Episode Overview

June is Mental Health Month, and that felt like exactly the right time to pause our spice series and talk about something that deserves just as much attention as anything physical we discuss on this show. Because here is what I want you to hear, friend. Your mental and emotional health is not a side note. It is not a footnote to life, to breast cancer, or to life after breast cancer. It deserves to be a priority, right alongside your physical health.

In this episode, I open up about a recent stretch of unrelenting pain that kept me from my beach walks and my workouts, and how quickly that physical struggle started to weigh on me mentally. I share it because I want you to know you are not alone in feeling the heaviness that can settle in after a diagnosis, during treatment, or even years down the road.

We also look at what the research actually shows. About a third of women in North America experience anxiety after breast cancer, and about a quarter go through some form of depression. One analysis of 17 studies and more than 12,000 women found that symptoms of depression stayed higher for over five years after diagnosis. And in a German study that followed the same women over time, about a third had higher anxiety and depression at the five to six-year mark than they did early on. This lingers, and that is not a personal failing. It is a very human response to a very heavy experience.

Here is something the research keeps pointing back to. The intensity of anxiety and depression is closely tied to the support and resources women have around them. We were never meant to go through hard things alone in a silo. Dr. Lisa Alschuler's work on oxytocin reminds us that isolation actually drives that connection hormone down, because we are creatures of community.

I also talk honestly about lifestyle and medication. Nourishing your gut, moving your body, and getting real food into your system genuinely supports your brain at a chemical level, and I lean on Dr. Chris Palmer's work on brain energy and mitochondrial health to explain why. But food and movement support healing; they do not replace it. And reaching for medication when you need it is not a moral failure. Sometimes it is the very thing that carries you across the hardest part of the bridge, so you can get to the other side and start making the choices that help you feel like yourself again.

I close with a simple reframe, I hope you will carry with you. When the thought "what is wrong with me" shows up, gently switch it to "what do I need right now?" No judgment, only curiosity. You deserve to feel well. You deserve joy in your days. And reaching out for support is one of the kindest things you can do for your brain.

Come join us in the Living Well After Breast Cancer Community on the Breast Cancer Recovery Coach app

Resources Mentioned:

Work with Laura:
https://www.thebreastcancerrecoverycoach.com/health 

Download for iPhone: 

https://apps.apple.com/us/app/kajabi/id1485646310

Download for Android: 

https://play.google.com/store/apps/details?id=kajabi.kajabiapp&hl=en_US

Dr. Lisa Alschuler's work on oxytocin, isolation, and movement

Dr. Chris Palmer, "Brain Energy"

"The Body Keeps the Score" by Bessel van der Kolk 

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Read the full transcript:

