You Can't Be Happy All the Time!

Dr. Rick Wirtz explains how body-mind psychology has evolved over time, and why sometimes it's completely natural to feel sad.

As the field of Mind-Body psychology began to evolve in the 1980s, there were many publications and books written which described how our emotional state affects our bodily functioning. We have known for a long time that stress can be manifest in the body in a number of forms. These include headaches, stomach distress, muscular tension, fatigue, and increased blood pressure among others. As research began to look at the effects of stress and other negative emotional states on the body's ability to fight off illness it became quite clear that chronic stress, anxiety, and depression had the ability to suppress immune function.

It was a natural extension of this literature that led to examining the roles of emotional influences on the development and treatment of cancer. It was quite easy to see that chronic levels of anxiety and depression could interfere with treatment in a variety of ways. Anxiety about treatment, as well as the lack of motivation inherent in clinical levels of depression, can easily interfere with an individual's ability to comply with treatment. Because of the heightened physiological arousal associated with anxiety, ones tolerance of physical discomfort is usually lower and nausea is often exacerbated. Both of these symptoms would make tolerating the side effects of chemotherapy all the more difficult. Anxiety can also make it more difficult to tolerate having blood drawn or receiving injections. Obviously, severe levels of anxiety resulting in panic or anxiety attacks may prevent the individual from leaving the safety of their own home to attend doctor's appointments or treatment. Depression can interfere with the individual's ability to be hopeful and thereby lead them to conclude that there's no point in treatment because it won't be effective anyway. The lack of energy inherent in depression can also increase the likelihood that the patient will feel unable to attend treatment or stay the course when treatment-related fatigue is added to their already lifeless state.

Although these and other symptoms associated with severe anxiety and depression can become severe impediments to completing and coping well with treatment, one of the unfortunate offshoots of the mind-body literature was to create fear among cancer patients that they were in effect killing themselves by having negative thoughts and feelings. This, in and of itself, may have created unnecessary anxiety and worry about the normal experiences of sadness and fear of the unknown. It is extremely important for cancer patients and their families to understand that these normal level experiences are not dangerous and do not compromise the individual's ability to fight their illness. It is only in the case of extreme and protracted symptoms that the body's natural disease fighting abilities seem to become compromised. Therefore, being anxious about today's treatment or tomorrow's appointment with the doctor, or feeling sad and having a good cry are not sources of concern. In fact, being aware of these emotions and expressing them openly with trusted friends, family, or professionals may be key to good emotional and physical health.