I describe here a simple tool to assess your state of mind, something I think is useful for anyone, not just people diagnosed with cancer. It also links in with my book, Stages of Suicide-How to Help your Mind which I am happy to say is now published in paperback form (and E-Book).

The Wolf with my book

How to Assess Your State of Mind

Introduction

For people with cancer, distress often peaks at the time of diagnosis and reduces over time. Clinically elevated distress is shown to endure in long-term cancer survivors at higher rates than the general population ¹. The awareness of the importance of anxiety and depression screening and timely treatment has increased ² but psychological screening is not routinely offered to cancer patients. Patients are often proficient at describing their physical side effects and symptoms to medical staff, but they are not necessarily effective at describing their psychological areas of need. There are extensive benefits for people to become good at identifying what specific psychological stressors they are experiencing and then advocating for themselves to reduce stress and pressure relating to these. These stressors may be financial, physical, emotional, social, practical or spiritual or religious. Monitoring the mind and being proactive in ways to prevent mental deterioration are important components in dealing with cancer. Feeling good mentally helps the immune system tackle both cancer growth and treatment side effects.

Here, I describe one of two tools to assess and help the mind. The second tool relates to a book I recently published in paperback form with a detailed mind monitoring Tool. It is also available in E-Book format.

Tool 1 – Assess your mind with the Distress Thermometer.

Tool 2 – Prepare for and assist your mind in the event it becomes irrational and unsafe using techniques in the book Stages of Suicide-How to Help Your Mind.

Tool 1- The Thermometer

This gauge was designed for cancer patients and is also an easy and useful tool for anyone regardless of physical health.

Circle the number (0-10) that best describes how much distress you’ve had during the past week, including the present day.

Choose a number from 0 to 10 that reflects how much distress you feel today and how much you felt over the past week. Ten is the highest level of distress you can imagine, and 0 is no distress. Most people can use this scale to rate their distress in a way that helps the cancer care team. If your response is 4 or above, you likely have a moderate-to-high degree of distress. Your doctor and/or cancer care team should find out more and offer some help with your distress.

The American Cancer Society explains,

“Not only does this tool tell your team about your emotional health, but it also gives you a chance to talk and work out problems during your visit. Surveys done in cancer clinics have shown that up to 4 in 10 patients have significant levels of distress. You are not alone in your distress.”

“Another part of the distress tool is the Problem List, or a list of things that may be causing your distress. For this, you read through a list of common problems and mark possible reasons for your distress. This helps your cancer care team know where you can best get the help you need. The list of physical problems helps you remember those you should tell your treatment team about.”

For those without a cancer care team, your General Practitioner is an important person to assist you and perhaps organise referrals regarding ticked items on the Problem List.

CLICK HERE for PDF of Problem List from NCCN Guidelines Version 1.2024 Distress Management and see below.

CLICK HERE to see more about this from the American Cancer Society Information.

The Distress score evaluates emotional distress and risk of suicide in patients with cancer. Clinically, for DT scores greater than 5 in patients with cancer, the risk of suicide greatly increases. ³

If your score is greater than 5, then you are at psychological risk and you should seek help from your General Practitioner, Psychologist, Oncology Team, Counsellor, Psychiatrist, Medical Practitioner etc.

Once stressors are identified, then taking actions to reduce their negative effect on your mind will likely expand your times of feeling good. Feeling good is a powerful way to support your immune system. Studies show that people’s moods can significantly influence the immune system ⁴.

Steps

Identify Stressors (using problem list).
Prioritise stressors according to intensity.
Brainstorm ways to reduce these as stressors.
Take positive action.

Problem List

Physical Concerns

 Pain

 Sleep

 Fatigue

 Tobacco use

 Substance use

 Memory or concentration

 Sexual health

 Changes in eating

 Loss or change of physical abilities

Emotional Concerns

 Worry or anxiety

 Sadness or depression

 Loss of interest or enjoyment

 Grief or loss

 Fear

 Loneliness

 Anger

 Changes in appearance

 Feelings of worthlessness or being a burden

Social Concerns

 Relationship with spouse or partner

 Relationship with children

 Relationship with family members

 Relationship with friends or coworkers

 Communication with health care team

 Ability to have children

 Prejudice or discrimination

Practical Concerns

 Taking care of myself

 Taking care of others

 Work

 School

 Housing

 Finances

 Insurance

 Transportation

 Child care

 Having enough food

 Access to medicine

 Treatment decisions

Spiritual or Religious Concerns

 Sense of meaning or purpose

 Changes in faith or beliefs

 Death, dying, or afterlife

 Conflict between beliefs and cancer treatments

 Relationship with the sacred

 Ritual or dietary needs

Other Concerns

References

Smith AB, Rutherford C, Butow P, et al. A systematic review of quantitative observational studies investigating psychological distress in testicular cancer survivors. Psychooncology. 2018;27(4):1129-1137.
Butow P, Price MA, Shaw JM, et al. Clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients: Australian guidelines. Psychooncology. 2015;24(9):987-1001.
Chiang YC, Couper J, Chen JW, Lin KJ, Wu HP. Predictive value of the Distress Thermometer score for risk of suicide in patients with cancer. Support Care Cancer. 2022;30(6):5047-5053.
Masih J, Belschak F, Verbeke J. Mood configurations and their relationship to immune system responses: Exploring the relationship between moods, immune system responses, thyroid hormones, and social support. PLoS One. 2019;14(5):e0216232.

Tool 2- Detailed Mind Monitoring Tool with Stages of Suicide-How To Help your Mind Book

You may also benefit from monitoring your mind using techniques in the short book Stages of Suicide-How to Help your Mind. When you are feeling good, it is worth setting aside time to prepare and work out some steps to take in preparation for bad times when you might experience indicators of pre-suicide stages. Monitoring your actions and emotions is valuable here. This book explains the six stages people can experience and describes practical ways to identify if you are experiencing them. Practical tools are included to help with maintaining a rational and safe mind.

Stages of Suicide – How to Help Your Mind

For more on how to Target Cancer with the Mind CLICK HERE