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Getting Through the Shock of a Devastating Diagnosis

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CFAH president and founder, Dr. Jessie Gruman, was interviewed for an article in the January 2011 issue of the e-newsletter HealthyWoman from Bottom Line. We are happy to bring you the full article below. To read other articles from HealthyWoman, you can visit their website here.

Interview by Jennifer Nelson

It could happen tomorrow. The doctor says, "I'm sorry, I have bad news..." and suddenly your life is turned upside-down, leaving you reeling from the shock of a potentially life-threatening diagnosis.

Social psychologist Jessie Gruman, PhD, author of AfterShock: What to Do When the Doctor Gives You ' or Someone You Love ' a Devastating Diagnosis, has been in this situation herself, five times, during her four separate bouts with different types of cancer plus the diagnosis of a dangerous heart condition. "Receiving bad health news sparks great personal upheaval...it is a time when nothing is certain and the future looks dark," Dr. Gruman said.

The period of initial shock can be especially difficult. "Your aim during the first few days is to absorb the news as best you can and to weather the storm of your own emotions and the responses of those who love you," Dr. Gruman suggested. What helps...

Treat the situation as a crisis. It is a crisis, so consider what you need to do to take care of yourself right now and do only that for the first 48 to 72 hours. Call in sick instead of going to work...sleep in or nap if you can...cry when you feel like it...watch TV in bed...take a walk if you feel closed in or agitated...eat what you want when you want (but be sure to eat something, even if you're not hungry, or you'll feel even more depleted). Give yourself this time to process what you've been told and start coming to terms with your situation. Remind yourself that you won't feel like this forever ' as time goes on, the shock wears off.

Avoid making hasty decisions. You may feel driven to start treatment immediately or have surgery now so you can put this problem behind you. But unless there is an actual emergency, it is better to slow down, according to Dr. Gruman ' because decisions made under duress are unlikely to be the best ones. There is rarely only one way to treat a disease, so take time to do some research, investigate your options, get a second opinion and find the right specialist. "You do have to tread a careful path between rushing in and delaying treatment unnecessarily...but there is no time in your life when it's more important to make careful and informed decisions. The only thing you must accomplish during the first 48 hours is to set up appointments to see your doctor and perhaps get some tests, so you will know when you'll have more information upon which to base your decisions," Dr. Gruman said.

Try not to blame yourself. Many people spend hours reviewing past behavior, looking for the cause of their condition. "I ate too much meat and too few vegetables...I should have gotten that colonoscopy sooner...I put myself under so much pressure." But diseases are caused by the convergence of many factors, including genetics, age, and exposure to germs and toxins, Dr. Gruman pointed out. Even if past behavior did influence your current health, the point now is not to blame yourself, but to make decisions that will help minimize the disease's impact going forward.

Important: There is a difference between feeling sad and feeling depressed. "Feeling tearful, having bad dreams and not wanting to get out of bed are common responses to life-altering bad news. But if you find yourself thinking, 'I am a bad person, I deserve this disease, I don't deserve to live,' seek help from a mental health professional immediately," Dr. Gruman urged.

Don't try to force yourself to be constantly optimistic. We live in a relentlessly upbeat society, so when you're sick, you may hear a lot about the importance of keeping up hope. But in reality, hope is sometimes hard to hang onto, and it's perfectly normal to slide back and forth between despair and hope ' even multiple times in a single day. "There is a pervasive belief that optimism can counteract disease progression, but when these links have been examined scientifically, they mostly evaporate," Dr. Gruman said. "Expressing fear, sadness or anger will not make your disease worse...and remaining upbeat all the time may prevent you from getting the support you need during this tough time."

Seek support from loved ones who validate your feelings. Endless optimism is not only an impossible standard to which to hold yourself, it also is a terrible burden for others to impose upon you. Dr. Gruman recalled a case in which, when a hospital chaplain asked a breast cancer patient how she was doing, the woman's husband replied for her, saying, "She's doing great, she's a trooper, she's going to be just fine!" And the wife said, "You always say that, but at night I'm scared, I'm lonely and I don't have anyone to talk to about how I really feel."

Lesson: Surround yourself with people who will listen to your honest concerns and who will say, "I'm scared too, but I love you and I'm here for you."

More Blog Posts by Jessie Gruman

author bio

Jessie C. Gruman, PhD is president and founder of the Center for Advancing Health. Her experiences as a patient — having been diagnosed with five life-threatening illnesses — inform her perspective as an author, advocate and lead contributor to the Prepared Patient Blog. Her book AfterShock helps patients navigate their way through the health care system following a serious or life-threatening diagnosis. You can follow her on Twitter @JessieGruman. | More about Jessie Gruman


Tags for this article:
Relationships/Social Support   Make Good Treatment Decisions   Inside Healthcare   Patient Engagement   Jessie Gruman  




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