Emotional effects of body changes

Having a physical change in your body can cause a range of emotions - such as feeling angry, anxious, sad or depressed. Everyone will deal with these changes in a different way.

You may experience some of the following emotions:

  • Anger – It is natural to feel like this about a body change.
  • Anxiety – This is one of the most common emotions people experience when dealing with body changes. It can cause physical sensations such as over-breathing, heart palpitations and dizziness.
  • Avoidance is a natural response when you feel anxious about something. One way to deal with avoidance is to face the change gradually at a pace that suits you.
  • Sadness and depression – You may have a low mood, feel tearful or want to hide away from the world.

There are some things you can do that might help:

  • Talk about how you feel with someone you trust.
  • Keep a diary to express your feelings and worries.
  • Try using relaxation, visualisation or meditation.
  • Do some physical activity or take up a creative hobby, such as painting.

Your feelings

At first, body changes can seem overwhelming. The feelings around 'losing a part of yourself' after a physical change to your body can be similar to the feelings of losing a loved one. You may have feelings of anger, anxiety, sadness and depression.

Feelings and emotions can come and go quickly. At times you may feel fine, but then suddenly you can feel overwhelmed, tearful or frightened. It is perfectly natural to feel like this after a major change to your body and is part of adapting to the way you see yourself after treatment.

There is no set time or method for this process of adapting; everyone does it at their own pace and in their own way. For some people it may take weeks, for others months or even years.

However, for some people getting to grips with a physical change to their body can feel overwhelming. They may feel that they will never be able to come to terms with what has happened. If this is the case, it may be helpful to look at your feelings and to share them. Perhaps write them down or speak to family or friends that you can trust about how difficult you're finding it.


Anger

It is natural to feel angry when coming to terms with a loss such as a permanent physical change to your body. While it feels uncomfortable, talking about it can often help people to accept a change.

You may feel angry about the unfairness of your cancer and the change cancer treatment has caused to your body. You can sometimes feel angry towards your doctor or nurse for what has happened.

We all have our own ways of dealing with anger. If you struggle to talk about anger, it might help to explore different ways of dealing with it.

  • You may want to go to a space where you feel safe to freely scream, shout and cry as loud and as much as you want.
  • Some people take up boxing or exercise classes to get anger 'out of their system'.
  • Music or other creative activities like painting, drama or dancing can also be useful to allow feelings of anger to be expressed.

'All of a sudden I felt like a wreck. I was not looking the best and that made me angry. I liked my long hair and wearing push up bras and making the best of myself. I didn't feel like me.'


Anxiety

We often feel anxious about situations that we think are unpredictable or dangerous. This causes the release of the hormone adrenaline which results in a 'fight or flight' response to help us tackle or escape from the perceived danger.

When coming to terms with a body change, you might experience either the change itself or talking to other people about it, as a 'perceived danger'. You may worry that people will laugh at you or comment on your appearance when you go out in public for the first time. This can make you feel anxious. Anxiety is one of the most common emotions felt by people with body changes.

Although some anxiety can improve our performance at times, such as during a job interview, too much anxiety is unhelpful. It can be an unpleasant feeling and can cause physical effects such as:

  • over-breathing (hyperventilating)
  • a sensation of your heart beating too fast (palpitations)
  • dizziness
  • sweating
  • dry mouth
  • a need to use the toilet more often
  • feeling sick.

These unpleasant effects can cause you to avoid anything which you think will make you anxious. For example, if someone's anxious about their appearance, they might avoid looking at a scar after an operation or in a mirror after they've lost their hair. When you start to wear a wig, going to the supermarket or meeting new people may be frightening. Some people may avoid anything to do with their colostomy bags.


Avoidance

Avoidance is a normal response for some people when they feel anxious about something. There is no set time for facing a physical change to your body. You will know when you feel ready to do it. However, family, friends or health professionals may confront you if they feel you may be avoiding the change in your body and this can be upsetting. It may be helpful to tell them about how you feel about the change.

