You do not have to wait for a crisis
Many people with cancer, and many of the people who love them, put off asking for emotional support. Some feel they should be able to handle it. Some worry that needing help means they are coping badly. Others assume a psychologist is only for people who are falling apart.
Distress is an expected part of living with cancer, not a personal failing. The National Cancer Institute describes a range that runs from normal adjustment, where a person gradually finds ways to manage, through distress that begins to affect quality of life, to more serious problems such as major depression. Help from a professional can be useful anywhere along that range, not only at the far end of it.
The American Cancer Society notes that it is normal to need extra help when you are dealing with cancer, and that many people who could benefit from support services never use them, often because they do not know about them or how to find them.
Signals worth paying attention to
These are not a checklist or a test, and none of them is a diagnosis. They are patterns that people often describe before deciding to talk with someone:
- The heaviness is not lifting. Fear or sadness used to come and go, and now it is there most days.
- It is shaping your choices. Worry makes it hard to take in information, keep appointments, or think through a decision.
- You are holding it all in. You protect family and friends from how you feel, and no one knows how hard this is.
- Home feels different. Arguments, silence or distance have grown since the diagnosis.
- Old pain has resurfaced. Earlier losses, past health scares or older family tension have come back.
- Your sense of yourself has shifted. You feel unsure who you are now, or what you want from the time ahead.
- You simply want somewhere to talk that is separate from your medical visits and your family.
Any one of these is a reasonable reason to reach out. You do not need several, and you do not need to wait for them to get worse.
Turning points when support is often needed
The National Cancer Institute lists times when people are more likely to need their distress checked and treated: soon after diagnosis, at the start of treatment, at the end of treatment, if the cancer comes back, and if the goal of treatment shifts to palliative care that relieves symptoms and improves quality of life.
The end of treatment surprises many people. Visits to the treatment team become less frequent, the structure of the past months falls away, and feelings that were set aside during treatment can arrive all at once. If you are at that point, or further along, Therapy for Cancer Survivors looks at support after treatment ends.
Caregivers and family members reach their own turning points, too: a hard conversation with the oncologist, taking on more of the daily care, or watching the person they love go through a recurrence.
When to call your medical team first
Some changes that feel emotional have physical causes, and the reverse is also true. The National Cancer Institute advises talking with your doctor about signs of stress and anxiety to make sure they are not caused by medicines or treatment. New or worsening problems with sleep, appetite, energy, pain or concentration belong with your oncology team, whether or not you also see a psychologist.
Your care team may already be asking about this. The American Cancer Society notes that many experts recommend screening everyone with cancer for anxiety and depression. When someone on your team asks how you are coping, an honest answer gives them the chance to connect you with support, which may be a social worker, a mental health professional, a palliative care specialist or a chaplain.
Questions about medication belong with your physicians or a psychiatrist. A psychologist can work alongside them, and with your written permission can coordinate with your doctors when that would help.
What a psychologist can offer
A licensed psychologist is trained to help people understand and manage strong emotional reactions, including those that come with serious illness. Therapy for cancer-related stress is a conversation, not a medical treatment. It can be a place to sort through fear, grief, anger or guilt, to think about how to talk with family, and to find ways of coping that fit your life during treatment and after it.
There is research behind this. The National Cancer Institute reports that studies of people having trouble adjusting to cancer have found benefits from emotional and social support, including counseling or talk therapy, such as lower levels of depression and anxiety and feeling more hopeful. That does not mean therapy works the same way for everyone, but it is a recognized part of cancer care, not an extra.
Dr. Lehmann, a licensed clinical psychologist in Franklin, Michigan, describes her approach as insight-oriented and integrative: it looks at your history, relationships and current circumstances, alongside practical feedback and coping skills. Read more about cancer-related emotional support. If you are not sure whether a psychologist, a social worker or a support group is the better fit, Psychologist, Social Worker, Psychiatrist, Chaplain: Who Helps With the Emotional Side of Cancer? compares the options.
Taking the first step
Reaching out does not commit you to anything. A first call or message is a chance to describe, briefly, where you are and what you are hoping for, and to hear whether the practice is a good fit. Mention whether you are newly diagnosed, in treatment, finished with treatment, or supporting someone else, and ask whether Dr. Lehmann can help with your situation. If she is not the right fit, it is reasonable to ask for a suggestion of someone who might be.
Appointments are offered during the day, Monday through Thursday, in the Franklin office or by telehealth for clients physically located in Michigan at the time of the session. The New Clients page walks through the steps.