 0:00
You're listening to Better Than Before Breast Cancer with the Breast Cancer Recovery Coach. I'm your host, Laura Lum Erm. I'm a certified life coach, and I'm a breast cancer thriver. In this podcast, I will give you the skills on the insides and the tools to move past the emotional and physical trauma of a breast cancer diagnosis. If you're looking for a way to create a life that's even better than before breast cancer, you've come to the right place. Let's get started. Hey friends, welcome to episode 466 of Better Than Before Breast Cancer. I'm your host, Laura Lum, or and last week on the show I talked about spices. I talked about how you can integrate spices into your healthy lifestyle plan, and how that supports your overall wellness, and how easy that is to go ahead and add some variety into your diet. And I told you last week that I was going to be following up with more information on how spices impacted our gut and our gut health, and then in turn how that gut health impacts our mental health, our emotional health, our brain health, but then I realized, well, wait a minute, June is Mental Health Month, and I have a very special episode coming up for you next week for Father's Day, and so I started thinking about, well, I don't want to wait to talk more about really specific mental health things until the end of the month. So I moved the schedule around, so we're going to talk about supporting our mental health. I'm going to talk with you today about why it's important to give very specific attention to the discussion of mental health and wellness, and then I'll circle back at the end of the month, and we'll go back to spices and how that can support everything as a part of your healthy overall lifestyle. Okay, so I want to be very clear when I say that mental and emotional health and wellness is not a side note, it's not an afterthought. It is not a footnote, not to life, not to breast cancer, not to life after breast cancer, not to living with breast cancer. Mental and emotional health has got to be as much a priority as physical health is. They are intertwined, they cannot be separated, and they both deserve attention. Now I know that mental wellness often comes with a lot of stigmas. We have a resistance, oftentimes, to medications that might support mental health. I'll talk about that here in a little bit, but it is so vital to pay attention to honor and give space to what we are going through mentally, and I'll share something with you. As I talked about on previous podcasts, I went through three months of honestly just living hell, like unrelenting pain. It was really, really bad, and I wasn't able to do my normal walks on the beach, I wasn't able to do my workouts, and I love exercise. I am one of those people who exercise makes me happy, and I look forward to it. And so, when I am forced into a situation where I'm sedentary, and not just sedentary, but sedentary and suffering, it takes a toll, you know. After a while, when we are physically uncomfortable, when we've had to make changes in our lives that aren't what we didn't necessarily like to do or want to do, that can be very hard on our mental well-being. And there was a time I woke up, I said to my husband, I.. I just have.. I feel like I have no life force in me right now. I don't want to.. I don't want to do anything. I don't want to literally do anything, like I don't want to get up out of bed, because the moment I move, I'm in so much pain that I feel like maybe I'm getting depression, and fortunately for me everything resolved pretty quickly after I got to that point, but after months of going through something, it is really hard to keep in a good mental place, right? When life is not going, or your body is not feeling the way you want it to feel, and this can apply to people who are going through cancer treatments.

4:23
God knows those are super hard, and you know, for me, I've been on some kind of treatment for the last five and a half years now. Some people are going through IV treatment, which is a lot more toxic, and so it's very real that these kind of things have a huge impact on our mental well-being, and not only because of the chemicals we're putting in our body to save our life, but because of what I just talked about, and the way, and the side effects, and how they impact our quality of life, but that's not only proprietary to those of us who are going through. Of treatment that applies to people who are going through life, right. So, if you're no evidence of disease and you're 456, years out of treatment, life is still not easy. Life comes with a lot of challenges, but I'll tell you what, once you've had a breast cancer diagnosis, I firmly believe that those challenges of life get exacerbated. There's.. it's like a stacking effect, because the thing is that once we've had a breast cancer diagnosis, it doesn't coal away, right? Like, talked about so many times, it's not like the flu, it's not like we had the flu, and we got better. We had a breast cancer diagnosis, and then we thought we're going to go through this, then it's going to be done, but then we started to realize, well, shit, it doesn't get done, it's here, it's lingering in my mind, and maybe my oncologist said, once you're five years out, you're good to go, or once you're seven years out, you're good to go, and so there's all this this undercurrent of waiting to hit that mark, where a doctor said, if you hit that mark, you're good, right? And then you hear stories from other people, people like me. Well, I hit the eight year mark before I had a recurrence, right? And so, floating in the back of our mind, we have the strange ache or pain, or we get frequent colds, or something. Maybe our immune system is struggling, and there's always that lingering shadow of, oh shit, is this cancer again. And so I think that when we are going through life, no matter what stage we're at here, whether we're dealing with disease or we're not, that it's always there with us, and it's followed up with, oh, wow, I didn't realize I was going to be doing these blood tests for x amount of years, or have follow-up scans, or whatever it is that you do with your oncologist. There's so much of treatment, and of course, there's aromatase inhibitors, and the effects they have on you for 10 freaking years after you finish treatment, right, that's a long time. Now, some people don't do the whole 10 years, some are told five, some are told seven. That's still a long time. And so, while we're doing this over and over years and years, it gets exhausting, right, and if it's that layer on top of just life in itself, it's like, God, can I catch a break here? And I do think that it's important for us to hold space for that, and to say, like, this isn't easy, you know, this is hard, and I'm trying to keep my shit together here, but sometimes it's really hard, and the reason why it's important to hold space for that is because you deserve support. And when it comes to mental health, I think this is one of the things that we just shun the support, whether it's medical support or it's another person. It's just I see it all the time, it's so common that we don't allow ourselves to get support, and we've got this story that I should be okay, I should be able to go through this on my own, and it's just not true. First of all, we're just not even meant to go through life alone, and certainly we're not meant to go through traumas alone, and so when we're struggling, and that's a very real thing, and we can say, like, man, I'm having a hard time. It's okay to say that, and it's okay to get support for that.