One way of dealing with avoidance, is to face the change in your body gradually. This is often done best with someone you trust or feel safe with or with a health professional, at a time when you feel ready.

For example, someone that had a mastectomy may first want to become comfortable with the idea of having lost a breast. Once they're ok with this idea, they may want to touch the area where the breast was. And when they are comfortable doing this, they may want to remove the dressing next time and look at the scar. This can happen over a period of time that is acceptable to you and in as many sessions as you need.


Fear

Often fear is bigger than the reality and you may find that your fear was completely unnecessary as the following example shows:

Gill's hair was growing back after treatment. She planned to meet a friend for lunch, but she was anxious about going out for the first time without her wig. She chose a quiet hotel and agreed to meet her friend in the hotel lobby. However, Gill didn't know that the hotel was holding a big event that day and people she knew were attending.

When Gill saw a lot of people her initial response was to leave as she was concerned about their reaction to her short hair. But she didn't want to let her friend down so she waited in the lobby. She noticed that her feelings of anxiety passed quickly as everyone she knew was so glad to see her, they didn't appear to notice her hair. Other people she didn't know just seemed to go about their business. This experience increased Gill's self-confidence.

It might also help to think about the advice you were given as a child: 'if you fall off your bike, get straight back on'. This positive approach lets you confront your fears which usually reduce or go away.


What might help

There are many other things you can do to help you manage your anxiety and to get control back:

  • talk about how you feel with someone you trust
  • keep a diary to express your feelings and worries
  • practice relaxation
  • use visualisation – for example, put together a picture in your mind of a place you like and where you feel relaxed, safe and comfortable. Take the time to think about this picture when you feel anxious.
  • try meditation, which helps to calm your mind and be more focused
  • use complementary therapies such as aromatherapy, reflexology, acupuncture or massage
  • practice abdominal breathing – see below.

Abdominal breathing exercises

Abdominal breathing exercises are very useful as they can be done anywhere. They work quickly and can help control feelings of anxiety. At first, you should practice them regularly when you are not anxious. They can be performed lying down, in a chair or standing up.

Breathing should be slow and gentle but not 'deep' as this can result in light-headedness.

  • Step 1 – Ensure that your shoulders, head and neck are relaxed, and supported if you are sitting or lying down.
  • Step 2 – Place one hand on your chest and one hand just below your rib-cage.
  • Step 3 – Slowly and gently breathe in (inhale) through your nose and feel your stomach and diaphragm move out.
  • Step 4 – When you have taken in a full breath, pause for a moment. Slowly and gently breathe out (exhale) through your pursed lips or nose.

Repeat this process for five minutes, three times a day for a few weeks.


Sadness and depression

When something unpleasant or difficult happens that changes our life, it's natural to feel sad or 'low' at times. But if this low mood continues or gets worse, then it may mean that you're depressed. Sometimes, it can be difficult to know if you're depressed or not. It may be other people who notice symptoms and suggest that you might need help. Symptoms of depression can include:

  • a low mood that's worse in the mornings and gets better during the day
  • feeling tearful (but sometimes finding it difficult to cry)
  • a sense of guilt
  • feeling a burden to other people
  • losing interest in things around you
  • unable to feel pleasure
  • finding it hard to concentrate
  • feeling that you want to hide away from other people
  • occasionally people may have thoughts about taking their own life.

You may also have physical symptoms like weight loss, loss of appetite, trouble sleeping or waking up early in the morning, tiredness and even pain.

If you find any of these feelings particularly difficult to deal with, speak to your GP, doctor, nurse or other health care professional at the hospital. They can listen and offer advice or refer you for professional support with a counsellor. We also have information on people who can help

You may also find it helpful to read how your thoughts can affect the way you feel about yourself.


Back to Body image after treatment

Taking control

Take control to help you feel more confident socially following changes to your body.

Tips on managing day to day

It can be difficult to talk about your body changes. There are ways you can prepare for awkward questions.

Effects on your sex life

Cancer treatment may affect your sex life. It can be helpful to get advice from a specialist.