Anxiety in palliative care

Having a serious illness introduces many surprise twists and turns into our life, along with uncertainty, unclarity, and loss. Like the feeling of pain, anxiety functions as a warning and serves to protect our life. Sometimes anxiety only manifests itself as physical symptoms, in which case we may not even identify the problem as anxiety.

Symptoms

There are many levels of anxiety. It can be

• mild, increasing psychological strength and concentration;

• moderate, and easy to manage; or

• severe, causing a great deal of suffering.

Common symptoms of anxiety include elevated heart rate and blood pressure, nausea, loss of appetite, insomnia, restlessness, increased uncertainty, and increased attention to physical symptoms. Anxiety may feel like being under pressure, making it more difficult to think clearly or to focus on activities, even ones we enjoy.

Anxiety affects our concentration and memory, even in the case of things familiar to us. When we experience anxiety, our thoughts and emotions are out of our control, and we may experience rapid mood swings. These mood swings, in turn, may distort our thinking.

Prevalence

It has been estimated that every other patient receiving palliative care experiences anxiety that warrants attention, and in 10 to 20 percent of the cases, the anxiety is severe and requires medical treatment.

Causes

There are many potential causes of anxiety. It may be related to a crisis caused by illness, psychological strain, or insufficient management of physical symptoms such as pain or side effects of medications. When it comes to changes in things or situations that are important to us, we all react with anxiety. Anxiety motivates us to take care of ourselves and to seek help; however, when anxiety becomes severe, it only serves to paralyse us.

In addition to illness, anxiety is impacted by all other factors causing strain in our life, but also by the help available to us.

Identifying anxiety

Once we are able to identify the anxiety in our mind and talk about it, both our physical and psychological symptoms often become easier to cope with. When it comes to treating anxiety, the primary aim is to restore a sense of security and control over one’s life. If we can identify the things weighing on our mind, we can start to look for solutions as well. Remember to be patient, and don’t hesitate to seek out more information.

Contact with professionals

In preparation for appointments with the doctor or nurse, it’s advisable to think of things weighing on your mind and write them down, if needed. It’s also a good idea to talk to your care team about whether your contact with healthcare professionals should be made more frequent due to the anxiety you’re experiencing. It might be a good idea to ask someone close to you to accompany you to your appointments. Being alone or feeling lonely increases anxiety and insecurity, whereas sharing your feelings makes them easier to bear.

Anxiety may also be connected to doctor’s or nurse’s appointments involving discussions of the progression of illness or new developments related to treatment.

Talking about things weighing on your mind

Things contributing to anxiety often include concrete worries and fears that may be eased by talking to the care team or going over treatment guidelines. Seeing a social worker, home care worker, hospital chaplain, or psychologist, or meeting up with family members, and naming and sharing the concerns weighing on your mind, may help you think more clearly, which in turn eases the anxiety.

Treatment with medication

There are various medications available for relieving anxiety, both for short-term and long-term use. Medical treatment of anxiety often combines medication with other treatment methods.

Talking about anxiety

First aid for anxiety can consist simply of being able to tell someone close to us how we’re feeling, and finding the words to explain what is causing us to experience anxiety or a sense of insecurity. This is no easy task, but putting anxiety into words and giving structure to difficult things, both in our mind and in discussions with others, are ways for us to move forward.

In addition to difficult questions, anxiety often stems from negative emotions such as anger, bitterness, and disappointment. When it comes to managing and processing our emotions, sharing is once again key. When we’re alone, we may become trapped inside an emotion that we see as negative, and are unable to move forward.

Finding words for emotions and sharing them

It’s important to try and express our thoughts and find words for our experiences. By talking to each other, we let ourselves be heard and understood better, and we are no longer alone with the things that are causing us anxiety. According to a proverb, “Grief shared is grief halved” – it can likewise be said that “Anxiety shared is anxiety halved”.

Enjoyable activities

Some common ways to control anxiety include physical activity, relaxation techniques, various art therapy techniques, music, or writing, perhaps keeping a journal. Taking part in activities we enjoy can lift our spirits and be an empowering experience, especially if we’re joined by a person close to us.

“Self-Help Program for Anxiety” at Mental Health Hub

You may also want to look up “Self-Help Program for Anxiety”, available at Mental Health Hub. This self-help program contains information and exercises for you to use, whether or not you have a diagnosed anxiety disorder. You can choose the topics and exercises that feel the most relevant to you.