Leukemia is a type of blood cancer in which blood stem cells develop abnormally in the bone marrow and crowd out healthy blood cells. Leukemia is the most common cancer diagnosis in children. Along with physical symptoms such as pain, fatigue, leukemia petechiae, and shortness of breath, children living with leukemia can also sometimes experience various mental health issues related to their diagnosis.
The full lived experience of leukemia comprises not only symptoms of the disease, family and parental stress after the diagnosis, and the harsh effects of cancer treatment, but also psychological distress caused by treatment and hospitalization. After remission, potential fear of relapse may also cause major social and emotional disruptions that can impact mental health.
With the right support, though, children facing leukemia can have better mental health outcomes.
Pediatric Leukemia and Mental Health
Psychological issues among children with leukemia may include anxiety, behavioral problems, sleep issues, intense stress, post-traumatic stress disorder (PTSD), and disruptive worries about the future. Depression and anxiety are the most commonly reported mood disorders among children with leukemia.
The uncertainty that comes with a cancer diagnosis is a common driver of anxiety. Not knowing what to expect from the next test result, an unexpected change in the treatment plan, and unknowns about long-term outcomes can leave a child feeling anxious.
Pediatric leukemia survivors may also cope with long term impacts on their mental health. Research suggests that even after remission, children who have survived leukemia had more symptoms of depression and anxiety than their siblings who hadn’t faced a diagnosis. This depression and anxiety can delay developmental milestones and interfere with meeting certain life goals, such as progressing through school and maintaining meaningful friendships or other interpersonal relationships.
What Contributes to Poorer Mental Health?
Beside the stress of leukemia itself, certain factors of living with leukemia can also impact mental health. These factors include social isolation, decreased self esteem, and developmental issues that may accompany leukemia.
Social Isolation
Many children or teenagers with leukemia feel “different” from their peers. They may worry about how their peers will respond to their leukemia diagnosis, symptoms, or treatment. They may find it easier to keep their distance. Depression may also contribute to a person withdrawing socially. However, social isolation, especially at a time when children and teens may need the support from friends and loved ones more than ever, can exacerbate mental health issues.
Disruptions to Academic Progress
Leukemia can lead kids to miss 10 to 20 weeks of school per year. Pediatric leukemia is also cause for many kids needing to repeat grades in school, attend special education programming, or be diagnosed with a learning disability.
Leukemia’s disruption of academic progress can be problematic, as educational achievement is thought to be an important predictor of social outcomes later in life. Educational experience is an integral part of a child developing cognitive and interpersonal skills that will help them successfully transition into adulthood and maintain good mental health.
Disruptions to Social Development
Interpersonal issues such as friendship, marriage, and sexuality are common concerns for pediatric leukemia survivors. Studies have shown that survivors of childhood cancer were less likely to have achieved standard milestones in psychosocial development (or achieve these milestones later) than their peers who don’t have leukemia.
For instance, childhood cancer survivors tend to get their first girlfriend or boyfriend at older ages than their peers who didn’t have cancer. Fewer people who had childhood leukemia get married than those who didn’t. These challenges can have long-term effects on a person’s mental health as they enter and navigate adulthood after pediatric leukemia.
Providing Psychosocial Support to Children With Leukemia
Mental and emotional support is crucial for anyone with leukemia. Research has shown that people with cancer may experience a better quality of life when they have solid support from family, classmates, and friends. Their treatment outcomes and prognosis may sometimes be improved with emotional support. The above mental health issues can be overcome with consistent encouragement and support, too.
Strong Support System
Support for psychosocial and emotional issues can come from a strong network of caring people. Having the support of family, teachers, and counsellors is vital. Emotional and psychological support can also involve professionals who can help with coping and adjustment.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) has proven helpful for children, parents, siblings and the family as a whole. CBT for children involves teaching effective emotional coping strategies. CBT also provides support in social skills development. Group therapies may help emotional and behavioral problems, and family CBT therapy may improve long-term family functioning overall.
Peer Support
Peer-to-peer support can also be helpful. Speaking to another who has lived through, adapted, and learned how to manage leukemia can provide a unique connection and help children enduring the same experiences and challenges.
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