simultaneously as upsetting triggers (chemotherapy or painful treatments) cause anxiety, stress, and fear even after the trauma has ended.

The traumatic event may cause symptoms such as:

• Flashbacks or nightmares
• Avoiding places, events, people, or things related to bad memories
• Feelings of fear or anger
• Feelings of guilt, hopelessness, or shame
• Complete loss of interest in activities that were once enjoyable 
• Hypervigilance
• Startling easily
• Inability to concentrate
• Insomnia
• Negative self-perceptions
• Palpitations or shortness of breath
• Self-destructive behavior (misusing drugs or alcohol)

PTSD can exaggerate the risk of other problems, including depression, alcohol and drug abuse, and eating disorders. PTSD can also affect relationships, work, and social life.

Treatment for cancer-related post-traumatic stress disorder may vary depending on the degree of severity:

• Medications: Antidepressants and antianxiety drugs help manage symptoms of post-traumatic stress disorder (PTSD), such as sadness, anxiety, and anger.
• Psychotherapy: Cancer patients or cancer survivors may benefit from cognitive behavioral therapy (CBT).
• Other approaches: Crisis intervention techniques, relaxation training, and support groups may help with symptoms of PTSD.