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Emotional Wellness

Emotional Wellness

Emotional health or emotional well-being also called Emotional wellness; is an individual's ability to control and handle their emotions and the different experiences they go through in life. The National Center For Emotional Wellness defines emotional wellness as "an awareness, understanding and acceptance of our feelings, and our ability to manage effectively through challenges and change." Emotional wellness is all about how you feel, How you accept and acknowledge them, how you exhibit them, and how you manage them in a certain way that helps control your cancer treatment and recovery. 

Also Read: Emotional and spiritual wellness

Why is it important?

Anger, stress, panic, agitation, and anguish can all directly affect you and your relationships. You may always think about how to deal with these constant feelings disturbing you. Sometimes, you can find it very difficult to open up about these topics with your family and friends. You will need help, and it is normal to find help during these circumstances but are unsure how to ask for it. All these responses and mind fluctuations can arise at any point in your cancer experience. 

What is the relationship between emotional well-being and health?

Everything in your life — emotional, social, spiritual, physical, and intellectual — connects in a state of well-being, for example, walking just 10-15 minutes a day gives your brain a boost. That means more energy, awareness, and a healthier outlook on life. Because exercise of any sort balances your dopamine and serotonin levels, it also improves your sleep and reduces stress and anxiety. All of this can make you better equipped to manage your feelings and emotions.

Understanding Emotional Wellness in Cancer:

  • Complex Emotional Landscape: Cancer patients often experience a spectrum of emotions, including fear, anger, sadness, anxiety, and hopelessness. Emotional wellness in this context means acknowledging these feelings, understanding they are normal, and finding healthy ways to express and manage them.
  • Stress and Anxiety Management: The uncertainty and challenges of cancer treatment can lead to significant stress and anxiety. Emotional wellness practices can help in developing coping mechanisms to manage this stress, such as relaxation techniques, mindfulness meditation, or engaging in supportive conversations.
  • Depression and Mood Fluctuations: It’s not uncommon for cancer patients to experience depression or mood swings. Addressing emotional wellness includes recognizing the signs of depression and seeking professional help when needed, along with employing self-help strategies to maintain a balanced mood.
  • Coping with Fear of Recurrence: One of the major emotional challenges for cancer survivors is the fear of cancer coming back. Emotional wellness involves developing strategies to cope with these fears, such as staying informed about the signs of recurrence, engaging in regular follow-up care, and finding support in survivorship groups.
  • Building Strength: Emotional wellness is about building strength – the ability to bounce back from difficulties. This can be nurtured through positive thinking, establishing a strong support network, and actively engaging in problem-solving.
  • Communication and Relationships: Open communication with healthcare providers, family, friends and support groups is vital. Emotional wellness in cancer care often involves learning how to communicate needs and feelings effectively and fostering strong support networks.
  • Finding Meaning and Purpose: Many cancer patients find that exploring and engaging in activities that provide meaning and purpose significantly enhances their emotional well-being. This might include hobbies, volunteer work, or advocacy.
  • Professional Support: Accessing professional support, such as counselling or psychotherapy, can be an integral part of maintaining emotional wellness. These professionals can provide tailored strategies to cope with the emotional aspects of cancer.
  • Self-Care Practices: Self-care activities like exercise, a balanced diet, adequate sleep, and relaxation exercises can play a significant role in maintaining emotional health.
  • Spiritual Wellness: For some, spiritual or religious beliefs and practices can offer comfort and strength, contributing significantly to their emotional wellness.

Improving emotional wellness can benefit in things like :

  • It makes you more conscious about your feelings
  • Helps you to learn and understand how to panic less and be more hopeful
  • It helps to handle stress better and improves your mental and emotional health
  • Makes you understand the importance of connections and helps to manage family and friends relationships
  • It allows you to open up about your feelings
  • It allows you to accept yourself and encourages you to ask for help. 

How to improve your emotional wellness?