Speaker 1 8:29
And not only is it okay, but I'm going to tell you, of course, I looked into some studies and the science that goes on behind all of this, and so I want to tell you, because I know a lot of you out there like to hear the science as well, that research has showed exactly what I'm telling you, so there's a lot of research out there from different countries, women who've been through breast cancer and breast cancer treatment and their long term side effects, but it's an interesting thing how the numbers will vary, and what I mean by that is, so if you look at research that's done in the Americas, right, so in North America, maybe the United States and Canada, the studies show that about a third of the women who have had breast cancer experience anxiety, and about a quarter of them go through some kind of depression. So first of all, I want you to take that stat in and realize that it is common, because one of the things that I hear women experiencing is they'll start to feel this heaviness, right, this emotional heaviness, they'll start to feel this, like I'm, I just don't feel right, you know, maybe I feel like I'm sludging through mud, maybe I feel like I'm having chemo brain, and I'm like two years out of treatment, but I can't focus. I'm tired all the time, like my brain is fatigued, or I just don't feel that sense of happiness that I remember having felt at some point. And we express that, and then people dismiss it, right? And a lot of times people will say, well, don't think like that, or don't say things like that, or you lived, you should just be happy, aren't you grateful, right? And that's all bullshit, because you feel the way you feel, and if you express the way you feel, and you're saying, I'm struggling, I feel this way, one, it is common, it happens, and I'm not saying dismissing, like, oh, you're so common. No, it's common, it's real. It happens, and it happens to a lot of women, and so it's very valid, is what I'm saying. By saying that it is, it's not like some rare thing that, oh my god, that's weird, you're the one that's not happy. No, it happens to a lot of people, so keep that statistic in mind, but also I think something really interesting that the research shows that the numbers vary widely where you look in the world, and some regions the rates of depression and anxiety are nearly double of what we see here in the Americas, and when researchers try to understand that, you know what it comes back to over and over again, support the resources that women have around them, the care they receive, the resources they have access to, so the the amount and the intensity of anxiety and depression can be very, very tied to and related to whether or not you decide you're gonna have to go through this alone or whether you find a support system and something to help give you the love you need through it, and then here's another thing, so I mentioned, like maybe you're three years out, or four years out, or five years out, and you think, why am I still feeling like this? I shouldn't still be feeling like this, and right there, a lot of self judgment. I'm sure you hear that, because the acceptance of, wow, I am feeling like this, hard stop, right? I am struggling, I am feeling like this, and so let's just own what we're going through, because I'll tell you what the research shows, that that absolutely does happen. There is a study that pulled together 17 studies that looked at more than 12,000 women who had a breast cancer diagnosis, and what they found is that symptoms of depression stayed higher in women who had had a breast cancer diagnosis than women who had never had cancer before, and they stayed higher for more than five years after diagnosis. So, this isn't something that we just move through in a couple of months. I don't even know why we have that expectation for a lot of women who have had a breast cancer diagnosis. The struggle lingers for a long time.

