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Mental Health Care Plays A Crucial Role In Enhancing The Quality Of Life: Psychologist Kajal Shah

Cancer is more than a medical battle; it’s an emotional journey filled with uncertainty and fear. Patients face a rollercoaster of emotions from diagnosis to treatment, including anxiety, depression, anger, and grief. These feelings are normal and essential in the cancer experience. Managing them is vital for maintaining control and hope.

The mind and body are closely connected. Mental well-being plays a significant role in the body’s ability to cope and recover from cancer. When the mind is at ease, the body can focus on healing.

In our conversation today, we have the privilege of speaking with Kajal Shah, a psychologist. She sheds light on the intricate relationship between mental health and managing a deadly disease like cancer, offering valuable insights into the emotional and psychological challenges faced by patients and caregivers, as well as her expert approach to addressing these issues.

What mental health issues are usually seen amongst cancer patients in your professional experience?

Many of the cancer patients I know have clinical depression or anxiety disorders like obsessive-compulsive disorder. Depression is one of the most reported mental health disorders in the general population, characterized by low mood, sadness, or loss of interest in activities that otherwise provide happiness or pleasure.
Just like fear and stress related to diagnosis often manifest themselves in the form of anxiety disorders like obsessive-compulsive disorder. Most of these disorders get diagnosed after cancer diagnosis, which means that the news linked to cancer and subsequent cancer treatment is what influences the mind. I also know a few cases where patients were diagnosed with schizophrenia after cancer, though it is usually rare. It depends on the patient and their ability to receive a piece of news like a cancer diagnosis.

Why do patients and caregivers experience these emotional and psychological challenges?

A cancer diagnosis is devastating, and it takes a massive toll on not just the patient but their families as well—especially those patients below 18 years of age. Most of them don’t know how to process the information, and their ability to function mentally and emotionally depends on their parents. Patients often suffer from overwhelming sadness or fear when they are diagnosed.

In general, patients enter a state of denial. I have interacted with people who say things like, “I don’t smoke, I haven’t done anything wrong” or “My child has done nothing wrong. He has no bad habits, but why does he have cancer?” The state of denial then leads to anger and depression, which, in turn, hampers the person’s quality of life.

In addition to that, we know that cancer treatment methods like chemotherapy and radiation therapy lead to a lot of side effects like nausea, fatigue, mouth sores, and more. Enduring these physical challenges also tends to take a toll on an individual’s health. Other than the conventional treatment of mental health disorders, it is essential to approach patients psychologically in a sensitive manner.

Cancer is a disease that is notorious for its deadly outcome. People know for sure that the ultimate end is inevitable. A lot of patients I know tend to accept that outcome and sometimes avoid treatment, saying things like, “What is the point of going through all that if death is a surety?” This mindset is fueled by a lack of awareness, which is a massive stone that is dragging people down the ocean. A lot of patients don’t have or cannot access all the information they are supposed to get. Oftentimes, they search on Google, but they get bombarded with a lot of unwanted information, leading to a state called cognitive overload. Cognitive overload is a state of mental exhaustion that occurs when the demands placed on working memory exceed its capacity and lead to burnout and stress. We have to give the right counselling.

How do you approach this scenario as an expert?

My role is to psychoeducate the patient, a process that combines the elements of cognitive-behavior therapy, group therapy, and education to provide knowledge about cancer to patients and their caregivers. The process itself is curated based on the cancer type and expected prognosis. The thing about prognosis is that it is too unpredictable for us to know the sure outcome. So, we provide the required information and then approach the patient and caregiver in a way they receive the diagnosis positively.

As professionals, we tell patients that “yes, cancer can be cured. You can fight this, and here is how. You need to be positive because a positive mindset influences the body.” We explain the connection between the mind and body and how they are interlinked when it comes to the quality of life. The body listens to the mind, so when it faces negativity, it reacts negatively, manifesting in the form of physical distress as well. Along with the advice of the oncologist, we counsel the patients to develop a positive mindset.

To help my patients develop a positive mindset, I sit down and talk to them about the treatment options and why it is imperative to face this scenario with a positive mindset. I share success stories of cancer patients and how everybody’s journey is different.

What about patients in later stages of cancer with a low prognosis? How do you approach them?

This is a very important question. Patients with a low prognosis or terminal patients have to be dealt with in a sensitive way because we don’t want to discourage them from undergoing treatment no matter what. Sometimes, the treatment can work wonders and literally extend their life or put them in remission. So we focus on that aspect. Other than that, our focus is on the quality of life. So, it is important to tell them not to stick to one idea about their condition. They need to be told what to expect and what not to expect. Then, we guide the parents on how to approach their loved ones affected by the disease and all the roles they can play as caregivers to enhance functionality. For example, if a patient cannot walk, then we counsel them about things they can do while being in one spot or while sitting on the bed. Patients look for a purpose, something they can do as opposed to being bedridden or sick all the time. Enhancing the quality of life alone is a victory against a deadly illness like cancer. Instead of counting the days until their ultimate death, patients get to make the best use of their strengths, and that change in mindset alone makes a lot of difference.

Several studies have linked cancer with mental health disorders. Do mental health diseases lead to cancer, in your professional opinion?

There are plenty of studies that link mental health diseases to cancer. There is much ongoing research as well, but we still don’t have clear-cut proof to show or warn patients about. We can’t say with certainty that a particular mental health disease can lead to cancer. However, it is important for people to know that the body and mind are connected and are dependent on each other. In addition to that, it is a universally known fact that cancers result from lifestyle habits, lack of proper nutrition, and poor immunity. Any habit that leads to poor immunity or malnutrition can lead to cancer. There is no direct link between mental health diseases and cancer, but when you look at them indirectly, poor mental health leads to low mood, stress, and poor self-esteem, which leads to poor eating habits or self-destructive habits like alcoholism, smoking, drug abuse, and more. Poor eating habits alone lead to malnutrition and immunity issues. This is why mental health issues should not be disregarded, and people should be encouraged to communicate better in order to address them from the root level.

Should mental health treatment or counselling be made a mandatory or a crucial part of a package involving holistic treatment of cancer?

 Mental health disorders require individual attention and treatment for a better quality of life. People with depression require anti-depressants, cognitive behaviour therapy, and more. I would suggest that counselling be made mandatory for cancer patients and their families for a better result of holistic treatment. Especially if the cancer patient is a child or an adolescent because they are the ones who struggle to communicate, as I mentioned in the above paragraph. Counselling will ensure that the patients get the right information as opposed to the wrong ones they get from online platforms or other unreliable sources. Counselling will ensure that they get to receive the treatment with the right mindset and build a strong and positive outlook for the future. Counselling plays a crucial role in enhancing the quality of life and showing that, yes, the patient has a lot of qualities and so many options to explore. Courage and confidence make the foundation for success in any battle.

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