Returning to work has substantial psychological and financial benefits, but it can be scary depending on your level of mental health following cancer. For example, you may be feeling anxious about going back to work and mixing with people following your diagnosis and treatment for cancer; you may be experiencing a level of sadness, loss, or distress faced with an actual or perceived inability to function at the same level you could before cancer; you might have some apprehension about returning to work but basically feel fine and just want to ‘get on with things’; or you may be feeling great and see what you have gone through as providing you with a new perspective on life. Whatever the case may be, each scenario will involve some management of or preventative action to maintain your mental health and prevent against the onset or lessen the impact of mental illness.
Click on the link below that is relevant to you:
I am feeling anxious and/or a degree of sadness in returning to work.
There are many reasons why someone might feel anxious about returning to work (e.g., people seeing and treating you as ‘different’ or “am I up to the physical demands of my job” etc.), all of which are completely normal following the diagnosis and treatment for cancer. Common signs of feeling anxious about being at or even thinking about returning to work may be a shortness of breath (i.e., difficulty breathing at a normal pace), a feeling of tightness in the chest or ‘butterflies’ in the stomach, or a sense of increased heart rate and/or sweating. You may also find that you mind is not your friend at these moments and tells you things like “you can’t return to work”, “you’re not ready”, “you’ll fail”, all with the intention to get you to avoid work and feel the temporary relief associated with the avoidance of work.
To help in these times you may want to learn about the following actions:
The amygdala – the reacting part of our brain – determines our emotional responses by classifying incoming information as either potentially threatening or pleasurable. Whatever is deemed pleasurable goes on to the prefrontal cortex – the thinking part of our brain – where it is analysed before it is responded to. But whatever is perceived as threatening is blocked and instead of moving to the prefrontal cortex results in an immediate reflexive reaction – what is known as the fight, flight, or freeze response.
While this is usually helpful (e.g., if you’re in the way of a moving car), the amygdala doesn’t make a distinction between what is real and what are just perceived threats. Thus, a reactive response might be triggered that is unwarranted and/or problematic. For example, you may freeze in a stressful situation that is not actually dangerous, but just perceived as dangerous like talking in front of a crowd or returning to work. Another name for this type of behaviour is unmindful behaviour (i.e., unmindful because the reaction occurs before your mind gets a chance to think about it). Conversely, when we consciously process information, i.e., when we think about things rather than just react to things, a time buffer is created between input and response which gives us time to analyse, interpret, and choose the best course of action. This is called mindful behaviour, a response that happens after our mind thinks about it.
A focus on the breath helps calm the body by slowing your heart rate, sharpening focus, and supporting brain functioning.
Controlled breathing (i.e, paying deliberate attention to drawing the air into the body, and expelling air out of the body) reduces stress and anxiety by overriding the “fight, flight, or freeze” response that may be set off by the amygdala and in turn gives control to conscious thought (refer to the section on Mindful awareness). When breathing is regulated, the brain is primed to focus, think first, and then respond. However, this requires practise. Learning to focus on and control your breathing can help you to become less reactive and more reflexive when you feel anxious or stressed. As you practise controlled breathing, your brain develops and reinforces the habit of responding to stress and anxiety by focusing on this practice. The more controlled breathing is practised, the more self-managed and mindful you can become.
Our brains have numerous types of neurotransmitters. Neurotransmitters are chemicals in our brain that allow signals to pass between neurons. We know that one of these neurotransmitters – dopamine – plays a role in producing and regulating our positive feelings. Put another way, high levels of dopamine equal feeling motivated to do things and good about the things we do. However, as dopamine levels drop so can our outlook on life. It may be that following the diagnosis and treatment of cancer you haven’t been very enthusiastic about or involved in many things, so as a result you may not have very high levels of dopamine. You will be happy to know, however, that we can trigger the release of dopamine by engaging in or even remembering pleasurable experiences like eating a favourite food, seeing friends, solving a puzzle, or generally accomplishing valued tasks. Yes, that’s right, engaging in or thinking about times when we did something pleasurable actually produces dopamine and in turn makes us feel good about ourselves.
Taking time in your day to schedule pleasant activities not only gives you a chance to refresh and gather your thoughts, but it helps to practice Mindful behaviour, controlled breathing, and trigger the ‘Feel Good’ neurotransmitter (refer to these sections above). Below is a list of ideas that you can do, although you are encouraged to add to this list with your own ideas.