12:42
There was also a small study about a couple of 100 women out of Germany, and the cool thing about this study is they followed the same group of women for several years, and they checked in on them at 40 weeks after diagnosis, and then again five and six years out, and the interesting thing here was that most of those women were doing better at 40 weeks than they were years later. About a third of them had higher depression and anxiety at the five to six year mark than they had early on. So that is really interesting, because what happens, assimilation back into life, and life is not all rainbows and unicorns, friends, and then we've got that other layer now stacked on top of it, and that, yes, it was just a small group, it's a couple of 100 women, but it's valuable information because it points to this fact that that long term dealing with effects and side effects and ongoing treatments takes a toll, right? When you're dealing with everything in life, this takes a toll too. And sometimes that heaviness, it catches up to us, and it's exhausting sometimes. I think, like, when we're in it, like when we're in the treatment, we just gotten the diagnosis, it's the whirlwind, we're in the treatment, that the crisis itself is like carrying you, right? I'm fighting this, I'm surviving, I'm doing everything I can, like you're running on adrenaline, and then when it's all over, and you have that time to just go, but in the world just happened here, that's when everything just starts setting in, and yet that's the part of this experience of a cancer diagnosis where we're now expected to get back to normal, right? And there's that, there's that other fallacy of being normal again. So, yes, the meal trains were coming while you were in chemotherapy and radiation, and now you're exhausted, and you're done, and you're relieved, but you're also traumatized, and where everybody go and now you're alone too, and now you're feeling misunderstood. This is heavy on our mind. It is very, very heavy on us emotionally. It's a lot of extra weight. And here's an interesting.. the women in that study, where they looked over 12,000 women, and they saw that things that these women reported that they had more anxiety. Depression, five or six years later, in that study, the people who had the hardest time tended to be the younger women, younger women who still had children at home, younger women who had other health problems on top of cancer as well, and so we can see again that the assimilation back into life while we're dealing with some kind of health issue or some kind of trauma, or is stacked on top of each other over time. It wears on us if we are not consistently looking to support ourselves. So, I have had clients who come to me six eight years out, but they never really processed anything, you know? They got through treatment and they did what they thought they were supposed to do, and like, I'm just going to get back to life. I'm going to go back to work. I'm going to do all the things, and they never gave themselves a chance to process what they actually went through, and they never reached out for the support or the understanding or the conversations to just be able to talk openly about what they went through, because talking in itself gives us some relief. And then years later, they're suddenly thinking, like, why am I feeling like this? What's going on? Because just like the book says, the body keeps the score, and we cannot undo a traumatic emotional and physical life experience. It's really important to give it the space that it needs. It's not that you're doing something wrong, it's not that you should be in a different place, that something should be better. It's just that this is where you're at, and on top of what you've been through, on top of what you're processing, while you're trying to re-assimilate into life or make changes in life that you've realized during your treatment you wanted to make changes about, and then you have this ongoing shadow of recurrence, right? That's a stressor, and if we don't talk about that and talk about the power you have.

Speaker 1 16:46
I have so many conversations with my clients about how we can think differently when it comes to recurrence, how we can step into our power and say to ourselves, like, okay, how can I reduce this fear that I have of recurrence, and there's ways to do it by looking at yourself and the support you're already giving yourself, looking at the decisions you're making in your life, how you're feeding yourself, the changes you're making in your life, and realizing that you're creating a life that's different from the life you had before you had the the initial diagnosis. Right, so there's ways to make that emotional weight less heavy, and there's actually some body of work by Dr. Lisa Alschuler. I think I've talked about her on the show before, where she talks about oxytocin, you know, the hormone that's in us, that love hormone, that hormone of connection. And in her research, she tells us that one of the worst things we can do to ourselves is isolate, because isolation drives oxytocin down, and we are, as she puts it, creatures of community and tribe. We were never meant to go through hard things alone in a silo. I don't know where that story comes from, but even the science shows us we were not meant to do that. So, reaching out, talking about it, finding a community that understands it's all so important, and it's all wonderful. It's beneficial. Think about it like the vegetables for your brain, right? When we're looking at our body, we're like, well, let me get in more salads, let me get in more vegetables. Let's do the same thing for our mental wellness. Let's realize that that's suffering, and it is suffering when we're in a dark place, when we're having anxiety, when we're feeling depressed, when we feel like I have no energy or desire to do life, that's hard on the body too. And it's a place where we need support, that would be like I would equate it by saying, like, your body feels sick, right? Your mind doesn't feel well. It's okay to support it, and there's so many tools that we can use to support it. So I'm going to talk to you about lifestyle, and I think that it's important to point out that a lot of people think, well, that's just ridiculous, like this is too easy, too simple, and it isn't. The things I'm going to talk to you about, there's science behind them, their studies behind them, they work, they help you feel better. But I also think there are times when we're in such a difficult place, we don't have the capacity to do these things, and so if I was to say to you, yeah, well, just, you know, eat better, get up and move your body, get up and exercise every day, and that'll help you feel better. And you're like, Laura, I literally don't want to get out of bed, right? I can't even get out of bed, like my brain is turned off, it's in like a quicksand somewhere. All right, we have to understand the capacity we have, and if we find ourselves at that point, and I'm going to talk about in a minute, there's no shame in getting medical support to get us to the place where this organ in our heads can function enough that we can make choices that will begin to help us feel better, and I know I have seen. Mean, I have family members that struggle with clinical depression. It is rough to watch someone there, and it's even worse to watch them there when they refuse help because of a stigma over taking a freaking pill. Okay, so yes, I'm going to talk about lifestyle, but then I'm going to talk very frankly about medicine, because I'll tell you what, in five and a half years of dealing with cancer, I have a whole different perspective on medication than I ever did in my whole life, but I do want to be very clear on the fact that eating well and getting exercise are not a replacement for medical care, and the choice for medical care is not a moral failure, it's not a moral test. So, what is true about our lifestyle?

