Mood

It is natural to feel a range of emotions after a cancer diagnosis, throughout the stages of treatment and when living beyond cancer. Some people may notice that they feel low, others may feel angry or frustrated, or anxious.

This page focused more on the experience of low mood but for more general information on the psychological impact of cancer you can go to psychological wellbeing, or specific pages on anxiety, loneliness or body image and cancer.   

Most people will feel low at times and may experience feeling:  

• sad 

• anxious or panicky 

• more tired than usual or being unable to sleep 

• angry or frustrated 

• low on confidence or self-esteem 

A low mood often gets better after a few days or weeks, but if it lasts 2 weeks or more, it could be a sign of depression.  

Other symptoms of depression may include: 

• not getting any enjoyment out of life 

• feeling hopeless 

• not being able to concentrate on everyday things 

• having suicidal thoughts or thoughts of harming yourself    

When you are living with cancer or going through treatment, it can sometimes feel hard to separate out what are the side effects from treatment and what are symptoms of low mood or depression.   

When living with and beyond cancer, you may feel sad and low for many reasons, including but not limited to how things in your life are about to or have changed, what you cannot do any more, physical side effects, uncertainty about the future, what you may miss out on depending on your prognosis, everything feeling overwhelming.  

Often if you have reached the end of treatment, people will expect you to be positive and happy, but we know for many people this can also be a difficult time. This may be due to losing frequent contact with your cancer team, worries about the future and recurrence, feeling isolated or still not like you “old self”.  

We find that when people are going through treatment they are pushing through and are focused on “surviving”, but once treatment ends this can sometimes mean people experience a flood of emotions which may include feeling low as you figure out what life means moving forward and reflect on what you have been through.   

In addition to the general tips about managing your emotional wellbeing at psychological wellbeing, it may be helpful to consider the following to help with managing low mood:   

• Allow yourself time to adjust to news of a diagnosis, a change to treatment plans or prognosis, or finishing treatment. It is normal to feel low in mood at these times, and it is likely with time that this will settle  
• Make room for your emotions. We do not always have to remain positive and allowing oneself the space and time to feel low or sad can sometimes help 
• Be kind to yourself  
• Talk to others about how you are feeling. That may include family and friends, peer support groups, your cancer team or a psychological professional  
• Tap into existing coping strategies for things that have helped when you have felt low before  
• Make room for uncertainty. Cancer is full of uncertainty, sometimes there is not an answer to your question, and this can lead to feelings of hopelessness. It can be helpful to try to focus on what you can control, and for things you cannot to try to let it pass and re-focus on the present moment by grounding yourself in your breathing or what you see around you.  
• Exercise or physical activity can often be helpful for low mood. See physical activity  
• When people feel low in mood, they often find themselves losing motivation to engage in activities, or due to cancer and its treatment feel too tired or ill to engage in activities. It can be helpful to think about what brings you pleasure and to try to engage in these activities as much as possible. You may have to adjust what you usually do given your health and energy levels, so make sure to pace yourself  
• Setting small, realistic and achievable goals or targets to work towards in different areas of life can help you feel like you are “achieving” something  
• If you are judging yourself or feeling like you are a failure in certain aspects of your life because of what you can’t do, then it can be helpful to take a step back from this. Be kind to yourself and ask yourself “what would I tell a friend”. 
• Gently challenging unhelpful thoughts can be helpful. For example, if you are a parent, you may be judging yourself for not being able to do the school run but you are still able to read a bedtime story to your child so remind yourself of this and the things you are still doing 

Resources  

 Cancer and depression support | Macmillan Cancer Support  

Cancer and low mood | Maggie’s 

NHS mental wellbeing audio guides: Mental wellbeing audio guides – NHS 

Further support 

It is natural to feel low in mood at times. However, if you are struggling and the tips on this page do not help then please do reach out for help.   

Peer support:  

Peer support can often be helpful, especially when people feel alone in their experience. There are a range of support groups available, you can speak to your cancer team about this for advice or look online  

Cancer self-help and support groups | Macmillan Cancer Support 

Psychological therapy

Psychological therapy can be useful, and usually involves meeting with someone one to one or in a group. Therapists may use a variety of techniques to support you including (but not limited to) ideas from cognitive behavioural therapy, acceptance and commitment therapy and compassion focused therapy. 

You can ask your cancer team for a referral to the Macmillan Cancer Psychological Support Team (CaPS) at St George’s Hospital if you are a patient under their care. Alternatively, you can speak to your GP about psychological therapy available, including your local Talking Therapies service.   

You can find information about the CaPS team at: Macmillan Cancer Psychological Support (CaPS) Team – St George’s University Hospitals NHS Foundation Trust 

You can find your local talking therapies service at: 

Find NHS talking therapies for anxiety and depression – NHS 

Support from cancer charities:  

Maggie’s Centres offer a range of psychological support including support groups, drop-in services, workshops and courses, and one to one psychological therapy: Our centres | Maggie’s. You can either drop in, email or call them.  

Macmillan offer a free support line on 0808 808 00 00, or you can email them for support: Emotional, financial and physical help for people with cancer | Macmillan Cancer Support 

Community Mental Health Teams

If you are already receiving support for your mental health, tell your team or therapist about your cancer diagnosis and how this is impacting you and your body image or confidence. For more information on this you can go to MH teams webpage 

GP 

You can speak to your GP about your low mood or symptoms of depression. They may be able to support you in thinking about onward referrals or medication.  

Thoughts of harming yourself or ending your life 

For some people when they are facing a difficult time, they can have thoughts of harming themselves or ending their life. If you ever experience this, please seek immediate support via the Samaritans (116 123) for someone to talk with, ask for an emergency GP appointment, call 111 who can connect you with your local 24-hour mental health crisis team, or visit A&E.  You are not alone.