  • Keep a record and monitor your feelings. Also, note down everything in a book about how you are feeling emotionally. If writing is difficult, you can also track any pictures, sketches, or any kind of music that helps you express what you are going through.
  • Open up about how you are feeling and things you are experiencing with your loved ones. It is sometimes easier said than done as you could think that it can become a burden for your family, but it is very critical to talk to someone you trust. You can also find a support group or any emotional wellness coach.
  • Educate yourself with self-care practices such as mindfulness meditation and conscious breathing practices. Mindfulness meditation is a practice that teaches you to be more aware and helps you stay in the moment. Conscious breathing helps you reduce stress, anxiety, and lack of energy. It can also reduce tension, help you stay focused on the present, and cut down future thinking which can cause a lot of stress for cancer patients and cancer survivors. Sometimes, even simple breathing techniques like pranayama can help improve fatigue, anxiety, depression, and the side effects of cancer. 
  • It becomes essential to tell your medical practitioner about your feelings—That's one of the most crucial steps. The medical practitioner and your health care team will introduce ways so you can have the best quality of life possible. Open up to them about the emotions you are going through before, during and after treatment. Your medical practitioner and the health care team can also recommend you to supportive counselling, and if required, they can examine and help you with anxiety and depression. 
  •   Look for individual counselling with an expert. There are plenty of professional social workers, doctors and psychologists who can help you with the intense emotions you are going through. It is essential to find a counsellor that you can open up and be comfortable with and someone with experience working with patients who have been diagnosed with cancer. 
  • Connect with a support group. It can also be a virtual meeting. Take part in those group gatherings going through similar phases, which can help you feel less lonely and provide help in a safe and supportive environment. If you are joining a support group for the first time, just make sure a professional counsellor is a part of it and is taking charge. 

Also Read: Navigating Emotional Wellness in Cancer Care

The Influence of Poor Emotional Wellness 

In many ways, not working through life with a positive attitude and emotional state can lead to bad outcomes, mainly because a negative emotional state is stressful and a wrong place to be in; hence here are some examples:

  • Low immunity levels: Stress can weaken the immune system drastically.
  • Hypertension: Stress that lasts long can also worsen the blood pressure
  • Increased illness: Stress can affect everything from heart problems to psychiatric issues
  • Relationship issues
  • Mind fluctuations that cause trouble in concentrating
  • Difficulties at work. 

Self Evaluation Questions

  • How do I feel on my emotional level?
  • What can I do to reduce my stress, anger, depression and sorrow?
  • Is there anyone I know who has had cancer who can recommend me to a support group or any professional counsellor if I need help in handling my feelings and mental difficulties?
  • What help will I need from my family and friends during my treatment and recovery?
  • How much will it cost for my treatment and recovery for standard medication? How much will it cost for my complementary medicine?

How to Cope With Cancer

  • Be an advocate for yourself: Learning about your disease, the diagnosis process and the treatments available is significant. Search for accurate, relevant information and speak to others to help you make informed choices and take the right steps you know. This will help to inspire you and relieve some of the negative feelings that go with cancer.
  • Recognize your feelings: Thinking through your cancer feelings can be beneficial because they can influence how you see yourself, your perceptions, actions and your life as a whole. Knowing what emotions you feel will help you to determine why you feel that way, and how to cope with it better.
  • Share your feelings: Research has shown that expressing anxieties and worries with others helps to emotionally support patients. Chat to friends and relatives, or express thoughts in a newspaper or artwork.
  • Turn to spirituality: Silent prayer, meditation, contemplation or turning to a religious leader's guidance could help you find peace and strength through your spirituality and faith.
  • Get help and support: When you feel tired, nervous, anxious or depressed about your situation, do not underestimate the value of finding support.

Managing Stress and Fear

Cancer is painful, almost without a doubt. Moreover, you might have new worries or need to make more decisions right when you think you have got your Stress level under control. Try to note when this happens: Stress is a natural reaction to what I am going through right now. It will then take some time to identify the causes of Stress and establish techniques to help mitigate them. Emotional wellness helps in finding ways to reduce Stress which will improve your physical and emotional well-being.

Not all cope in the same way with pain, Depression, Anxiety, or other negative emotions. Your coping style may have helped you cope very well. Additionally, you may find your old ways of coping do not work and you need to learn new skills. In general, it is safer and healthier to use an aggressive coping strategy than attempting to solve the problem.