20:48
When you nourish your gut, when you move your body daily, when you get those endorphins from exercise, when you put real wholesome food into your body, you are not only performing an act of self-care, you are changing yourself at a chemical and molecular level in ways that support the healthy functioning of your brain. This is where the work of Dr. Chris Palmer. Love him, he's a Harvard-trained psychiatrist. His book, Brain Energy, he lays out these brilliant ideas that I find very helpful, and his whole central proposal is that at the core, mental disorders are metabolic disorders of the brain, and the piece of that that fits everything that we're talking about here is mitochondrial health. The health in those little tiny energy engines in every one of your cells directly affects how both your body and your mind function through your metabolism, through your hormones, through your neurotransmitters, and through inflammation, and yes, inflammation can affect your brain. So, yes, it is important. And if you notice, like when you're filling in a funk, for me, when I feel in a funk, I just don't want to eat, which is also not healthy and not good if I don't feel well, I just don't want to eat, and that doesn't lend itself to nourishing a body. A lot of people, when they don't feel well, what do you, if you don't have energy, you want to go to the easiest thing, and the easiest thing is typically processed food or high sugar food. Very rarely, like I mean, does it ever happen at all? Have you ever met a person who's going through anxiety and depression, and they're just like, "Oh no, I only want the healthiest organic meals, let me get up and prepare everything for myself. No, it doesn't work like that, right? So we can see the vicious cycle that when we don't feel well in our brain, we really don't make decisions that are healthy for our body, and then when our body isn't healthy, our gut isn't healthy, and that makes the brain even worse, right? So we've got to be able to see this cycle, and we've got to be able to see where we're at on the spectrum. Are we in a place where we do have the capacity to make better decisions to support ourselves? And if so, who can you turn to? Because I really think accountability is important, and I don't mean it from a disciplinary standpoint, but I mean accountability to the fact that you've said I'm really struggling mentally, I know myself, I know that I have to change the way that I'm eating and get up and force myself to take a walk and be out in nature every day. Turn to a best friend, a sibling, a spouse, a coach, somebody, and say I need to do this. Will you help me? Will you do it with me? Will you check? I want you to ask me every day if I've done my walk yet, right? Like, if you, you are in the place mentally where you know you can do it and you need to do it, get that accountability to help you. Actually, Dr. Al Schuler, in her work, also pointed out that movement helps modulate how the body handles estrogen, and that women who don't move tend to face more hormonal imbalances. So, just that daily walk every day can make a big difference in your life. But neither Dr. Alschuler or Dr. Chris Palmer are saying that this is a simple fix, right? Food and movement support healing. They don't replace it. So, please don't hear any of this. If you just eat better, you just feel better, right? That is not the message I'm trying to get across, but it is a support system. And so, let's talk about medication. Let's talk about sleep support, anti-depressants, anti-anxiety medication. There's a lot of resistance around this topic, and many, many women want to do the work that they think, or they say, is naturally right. I want to, I want to heal naturally, and that makes sense.

