Creating Mental Balance for Resiliency of BIPOC Breast Cancer Patients
For breast cancer patients, the balance of one’s mental state can be a determining factor in the outcome of one’s physical state. For the BIPOC community, gaining control of one’s mental state may pose more of a challenge. Underlying factors such as cultural differences, stigmas surrounding mental health, lack of understanding, and lack of access to mental health resources continuously play against this population on a systematic basis. Adding a chronic illness into the equation can elevate existing levels of stress. Mental health influences the whole system of mind, body, and soul. Understanding the BIPOC relationship between socioeconomic and psychological ramifications of breast cancer can significantly change the outcome of their journey and generate a clearer path in achieving resiliency.
Why is mental health so important when one is chronically ill?
Having control of your mental health has the ability to influence many aspects of life, especially your overall health. Breast cancer diagnosis and the associated treatments can amplify stress levels in patients (Fradelos et al., 2018). For the BIPOC community, this adds to the preexisting stressors in their lives. Understanding the general importance of mental health and removing the ignorance around the topic will benefit chronically ill patients and aid in their survivorship. For individuals in the Black and Hispanic community, depression tends to be persistent; multiracial individuals have reported mental illnesses at a higher rate than other populations; and American Indians have higher rates of post-traumatic stress disorder and alcoholism than other ethnic populations (American Psychiatric Association, 2017).
Understanding mental health comes with the ability to swiftly identify symptoms of mental illnesses such as anxiety and depression. Identifying these symptoms can assist with breast cancer patients’ treatment options and overall quality of life (Kim et al., 2016). Recognizing the signs early can help patients cope with their illness. Know the signs:
Be aware of energy levels (i.e. low energy, feelings of tiredness, little to no or oversleeping) (American Cancer Society, 2020)
Relationship problems due to mood swings (Mentalhealth.gov, 2020)
Eating a lot or too little (Mentalhealth.gov, 2020)
Any signs of little to no interest in previously enjoyable activities (American Cancer Society, 2020)
Suicidal ideations and/ or attempts (American Cancer Society, 2020)
Trouble focusing, feelings of confusion, anger, worried, hopelessness (Mentalhealth.gov, 2020)
In addition, it is important for the patient’s physician to perform a mental health screening to determine prior and/or familial history (Fine, 2001). If the physician is aware of preexisting disparities, it can assist in better care for the patient. Socioeconomic factors and access to treatment are a couple factors that influence the quality of care BIPOC patients have. These factors significantly affect the African American community (Coughlin et al., 2015). Understanding that the quality of life for BIPOC patients varies from white patients can provide a clearer idea of the steps to take for improved survivorship. Ignoring such disparities weigh on the mental health and outcomes for breast cancer patients within the BIPOC community.
How can BIPOC breast cancer patients understand the impact mental health has on the mind and body?
Firstly, BIPOC patients can break the stigmas associated with mental health through education and resolution. This gives them insight and control over their choices.While BIPOC breast cancer patients may lack the comfortability to express their feelings it is important to do so. Expressing those feelings through writing or speaking to a healthcare professional can be a weight off the shoulders. The American Cancer Society suggests seeking help from support groups, counseling, or inquiring about depression treatments (American Cancer Society, 2020). Speaking with a counselor can help with understanding what causes these emotional stressors. see link here.
So what is physiologically happening to the body under stress? The sympathetic (SNS) and parasympathetic (PNS) nervous systems help regulate stress levels (American Psychological Association, 2020). When the body is experiencing stress, this activates the SNS which releases hormones as a response. Thus increasing the heart rate and elevating glucose levels. To deflect this response, the PNS brings the body back down to a resting state by slowing the heart rate; acting in the opposite manner of the SNS. Understanding how stressors affect the body aid in determining stress management activities.
What does resilience look like for the BIPOC community?
Resilience will look much different for this community than any other. This community will also need to break barriers and old ways to reach their true level of resiliency. Resilience focuses on behaviors, actions, and thoughts (American Psychology Association, 2012). Resiliency is changing the mindset and saying, “Here is my diagnosis and this is what I will do about it”. Resiliency to these individuals may look like having to work twice as hard as white individuals to avoid failing or losing an opportunity (DeSante, 2013). While this is in the context of work, it can be applied to a BIPOC patient’s disease as well. There is this underlying thought of, “I must fight harder than this group for my survival”, that displays through many aspects of these individuals’ lives. However, as Sisco (2020) describes, ideas such as this can heighten stress and be self-limiting (Sisco, 2020).
