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Madison, Wis. — When you experience an unexpected change in your health – a diagnosis, an injury or even a surgery – it can feel as if your world has turned upside down. And it can affect the whole family.
UW Health psychologist Shilagh Mirgain, PhD, said that feelings of fear, sadness, anger and worry are all normal.
“It can be difficult to accept, and there are times where you may even feel like it’s not true,” said Mirgain.
Common feelings when experiencing a health crisis
It is natural to experience a range of emotions when someone is first diagnosed with a disease like cancer or diabetes.
Shock: In the beginning, feelings of confusion or being overwhelmed are normal. There may even be times a person doesn’t believe the diagnosis or acts as though it’s no big deal.
Fear / Helplessness / Confusion / Worry: With any diagnosis there are suddenly a lot of unknowns and the big questions start to come up. “There are often so many threats to security,” said Mirgain. “Big questions like, What will happen to me? My family? My job? And if lifestyle changes are needed, like quitting smoking or changing eating habits, that creates even more pressure.”
Anger / Frustration / Irritability: There can be a lot to get angry about. Frequent doctor appointments. Giving up favorite foods. Not being able to do certain things. All of the changes and demands may leave a person feeling frustrated and less patient with others.
Sadness / Grief / Depression: Mirgain said that a sense of loss is to be expected. “It’s common to feel discouraged and even inadequate. Feelings of guilt and a loss of self-worth are also common. It may even result in avoiding being around family and friends.”
In many instances, the different feelings ebb and flow, but eventually become less intense as time progresses. Mirgain said that if the negative feelings persist or cause significant upset, it is important to speak with a primary care physician about it.
“Everyone is different, so while we say feelings are 'normal,' it’s important to remember that everyone experiences things in their own way,” she said, noting that it’s important to keep some perspective. “When a person’s health condition changes or they receive a diagnosis or experience an injury, they’re confronted with their own mortality. Their bodies may have changed; there may be scars or a loss of mobility. All of these things require a lot of psychological adjustment.”
Issues to watch out for
To help cope with the new reality, Mirgain suggests it’s important to recognize some common behaviors that can develop as result of a change in health status.
The broken alarm signal
Our bodies can send us signals all the time – increased heart rate, aches, pains, etc. After a diagnosis, even the slightest aches can take on greater significance due to worry that it's a sign of something more.
“A person who needed a stent might become preoccupied with their heart beat, noticing aches and pains in their chest and become afraid they’re having a heart attack,” said Mirgain.
The challenge is that the worries can persist, despite reassurance from doctors, trips to the Emergency Department and even medical tests.
"The health anxiety becomes a vicious cycle and can actually create physical symptoms – increased blood pressure, increased heart rate, irregular breathing patterns. These symptoms can lead to even more visits to the doctor. This is what I refer to as a 'broken alarm signal,' " said Mirgain.
She stressed that the bodily sensations are real, it’s just that they’re not interpreted accurately and often, people start looking for problems and become pre-occupied with finding them. Eventually, individuals may stop traveling because they don’t want to be too far from their home or medical team. They may even avoid going out to avoid germs, or stop doing things they enjoy because they suddenly feel too risky.
“It’s important to talk with your physician about any concerns,” said Mirgain. “But at the same time, it’s important to recognize that it’s not the symptom causing our anxiety, it’s the meaning we give to it.”
She gives the example of being out for a walk and feeling pain. It’s normal to feel aches and pains in our bodies. Before leaping to the conclusion it’s something terrible, it can be helpful to have coping statements.
"If you're out for a walk and feel an ache or pain, rather than stopping the walk out of fear it’s something more, it can be helpful to say to yourself, 'This is just a normal ache. I can continue to enjoy this walk with my friends,' " she said, adding that it can be tricky. "You don’t want to dismiss pains, but at the same time, it is important to keep them in perspective."
Creating a victorious cycle
While health anxiety can lead to a vicious cycle, Mirgain recommends creating what she calls a "victorious cycle."
"You can re-commit to working on goals around making healthy lifestyle changes, which can help create a sense of taking charge," she said.
Mirgain recommends taking one action a day in the direction of your health, whether that’s exercise, drinking enough water, relaxing or finding social support. Research suggests that people with more social support tend to feel less anxious and depressed and have a better quality of life when diagnosed with a chronic medical condition. Attending a support group, joining an online community or even talking to other patients in the waiting area of the health clinic can help create a connection with others.
"It can feel personal, like you’re the only one going through this, but the reality is that there are others who are experiencing similar things. Finding support can help make it feel a little less overwhelming,” said Mirgain.