Active Ways to Cope

Take action to get rid of the problem

  • Plan how to deal with the problem
  • Look for advice and information to deal with the problem
  • Look for sympathy and emotional support
  • Accept that the problem exists and decide what you can and cannot control
  • Try to get a new perspective by making the best of the situation
  • Become aware of your feelings about the problem and express them to others

Using Avoidance to Cope

  • Deny that the problem exists
  • Withdraw from social experience
  • Avoid any thoughts about the problem
  • Wishful thinking
  • Use drugs or Alcohol to forget the problem
  • Blame and criticize yourself for the problem
  • Keep extra busy and ignore the problem

The research has revealed that quality of life is improved by using emotional wellness programs that include stress management interventions. Some of the essential emotional wellness are discussed below:

Mind-body approaches: They aim to relax the mind and body using various techniques. It focuses on clarifying the mind, improving focus, enhancing decision-making capacity, managing stress or resolving conflict. It also helps reduce pain, fatigue, stress, anxiety, nausea and vomiting, depression, sleep disruption or other symptoms common in cancer and cancer treatments. Some of the techniques are:

Qigong: It is a system of coordinated body posture and movement, breathing, and meditation used for health, spirituality, and martial arts training.

Tai Chi: It is the art practised for defence training, health benefits, and meditation.

Yoga: It is the group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind and gain insights of peace within oneself.

Deep breathing: It is an easy way to relax and let all the worries go away. It requires only a few minutes to carry out this exercise. 

Meditation: It is the practice of paying attention to the present moment with an accepting, nonjudgmental disposition.

Hypnosis: It is the human condition involving focused attention, reduced peripheral awareness, and an enhanced capacity to respond to suggestions.

Music therapy: It is the clinical and evidence-based use of music interventions to accomplish individualised goals within a therapeutic relationship by a trained professional who has completed an approved music therapy program.

Guided Imagery: These practices help reduce cognitive, and emotional stress, and fatigue among cancer patients which has evolved due to the integration of various treatment approaches. It mainly includes motivating sentences, music, and breathing and relaxation training. It has helped cancer patients relax and has been effective in relieving the adverse side effects of chemotherapy, such as nausea, vomiting, anxiety, and depression. It is effective in improving the overall care for patients. 

Cognitive-behavioural therapy (CBT): It is a type of psychotherapy that aims to help patients change behaviour by changing thoughts and feelings. It shows efficacy in treating mental, emotional, personality and behavioural disorders such as insomnia and depression. CBT has also been used to treat anticipatory side effects such as nausea and vomiting during chemotherapy.

Mindfulness: It is the method of achieving a state of mind that is aware and in control. It helps reduce stress, improve physical health, and maintain harmony in life. It is considered an effective pain control method in cancer. Its practice has helped in reducing sleep disorders among cancer patients and survivors.

Art therapy: It uses the creative process of making art to improve cancer patients' physical, mental and emotional well-being.

Biofeedback: It is concerned with electrical sensors or other instruments that report information about body status back to the patient. It aims to make the patient learn to respond to and act on any changes in the heart rate, blood pressure, breathing, muscle contraction, brain waves, sweat glands or skin temperature. 

Zen Integrative Oncology Wellness Protocol 

The emotional wellness  provided by Zen Integrative Oncology Wellness Protocol is discussed below:

Zen Emotional Counselling Protocol: It is integrated for cancer patients and their loved ones. It is a significant step taken to improve the psychological distress of cancer patients. It shows efficacy in improving the quality of life of cancer patients. It reduces stress and promotes mind-body therapies in the form of effective supportive care strategies during and after cancer treatment. The Zen Emotional Counselling Protocol provides 15 sessions with expertise in mind-body medicine for dealing with the emotional distress that occurs due to cancer diagnosis and treatment among cancer patients. The coaches focus on mind-body fitness and ensure that the patient and their families can take the best step forward. The program also includes a dedicated Cancer Coach for round-the-clock care.

Clinical evidence:

The clinical practice guidelines for emotional wellness have included integrating emotional wellness interventions to reduce anxiety, mood disturbance, and chronic pain and improve the quality of life in cancer patients. Clinical practices have shown the efficacy of emotional wellness among cancer patients in various studies. Some of them are discussed below:

  • The incorporation of the mind-body approach has been effective among lung cancer patients in reducing the symptoms and side effects of treatment (Deng et al., 2013).
  • Meditation, music therapy and yoga have shown efficacy in reducing chemotherapy-induced side effects such as nausea and vomiting among breast cancer patients (Greenlee et al., 2017).
  • The integration of cognitive-behavioural therapy, mindfulness, relaxation or guided imagery has been effective in managing chronic pain among the survivors of adult cancers (Paice et al., 2016).
  • Improvement in the immune parameters among women with stage 1 breast cancer has been observed when the patient has incorporated relaxation, guided imagery, and biofeedback (Gruber et al., 1993).
  • CBT effectively reduces anxiety, mood disturbance, and chronic pain and improves the quality of life among cancer patients (Deng et al., 2009).
  • The combination of CBT and hypnosis has effectively reduced the emotional distress among women with breast cancer who have undergone radiotherapy (Montgomery et al., 2017).

