Clinical psychologist Dr. Heather Derry-Vick from Hackensack Meridian Health in New Jersey shared several strategies AML patients can practice to help reduce stress and improve their quality of life. Watch her presentation below or read the event’s summary. 

Event Summary

Dr. Derry-Vick explains the relationship between stress and cancer, emphasizing patterns and effects. Recent research findings are highlighted, especially those related to AML patients' experiences. Stress management techniques that patients can implement in daily life are discussed. Patients are instructed when and how to seek support from healthcare professionals, particularly those specialized in stress and coping in cancer care. 

“It's not about eliminating stress but understanding and managing its impact on our lives.” - Dr. Derry-Vick

Signs of Stress

When discussing stress, it's crucial to recognize its signs. Stress occurs when a situation pushes our limits, similar to a rubber band stretching. This can lead to emotional changes, such as heightened feelings of nervousness, frustration, or sadness. Additionally, our thought patterns might become more negative or worrisome. Physically, symptoms like difficulty sleeping, tension, headaches, and trouble concentrating might manifest. While these are common indicators, everyone's experience with stress is unique, and some might have specific signs not listed here.

Stress in AML

AML-related stress persists beyond the initial diagnosis and treatment phases, with different experiences triggering various stress levels over time. It's vital to recognize these patterns and understand that feeling stressed or anxious is a natural reaction. Dr. Derry-Vick’s goal is to equip individuals with coping skills, not to downplay their feelings. The objective isn't to remove stress but to comprehend and mitigate its effects.

Negative Effects of Stress

Cancer-related stress is both common and detrimental, impacting daily functions, social interactions, and physical symptoms. Research on stress often involves surveys, interviews, and observations. A study on AML patients post-stem cell transplant revealed that physical symptoms decrease over time, but anxiety and fear remain consistent. There is a continuous need for stress management throughout a patient's cancer journey.

Coping Strategies

In a study focusing on newly hospitalized AML patients, coping strategies were examined. The results indicated two types of coping methods:

1. Avoidant coping strategies (less helpful): These strategies, like self-blame or minimization, resulted in increased anxiety, depression, and a reduced quality of life.
2. Helpful coping strategies: Seeking emotional support, problem-solving, or seeking information led to reduced anxiety, depression, and an improved quality of life.

The study emphasizes that even during stressful situations, the manner in which individuals cope can significantly affect their well-being.

Stress Management Tools Tips

• The strategies presented are backed by substantial research and clinical experience with cancer patients, attesting to their effectiveness
• Implemented strategies tend to be more effective with consistent practice
• Experiment with the following stress management tools and integrate the ones that work for you
• Set attainable goals, such as reducing stress rather than eliminating it
• Incorporate strategies into daily routines, especially during calm periods to prepare for more stressful times
• Equip oneself with multiple coping strategies to address different challenges

Relaxation Exercises

Relaxation exercises help calm the body and mind. To counter stress, practice a chosen exercise daily for at least five minutes, incorporating it into a regular routine. Relaxation exercises can include:

• Deep breathing: A method where you sit comfortably, slow down your breathing, and focus on inhaling through the nose and exhaling through the mouth, and counting the breaths to enhance awareness
• Mindful breathing: Concentrating on the present moment without altering the breathing pattern
• Focus breathing: A guided mindfulness technique where participants find a quiet place, sit comfortably, and perform a body scan. They observe their natural breathing, intentionally control it, acknowledge distractions, and refocus. The pauses in breathing lead toward meditation, and participants note sensations and feelings before and after
• Muscle relaxation
• Guided imagery

Plan Engaging in Pleasant Activities

Engaging in short, enjoyable activities is an effective coping strategy to enhance well-being. Activities should be enjoyable in the moment and align with one's personal values and strengths. Planning these activities, such as taking walks or phone calls with loved ones, and incorporating them into daily routines can help reduce stress, especially during challenging times like awaiting medical results. Flexibility is essential, and it's crucial to adapt if an activity doesn't bring the anticipated joy. 

Balancing Your Thinking

The skill "balancing your thinking" is based on the idea that thoughts, emotions, and physical symptoms are interconnected. When under stress, these three factors can form a cycle: negative or worried thoughts can lead to heightened stress and anxiety emotions, which in turn manifest as physical symptoms like tension. These physical symptoms can then reinforce negative thoughts, creating a feedback loop. Recognizing this cycle is essential to break the pattern and restore balance in one's thinking and emotional well-being.

Practice Taking a Pause

When stressed, it's important to examine our thoughts to determine if they are negative or unproductive. Instead of succumbing to these thoughts, aim for balanced thinking by considering all aspects of a situation. This includes acknowledging personal coping abilities, seeking support, and recalling past resilience. It can be useful to write down these balanced thoughts to reflect on later, and getting in the habit of writing them down helps create a thinking pattern over time. Practicing balanced thinking can be challenging, but with persistence, it becomes more manageable, and it has been beneficial for many.

Preparing for Appointments

Cancer patients frequently experience stress and anxiety before medical appointments. To effectively prepare, it's advised that they create a list of questions in advance. This can reduce anxiety and ensure important topics are discussed. Utilizing resources like the National Cancer Institute for question guidance and bringing a trusted person to appointments can also help their experience.

Additional Tools

Additional strategies to manage stress include engaging in physical activities like regular walks and maintaining a nutritious diet. Leveraging social support from family, friends, neighbors, support groups, peers, and the healthcare team is crucial. When seeking support, consider individuals who can provide information, problem-solving skills, or emotional comfort, noting that these roles might be filled by different people. Lastly, many find solace and stress relief through practicing their faith or spirituality. 

Health Care Team Members

Patients are encouraged to consult their cancer care team for additional support and resources. It's essential to be aware of specialists within or recommended by the healthcare team, such as mental health professionals, palliative care experts, integrative medicine specialists, and spiritual care teams. These professionals can assist patients in navigating the challenges of their cancer journey.

Signs You Need More Support

If an individual is experiencing increased anxiety, depression, or difficulty in coping, it might be beneficial to consult a healthcare professional. Indicators include persistent feelings of sadness, hopelessness, loss of interest in usual activities, constant nervousness, or uncontrollable worrying, particularly if these feelings persist for two weeks or more. If one resorts to unhealthy coping mechanisms, like substance abuse, or if the feelings interfere with daily activities or cause significant distress, it's crucial to seek support from a healthcare provider.

Emergency Resources

If someone has thoughts of harming themselves or others, especially if these thoughts are increasing or there's a risk of acting on them, it's crucial to seek immediate assistance. Emergency care options include visiting an emergency room or calling 9-1-1. Additionally, the 988 crisis lifeline and a crisis text line are available for urgent support. Everyone should be aware of these resources for their own safety or to assist someone in need.

Summary

Dr. Derry-Vick delves into the relationship between stress and cancer, with a focus on AML patients. Stress symptoms can be emotional, cognitive, or physical, and while these indicators are common, experiences vary by individual. Different coping strategies, from relaxation exercises like deep breathing to engaging in pleasant activities, have varying impacts on well-being. Recognizing interconnected patterns of thoughts, emotions, and physical symptoms is essential for balanced thinking. If stress symptoms escalate or persist, especially feelings of harm, seeking immediate professional assistance or emergency resources is crucial.

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