24:33
We want to keep our bodies as clean as possible, we want to heal the terrain of our body, we want to do things the right way, and we worry about reaching for medication, because that's like, I can't do it on my own, it's not all natural, it's putting more toxicity in me, I should be able to do this on my own, but if you are not sleeping because you have anxiety or depression, your body can't heal, if you're in a place that's so heavy and so dark that you cannot care for. Yourself, you cannot show up for yourself. You cannot make the lifestyle choices that I just talked about. Then, allowing yourself medical support is absolutely not a failure, is completely the opposite. It's an act of love. Sometimes medication is the thing that carries you across that hardest part, or that stretch of the bridge, so that you can get to the other side of it and make the choices that support you in the healthiest way. It doesn't have to be forever. I was having a conversation with one of my kids who was taking antidepressants for some time, and he said to me, you know, I'm not taking that anymore, and I said, Oh, well, tell me how you feel about that, or why did you come to that decision? And he said, I made changes in my life, and I'm so much happier with my life that I don't need it anymore. That's a real thing, guys. If life is not aligned with us, and it's really heavy for us, we're dealing with some really critical stuff for a long time. It can take its toll, and medication can be exactly what we need to support ourselves through that, so please know that reaching out for help is an act of love, not a failure, not a weakness, and it's something that's available to you for a reason, right? Because sometimes we need it. So let's wrap this up. Let's look at mental health awareness month, and let's look at the things that we can do to support ourselves, so that we can experience optimal mental health. We can make sure we are nourishing ourselves with good, wholesome, real food. We can practice mind-body exercises. We can get out in nature on a consistent, irregular basis, that's so helpful. Things like mindfulness practices, like not having overwhelming to-do lists, but really being present and paying attention to what you have happening right now, doing things like gentle yoga. These are not just like, "Oh, that's so cool, I can be so calm, but there's studies that show the benefits of this, there was a 2024 analysis that brought together 47 randomized controlled trials, right, the gold standard ones of more than 4500 women, and they found that mind body exercise, so what is that, we're moving, but we're present, we're moving and we're breathing, we're connecting to our body, and that study found that mind body exercise improved both anxiety and fear of cancer recurrence. So, if you want one small place to start, it could just be five quiet minutes of breathing, getting in touch with your body every morning before you get out of bed, every evening as you're falling asleep. We don't need to light knuckle our way through life, that's not self-care. There was a 2025 review that looked at 12 different support programs, 10 of them showed significantly lower fear of recurrence afterwards. So, fear is treatable, it can be acknowledged, it can be looked at, it doesn't have to be a permanent fixture of your life, even if it feels like it's so heavy that that's what is happening right now. And finally, here's a really easy one: laughter, laughter in community. Talk to your friends, your families, tell jokes, look for funny things on Instagram. If you're going to go on social media, find some funny things. I love to look for videos that literally bring me to tears, because I'm laughing so hard. Right, call people, connect to people, come out of that silo of isolation, reach out, because support is something you deserve, and support is one of the kindest things you can do for your brain and your brain chemistry. So I want to leave you with a thought or a reframe, maybe it is. If this thought enters your mind, what's wrong with me?

28:50
If you hear yourself think that, I want you to switch that thought and ask yourself, what do I need right now? That's the practice, not what's wrong with me, but I'm noticing. Wow, I just don't feel the way I want to feel. What do I need right now? That is the question. No judgment, only curiosity. You deserve to feel better. You deserve to feel well, you deserve to have joy in your life every day. So, ask yourself, what do I need? And then reach out and get that it is an act of love. You don't need to apologize for where you're at mentally and emotionally, treating it, getting support for it is a real part of your healing, and no apologies are necessary. All right, my friends, let's all give our mental and emotional health the energy and the love that it deserves as we go through this month and all the months. And I will talk to you next week. Until then, be good to yourself and expect. Other people to be good to you as well. Take care,

30:02
you've put your courage to the test, laid all your doubts to rest. Your mind is clearer than before. Your heart is full and wanting more. Your future's at the door. Door, give it all you got. No hesitating. You've been waiting all

30:30
your life. This is your moment. This is your moment this is your moment to shine to shine.