By cancer types:

Lung cancer: The emotional wellness in lung cancer patients improves the quality of life and survival rates by adopting to following approaches:

  • Mind‐body approaches: These include Meditation, Yoga, Tai Chi, Qigong, and Cognitive Behaviour Therapy (CBT) stress management. 
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture and Massage.

Skin cancer: The emotional wellness in skin cancer patients improves the quality of life and survival rates by adopting to following approaches:

  • Mind‐body approaches: These include Meditation, Yoga, Walking, Relaxation techniques, and Cognitive Behaviour Therapy (CBT) for stress management 
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture, Acupressure, and Massage
  • Blood cancer: The emotional wellness in blood cancer patients improves the quality of life and survival rates by adopting to following approaches:
  • Mind‐body approaches: These include Meditation, Yoga, Hypnosis, Music therapy, Guided imagery, and Tai chi.
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture, Aromatherapy, and Massage.
  • Energy therapy: It includes a healing touch.
  • Head & neck cancer: The emotional wellness of patients with head and neck cancer involves the following approaches:
  • Mind‐body approaches: These include Meditation, Yoga, Behavioral Therapy, Music therapy, Guided imagery, Tai Chi, and Qigong help in reducing the side effects and stress of treatment outcomes.
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture, Acupressure, Aromatherapy, and Massage.
  • Energy therapy: It includes Reiki.

 Liver cancer: The emotional wellness of patients with liver cancer involves the following approaches:

  • Mind‐body approaches: These include Meditation, Yoga, Behavioral Therapy, Guided imagery, Tai Chi, and Qigong which help in reducing the side effects and stress of treatment outcomes.
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture, Acupressure, and Massage.
  • Pancreatic cancer:  The emotional wellness of patients with pancreas cancer involves the following approaches:
  • Mind‐body approaches: These include Meditation, Yoga, Relaxation therapy, Hypnosis, Biofeedback, and Art therapy that help in reducing the side effects and stress of treatment outcomes.
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture, and Massage.

Brain cancer:  The emotional wellness of patients with brain cancer involves the following approaches:

  • Mind‐body approaches: These include Meditation, Yoga, Relaxation therapy, Hypnosis, Qigong, Cognitive Behavior Therapy (CBT) for stress management, and Cognitive Behavioral Therapy for Insomnia (CBT‐I) that help reduce the side effects and stress of treatment outcomes.
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture, and Acupressure.
  • Energy therapies: It involves Touch Therapy.
  • Bioelectromagnetic-based therapies: These include Optune.
  • Kidney cancer:  The emotional wellness of patients with kidney cancer involves the following approaches:
  • Mind‐body approaches: These include Meditation, Yoga, Relaxation therapy, Hypnosis, Music therapy, Art therapy, Aromatherapy, Hyperthermia and Tai Chi help in reducing the side effects and stress of treatment outcomes.
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture, and Massage.

Breast cancer:  The emotional wellness of patients with breast cancer involves the following approaches:

  • Mind‐body approaches: These include Music therapy, Hypnosis, Expressive art techniques, Cognitive Behavioral Stress Management (CBSM), Relaxation techniques, Cognitive Behavioral Therapy for Insomnia (CBT‐I), Mindfulness meditation, Taichi, Qigong, Stress reduction practices, Yoga meditation, Yoga that help in reducing the side effects and stress of treatment outcomes.
  • Body‐manipulative therapies: It is effective in managing side effects involving Acupuncture.
  • Colorectal cancer:  The emotional wellness of patients with colorectal cancer involves the following approaches:
  • Mind‐body approaches: It includes guided imagery which reduces anxiety, pain and narcotic effects after colorectal surgery.

