Everyone’s emotional reaction to melanoma is different. As you struggle with issues of diagnosis and treatment, you may also face the social pressures that can even come from well-meaning friends who want more than anything for you to be OK. Psychologists who work with cancer patients have found a pattern of responses that is characteristic of a healthy adjustment. The three phases are initial response, distress, and adjustment. These three phases take you through the normal grieving process which is important to experience.

The initial response is usually shock and disbelief. This is followed by a period of distress that lasts a few days to a week or two and is characterized by both anxiety and depression. As you learn about your options and begin to see a treatment plan form, there is a passage into the adjustment mode.

You may experience persistent sadness, in addition to:

1. Anxiety or depression
2. Decreased sexual interest
3. Fatigue
4. Difficulty concentrating, remembering, and making decisions
5. Insomnia or oversleeping
6. Weight or appetite loss
7. Restlessness and/or irritability

Normally, many of these symptoms would be considered unhealthy, but for a person with a new melanoma diagnosis they are a normal part of the process of dealing with this new reality. However, feelings of hopelessness and guilt are signs that should be considered indicators of more serious distress.

COPING WITH ANXIETY

A melanoma diagnosis is extremely stressful. Here are some tips to help you cope with anxiety:

1. Many people find that knowledge about their disease actually help to alleviate anxiety. Seek information through your physician, the patient education center at the hospital, your local library, and from melanoma online information and support tools.
2. Take control of the things that you have control over, eat a healthy diet, get some exercise.
3. Connect with loved ones.
4. Join one of our melanoma support groups and/or get a “Buddy” from Billy’s Buddies, our patient advocacy and support program.

GUILT

Labels about melanoma can lead to guilt, which can be a huge burden for newly diagnosed patients. You may feel guilt about causing your melanoma, about having your family go through it, or about not being able to do what you did before, even if it is only for a short period of time. It’s not unusual to try to find an answer to why your melanoma developed, but focusing on the cause can lead to additional stress. It doesn’t do any good to look back. You have the capacity to stop blaming and judging yourself by realizing you cannot change the past and must focus on moving forward. Guilt can be a barrier to living your life fully, which is why experts recommend talking through these feelings with a helping professional or support group.

DEPRESSION

Studies show that nearly a quarter of all cancer patients will have symptoms of depression or an anxiety disorder during treatment. However, feelings of anger or sadness about your melanoma and the changes it brings are normal and may actually help you cope. Persistent feelings of helplessness or hopelessness and sense worthlessness are not typical and you should notify your doctor.

When diagnosing depression in cancer patients physicians place more emphasis on symptoms such as loss of pleasure, hope, and self-worth that last for more that two weeks instead of side effects that can also be caused by cancer and its treatments including fatigue and weight loss. In addition, some therapies, including hormone treatments and interferon, are associated with mood disturbances.

According to the National Comprehensive Cancer Network guidelines, patients with a high level of anxiety or depression should consider talking with a mental health professional who can more adequately assess what type of treatment is warranted. Remember, depression is a treatable condition. It’s an illness just like melanoma, so don’t be afraid to get the help you need.