Patients need to be equipped with necessary tools to be resilient. Stress Management and Resilience Training (SMART) is a program designed to promote self care through mindfulness activities aimed to help reclaim control and mitigate stress (Benson Henry Institute, n.d.). SMART has shown to reduce stress and improve the quality of life for breast cancer patients (Seiler and Jenewein, 2019). This intervention improved self-esteem, hope, and promoted positive ideals.
Can one be resilient when they are chronically ill?
More faith, less fear; less resistance, more surrendering. According to Coughlin et al. (2015), “People who lack hope may be more likely to use negative coping strategies...to alleviate stressful circumstances” (Coughlin et al., 2015). Coping with breast cancer through hope is key to achieving resiliency for breast cancer patients. Realizing that the present feelings being experienced at that moment won’t last and checking in mentally is paramount for hopeful and optimal outcomes. Positive psychological and social responses to negative circumstances help push the patient into achieving resiliency.
Breast cancer patients of the BIPOC community have many obstacles to overcome along their journey and their fight to live. They must battle through the chronic illness itself as well as personal and outside barriers to achieve their resiliency. Mental health is an influential factor in shaping a positive mindset to navigate through stressors that can affect the mind body and soul. The correlation between breast cancer, mental health, and resiliency will continue to develop as we follow these individuals along their journey to survive and thrive.
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India El is a native of Virginia. She has a background in biology and is pursuing a MS in regulatory affairs at George Washington University. India is interested in government policies and regulations regarding clinical research and mental health. She is a health equity ambassador at Diverse Health Hub.
Breast Cancer Resources
ALAS-WINGS- Empowering Hispanic women about breast cancer awareness
American Indian Cancer Foundation
The Male Breast Cancer Coalition
The National LGBT Cancer Network
Sisters Network Inc- A NATIONAL AFRICAN AMERICAN BREAST CANCER SURVIVORSHIP ORGANIZATION
References
American Cancer Society (2020). Emotional, mental health, and mood changes. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/emotional-mood-changes/depression.html
American Psychiatric Association (2017). Mental health disparities: diverse populations. https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-Diverse-Populations.pdf
American Psychology Association (2012). Building your resilience. https://www.apa.org/topics/resilience
American Psychology Association (2018). Stress effects on the body. https://www.apa.org/helpcenter/stress/effects-nervous
Benson Henry Institute (n.d.). The tools and support needed to better face life’s challenges. https://bensonhenryinstitute.org/smart-program/
Coughlin, S. S., Yoo, W., Whitehead, M. S., & Smith, S. A. (2015). Advancing breast cancer survivorship among African-American women. Breast cancer research and treatment, 153(2), 253–261. https://doi.org/10.1007/s10549-015-3548-3
DeSante, C. D. (2013). Working twice as hard to get half as far: Race, work ethic, and America’s deserving poor. American Journal of Political Science, 57(2), 342–356.
Evangelos C Fradelos, Dimitra Latsou, Dimitroula Mitsi, Konstantinos Tsaras, Dimitra Lekka, Maria Lavdaniti, Foteini Tzavella, & Ioanna V Papathanasiou. (2018). Assessment of the relation between religiosity, mental health, and psychological resilience in breast cancer patients. Contemporary Oncology (Poznań, Poland), 22(3), 172–177. https://doi.org/10.5114/wo.2018.78947
Fine R. L. (2001). Depression, anxiety, and delirium in the terminally ill patient. Proceedings (Baylor University. Medical Center), 14(2), 130–133. https://doi.org/10.1080/08998280.2001.11927747
Kim, J., Lim, S., Min, Y., Shin, Y., Lee, B., Sohn, G., Jung, K., Lee, J., Son, B., Ahn, S., Shin, S., & Lee, J. (2016). Depression Screening Using Daily Mental-Health Ratings from a Smartphone Application for Breast Cancer Patients. Journal of Medical Internet Research, 18(8), e216–e216. https://doi.org/10.2196/jmir.5598
MentalHealth.gov (2020). What Is Mental Health? https://www.mentalhealth.gov/basics/what-is-mental-health#:~:text=Mental%20health%20includes%20our%20emotional,childhood%20and%20adolescence%20through%20adulthood.
Seiler, A., & Jenewein, J. (2019). Resilience in Cancer Patients. Frontiers in psychiatry, 10, 208. https://doi.org/10.3389/fpsyt.2019.00208
Sisco, S. (2020). Race-Conscious Career Development: Exploring Self-Preservation and Coping Strategies of Black Professionals in Corporate America. Advances in Developing Human Resources, 22(4), 419–436. https://doi.org/10.1177/1523422320948885