Ovarian cancer:  The emotional wellness of patients with ovarian cancer involves the following approaches:

  • Mind‐body approaches: These include Meditation, Yoga, Taichi, Music therapy, Relaxation techniques, Hypnosis, Cognitive-behavioral therapy, and Acceptance and Commitment Therapy (ACT).
  • Body‐manipulative therapies: It is effective in the management of side effects involving Acupuncture, and Massage.
  • Prostate cancer:  The emotional wellness of patients with prostate cancer involves the following approaches:
  • Mind‐body approaches: These include Meditation, Yoga, Taichi, Music therapy, Relaxation techniques, Hypnosis, Tai chi, Expressive art techniques, and Cognitive Behavior Therapy (CBT) stress management.
  • Body‐manipulative therapies: It is effective in the management of side effects involving Acupuncture.
  • Energy therapies: It includes Reiki.
  • Bioelectromagnetic-based therapies: These include transcutaneous electrical nerve stimulation (TENS).

Emotional Counseling:

It is integrated for cancer patients and their loved ones. It is a significant step taken to improve the psychological distress of cancer patients. It shows efficacy in improving the quality of life of cancer patients. It reduces stress and promotes mind-body therapies in the form of effective supportive care strategies during and after cancer treatment. The counselling provides sessions with expertise in mind-body medicine for dealing with the emotional distress that occurred due to cancer diagnosis and treatment among cancer patients.

The clinical practice guidelines for emotional wellness have included integrating emotional wellness interventions to reduce anxiety, mood disturbance, and chronic pain and improve the quality of life in cancer patients. Clinical practices have shown the efficacy of emotional wellness among cancer patients in various studies. Some of them are discussed below:

  • The incorporation of the mind-body approach has been effective among lung cancer patients in reducing the symptoms and side effects of treatment (Deng et al., 2013).
  • Meditation, music therapy and yoga have shown efficacy in reducing chemotherapy-induced side effects such as nausea and vomiting among breast cancer patients (Greenlee et al., 2017).
  • The integration of cognitive-behavioural therapy, mindfulness, relaxation or guided imagery has been effective in managing chronic pain among the survivors of adult cancers (Paice et al., 2016).
  • Improvement in the immune parameters among women with stage 1 breast cancer has been observed when the patient has incorporated relaxation, guided imagery, and biofeedback (Gruber et al., 1993).
  • CBT effectively reduces anxiety, mood disturbance, and chronic pain and improves the quality of life among cancer patients (Deng et al., 2009).
  • The combination of CBT and hypnosis has effectively reduced the emotional distress among women with breast cancer who have undergone radiotherapy (Montgomery et al., 2017).

Questions for your medical practitioner or your health care team?

   - How long should I expect to feel sad, anxious, nervous, depressed, and what do I need to do to cope with those feelings?

  • Are there any support groups or private counsellors who can assist me?
  • Is it safe for me to engage in sexual activity, and are there any types of sexual activity that I should avoid?
  • What can I do to reduce or limit the amount of stress I'm experiencing?

With specially designed and personalised programmes, ZenOnco.io can assist cancer patients in attaining emotional and spiritual wellness. With the help of therapy and personalised programmes that provide support and also teach cancer patients to tune in to their thoughts and feelings, develop an optimistic outlook, learn and understand more about stress management techniques, and also, most importantly, find acceptance and forgiveness for themselves, we can also assist patients in their pursuit for spiritual wellness by teaching them medication techniques, curiosity stimulation, training them to see obstacles as an opportunity and also helping them to see the bigger picture in life. 

You can consult our Onco phycologists ZenOnco.io, The world's first integrative oncology health care platform that makes quality integrative oncology cancer care accessible to all. All the emotional wellness programs are provided only after consultation and are based on what is required for the patient. Our In-house Onco phycologists have had more than 10+ years of experience in the field.  

About Zen - ZenOnco.io provides cancer patients with comprehensive care that includes both medical as well as a complementary treatment. Medical treatments can include chemotherapy, radiation therapy, etc. Complementary therapies can consist of an anti-cancer diet, Ayurveda, medical cannabis, etc. When in combination, these therapies can improve the quality of life and also increase the patient's chances of cure.

Elevate Wellness & Recovery in Cancer

For personalized guidance on cancer treatments and complementary therapies, consult our experts at ZenOnco.io or call +91 9930709000

Reference:

  1. Stewart-Brown S. Emotional wellbeing and its relation to health. Physical disease may well result from emotional distress. BMJ. 1998 Dec 12;317(7173):1608-9. doi: 10.1136/bmj.317.7173.1608. PMID: 9848897; PMCID: PMC1114432.
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