Mental Health, Mindfulness and Yoga

Feeling anxious or low after a breast cancer diagnosis is very common, and it doesn't mean you're coping badly. In this video, I'll explain what's normal; what mindfulness and yoga may offer; and where you can find support, including urgent help. A UK study followed women with early breast cancer for five years. Nearly half had significant anxiety, depression or both at some point in their first year. By the fifth year, this had fallen to fewer than one in six; and for most women, it eases gradually rather than at any set milestone. For many women, fear of the cancer coming back is the most common ongoing worry, and it often flares around scans, appointments and anniversaries. The end of active treatment can be one of the hardest times, when appointments stop and there's suddenly time to think. Wanting help then isn't a sign of weakness, and effective support is available. One option is mindfulness-based stress reduction, an eight-week group course of meditation, body awareness and gentle movement. International cancer guidelines recommend it for anxiety and depression, during and after treatment. The NHS notes it isn't right for everyone and can make some people feel worse. If you have a mental illness, Cancer Research UK advises talking to a professional first. If a course isn't practical, meditation apps are popular, and one that helps you sit quietly for ten minutes a day may well be worth having. The trials behind them are small, though, and an app isn't a treatment for depression. Most aren't assessed by the NHS, so read the privacy notice before you share how you're feeling. Yoga is another option that can help with tiredness; sleep, and quality of life around treatment. The benefit is real but modest, and the trials haven't shown a clear effect on depression. It also tends to fade once classes stop, which is a good reason to keep going. Before you start, talk to your surgeon or physiotherapist, particularly if you've had reconstruction, and tell your instructor about your surgery. Yoga should add to your shoulder exercises after surgery rather than replace them. Gentler styles, such as restorative, hatha or Iyengar yoga, usually suit best at first. Wait until your wound has healed and your shoulder moves freely before putting weight through your arms. You should also avoid hot yoga during treatment. If following hormone therapy, check with your team before deep twists or forward bends due to potential thinning of your bones. It also helps to ask your instructor not to use deep massage or strong adjustments on your treated side. When choosing an instructor, it helps to know that no single organisation regulates yoga teaching in the UK. However, the British Wheel of Yoga and Yoga Alliance Professionals both keep registers of qualified instructors, which can be a helpful place to start. Sometimes self-help isn't enough, and if low mood lasts for more than two weeks, please see your GP. In England, you can also refer yourself to NHS Talking Therapies without needing a diagnosis. Elsewhere in the UK, your GP surgery or breast care nurse can tell you what's available locally. To refer yourself, search online for NHS Talking Therapies and enter the name of your GP surgery, and your local service will contact you. As well as depression and anxiety, it helps people cope with long-term physical conditions, and it may offer guided self-help, cognitive behavioural therapy or counselling. For more urgent help or if you're having any thoughts of harming yourself, contact your GP that day; or call NHS 111 and choose the mental health option. If you've harmed yourself, or feel you can't keep yourself safe, call 999; or go to A&E straight away. Breast Cancer Now, and Macmillan Cancer Support both run free helplines; and Samaritans are there to listen at any hour. Your breast care nurse is often the best first person to talk to. If you'd like to talk any of this through, please get in touch with me or my team.