Post-traumatic Stress Disorder and Cancer

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder. Some people develop PTSD after experiencing a frightening or life-threatening situation. PTSD is most often referred to in situations such as living through war, a sexual or physical attack, abuse, or a serious accident. Cancer and cancer treatment can also cause PTSD. For example, one study shows that nearly 1 in 4 women who had recently been told they had breast cancer had PTSD.

What are the signs and symptoms of PTSD?

Signs of PTSD include feelings of anxiety that do not go away, keep getting worse, and may affect your daily life.

Other signs of PTSD include:

• Having nightmares and flashbacks
• Avoiding places, events, people, or things that bring back bad memories
• Strong feelings of guilt, hopelessness, or shame
• Trouble sleeping or concentrating
• Continuous feelings of fear or anger
• Loss of interest in activities and relationships that used to be enjoyable
• Self-destructive behavior, such as misusing drugs or alcohol

You may also have frightening or unwanted thoughts. Or you may have difficulty feeling any emotions at all.

How can cancer cause PTSD?

PTSD can happen after you go through an event or see an event that is traumatic. Often, this is a life-threatening event, but not always. You may develop PTSD from cancer for several reasons. These include:

• Learning you have cancer
• Having pain or other physical problems caused by cancer
• Getting tests and treatments
• Receiving upsetting test results
• Long hospital stays or treatments
• The cancer's return or fear of its return

What are the risk factors for PTSD?

It is not clear why some people develop PTSD while others do not. Certain factors may make you more likely to experience it. Learning you have cancer at a young age is one factor. One study found that survivors of childhood cancer were at greater risk of developing PTSD. People who had longer, more intense treatment were especially at risk. Another study found that almost 1 in 5 babies and preschoolers with cancer have PTSD.

PTSD from cancer also seems to be more common in:

• People who had PTSD or another mental health condition before learning they had cancer
• Women from minority groups
• People with high stress levels
• People who use drugs or alcohol to avoid stress
• People with less formal education
• People with low or no income
• Single people

PTSD is less likely if you:

• Get strong support from family and friends
• Have correct information about the stage of the cancer
• Have good relationships with your health care team members

Can caregivers get PTSD?

Yes, PTSD can also affect caregivers. Learning that a loved one has cancer, seeing them in pain, and going through a medical emergency can cause trauma. A caregiver may develop PTSD during the treatment period. Or they may develop it afterwards, even years later.

One study found that almost 1 in 5 families with teenage cancer survivors had a parent with PTSD. Research also shows that parents of children receiving cancer treatment often develop stress-related symptoms.

What can I do about PTSD symptoms?

PTSD is different for each person, and symptoms can come and go. You usually develop symptoms within 3 months of a traumatic event. But they can also occur several months or even years later. Talk with a member of your health care team if you have any of the symptoms above for more than a month.

If you are experiencing PTSD and you have cancer or are a cancer survivor, you should seek treatment for your PTSD symptoms. This is important because some people with PTSD may avoid the tests, treatments, and survivorship care they need. It can also raise your risk of other problems. These can include depression, alcohol and drug abuse, and eating disorders. PTSD can also affect your relationships and work.

How is PTSD treated?

Treatments depend on your specific symptoms and situation. Common treatments are listed here and are often combined.

Psychotherapy. This means talking with a mental health professional, like a counselor, who has experience treating PTSD. Some counselors specialize in helping people with cancer or cancer survivors. You may talk with a counselor by yourself or in a group. In the United States, some health insurance companies pay for treatment; check with your health insurance company for more information. Read more about the benefits of counseling.

Medication. Antidepressants and anti-anxiety drugs can help manage such PTSD symptoms as sadness, anxiety, and anger. You may be prescribed medication in addition to counseling.

Support groups. Support groups can help you cope with the emotional stress of cancer. Your group can be a safe place to share experiences and learn from others. Research shows that support groups can help you feel less depressed and anxious and become more hopeful. Learn more about support groups.

Get help with PTSD

Talk with your health care team about help for PTSD. They can help you find support services, including counseling and support groups in your community. Here are some other tips for finding help:

• Contact your local health department, community mental health agency, or family services agency.
• If your job has an employee assistance program, ask if it provides mental health counselor referrals.
• In the United States, ask your health insurance company for a list of local mental health counselors, or check the insurance company's website.
• Use free online referral services, such as the Anxiety and Depression Association of America’s Find a Therapist tool and the Substance Abuse and Mental Health Services Administration’s Behavioral Health Treatment Services Locator. Please note these links take you to other, independent websites.

Questions to ask your health care team

• Tell them about the symptoms that are bothering you the most. Ask, "Do you think I could have PTSD? If not, what else could be causing this?
• What do you recommend to help relieve my symptoms?
• How long can I expect to have the symptoms? Can they be treated?
• Do I need to take medication? Are there other things I can do?
• Can I talk with a counselor about my symptoms?
• Do you know of a support group for people with my type of cancer or treatment? Or can you help me find one?

This information was originally published at https://www.cancer.net/coping-with-cancer/managing-emotions/post-traumatic-stress-disorder-and-cancer.