What we believe about a situation can influence the way we feel. Put another way, it’s not usually the actual event that makes us feel good or bad but the way we interpret that event. With this in mind, everyone falls into unbalanced thinking traps from time to time – it’s just part of life – and this is more likely when you feel sad, angry, anxious, or stressed, or when you’re not taking good care of yourself (e.g., like when you’re not eating or sleeping well). Returning to work following the diagnosis and treatment for Cancer can be stressful and therefore a likely time to fall for some common thinking traps. But remember, while these are normal, they are just traps. These ways of thinking can prevent you from seeing what’s really going on in a situation and increases the likelihood of automatic or reactive behaviors.
Some common thinking traps are outlined below:
I feel OK about returning to work and just want to ‘get on with things’.
Surprisingly, you may find that following Cancer treatment you are feeling similar to how you did before your diagnosis, and that may be with or without a level of anxiousness or uncertainty. Whilst you recognise what you have been through is serious, you just want to get on with life. This is great. Below are some things that you might want to consider to assist you to ‘get on with things’:
Set SMART Goals
When setting goals it is helpful to ensure they are Specific (vague goals lead to vague, half-hearted attempts to achieve them), Measurable (you need to be able to evaluate your progress), Achievable (If you don’t own it, you’re unlikely to sustain effort), Realistic (you must be capable of achieving the goal), and Time-framed (you need to have a clear idea how long and how often you will engage in the activity).
The table below can assist you to record your goals and ensure they are SMART.
| S | Specific:
Ensure your goal is specific |
(Insert Goal Here)
|
How will I achieve this SMART goal?
What are the steps I will take? |
| M | Measurable:
How will you measure your goal |
|
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| A | Authentic:
Is it your goal? Will you maintain motivation to achieve it? |
|
|
| R | Realistic:
Is the goal realistic? For example, is it too easy or too hard? |
||
| T | Timely:
Have a time limit. For example, what is the time for me to achieve the goal? |
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Knowing how to effectively problem solve is a useful skill to improve your flexibility and efficiency at home and work. Effective problem solving involves identifying what the current problem is and possible ways to deal with it. You then choose which of the possible ways identified is the preferred or viable option. Once you have decided on the best option, you put the plan into place and finally evaluate how effective it was in solving the problem.
The first step in effective problem solving is deciding if it is an actual problem that can be or even needs solving?
Some questions to ask may be:
If the problem you are worried about is unrealistic and unlikely, and something you have little control over, then although it might appear that it is ‘real’ it may not be an actual problem that needs a solution. However, if the problem is real and something you can do something about, then a problem solving strategy may be a useful way to deal with the problem.
A framework to do this is provided below.
Possible Solution #1(Advantages / Disadvantages) :
Possible Solution #2 (Advantages / Disadvantages):
Possible Solution #3 (Advantages / Disadvantages)
I am looking forward to returning to work and getting back into some usual routines. I feel ready and able to make contributions that matter to me
After what you have been through (i.e., the diagnosis, treatment, and now recovery from Cancer) you can now start to prepare for your return to the same job, new job or maybe study. In fact, you may even have an extra spring in your step as you are eager to get on with things. In order to maintain your enthusiasm and wellbeing it may be useful to check in on some basic strategies to keep you heading in the direction you choose. Here are some effective considerations that may help guide you on your way:
Sometimes we find ourselves living more aligned how we negatively perceive ourselves rather than the values we aspire to. For example, on one hand you might be thinking “I am different, people will treat me as such, so I will stay in the background”, when you really want to pride yourself in being ‘courageous’ in situations and have the confidence to stand out.
Our negative perceptions are usually the result of strongly held ideas about ourselves, other people, the world and the future – formed in childhood – that then lead to a distorted view of circumstances or events. On the other hand, our character strengths are those qualities about ourselves that we value and that matter most to us, like authenticity (being true to who you are), expressing gratitude (being thankful), or courage (standing up for what you believe in). Recognising and using your character strengths may be a helpful way to ensure that the decisions you make when you return to work are in line with what matters most to you.
An example of the benefits offered through expressing gratitude can be seen in the video link: https://www.youtube.com/watch?v=oHv6vTKD6lg
One way to identify your character strengths is by doing the free VIA survey (https://www.viacharacter.org/www/). The survey takes around 15 minutes to complete and when finished you will be provided with a list of your 24 character strengths ranked according to your responses (including your top five). With this knowledge you can challenge any unhelpful perceptions or beliefs you may have and work towards living the life that matters most to you.
Research indicates that poor quality sleep impacts on all aspects of your functioning (e.g., physical, mental and emotional health) and stops you performing at your best. As you return to work it will be important for you to maintain good sleep practice that can support and maintain you to function at your best.
If you are having sleep difficulties, here are 10 important sleep hints that may assist in restoring your sleep balance. If you have no problem with the quantity or quality of sleep you are getting, while you can still use these as a guide they are not essential.
Top 10 Common Sleep Hygiene Tips (in no order):