An Unexpected Life
An Unexpected Life
My Anxiety Has Anxiety! (Guest April Moran)
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Is your head spinning? Your heart racing? Does life feel out of control?
Join the club! In this chaotic world anxiety is at an all-time high. But don’t lose hope - help is here!
In this episode, Marianne Banister talks with Anxiety Expert and Cognitive Behavioral Therapist April Moran, about how you can add some calm to your life with easy practical tips. Enhance your body and mind connection for your overall health and wellness. It’s especially important for those fighting cancer or other chronic conditions.
What You’ll Learn in This Episode
✅ The toxic impact of stress hormones on your body
✅ The link between anxiety and cancer
✅ Easy techniques to calm your mind and body
Links
🔶 Stress and Cancer: bit.ly/4kVuDV3
🔶 Cortisol and Cancer: bit.ly/4kWDeXA
🔶 Anxiety Ruining Your Vibe? https://bit.ly/4j1GvTx
Claire Marie Foundation Mission
“ The Claire Marie Foundation provides clarity and hope in the fight against adolescent and young adult melanoma through awareness, education and prevention.
Follow and Connect
🔶 LinkTree
Welcome to Radio Red. The scariest stories you've ever heard in your life. We go. This was a huge people. Something here. Something out of this world.
SPEAKER_02There was a woman moving through the hall. I stepped back and I was completely alone.
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SPEAKER_03Can we just talk about anxiety for a moment? I'm sure it's on high alert for most people these days. It seems we all have some level of it. And I just have to share with you a story of a friend who's so bad for her, even her emotional support animal, is now on anti-anxiety meds. It's true. What can you do? Right? What can you do in this world these days? Well, it turns out there is quite a bit that we can do. Let's just say it's all part of living an unexpected life. Hello and hello again. I'm Mary Ann Bannister with the Claire Marie Foundation. If you've been following our story, you know our foundation is all about raising awareness of adolescent and young adult melanoma. And the reason I'm so passionate about doing this is because I lost my daughter Claire to melanoma when she was 17 years old. And honestly, it all could have been prevented just if the medical community knew enough about this disease to help us along the way. Claire was just 14 when she was diagnosed. And I'm telling you, just reflecting on the kid she was at that time, she was pretty happy. She was pretty low-key. She was so excited about entering her freshman year of high school. She was an athlete. She was an artist. She was all wrapped up in this aerobic competition that was going to be going on at her school. In short, she had the world right in front of her. And this was the last thing we expected because she took no risks. She didn't tan. She wore sunscreen. But what we didn't know was that her hormones could kick in and create melanoma in her body. We were blindsided as a family, absolutely gobsmacked over the whole thing. We just couldn't understand it. But the best thing, the very first thing we did in deciding this, her dad and I decided that we needed to get her somebody special to talk to, a therapist who could help her navigate all that was ahead of her. Because we knew that mental wellness can help your body heal and fend off and fight the raging disease that is cancer, among other things. So we found what I call Claire's guiding light, an absolute wonderful person, April Moran, who is joining us here today. Hi, April. Thank you. It's so good to see you.
SPEAKER_04Glad to be here, Marianne.
SPEAKER_03You know, I could go on and on for a good, you know, 10, 15 minutes just with your accolades and your credentials. But we're going to keep it short and most basic here, that I want the listeners to know that you have 25 years experience, at least, not to age you or anything. But in specialty, really, of like anxiety disorders. And you're also with the very distinguished Beck Institute as well. And of course, so proud that you're part of our Claire Marie Medical Advisory. And I'm always, I always love talking with you as a friend, as an advisor, getting insight on what we can do with our mental health and our physical health and and how it all still comes together. So just starting off this conversation, how important is your mindset when you're dealing with something like a chronic disease, especially cancer?
SPEAKER_04Well, that's a great question, Marianne. It's really important that a person has a space to be able to process and understand what is happening emotionally, uh, a severe loss of control. So you look at people who have never had cancer before, and once they are diagnosed, over half of them meet criteria for generalized anxiety disorder. So let's let's talk about what that is. GAD, generalized anxiety disorder, it's a a marked sense of fear and constant foreboding, a feeling of dread, marked with sleeplessness, irritability, indecisiveness. So it's important to understand that anxiety does the most to interfere with the processing of information. So uh one of the most important reasons uh uh to talk with a therapist, a counselor, is that the person struggling with cancer needs a place where they can manage that anxiety and make the best decisions going forward. Untreated anxiety is actually connected to uh a difficulty in following a doctor's orders for treatment. And so if we can get the person with cancer's anxiety managed, then they can move forward in a way that they can show up for themselves for the treatment.
SPEAKER_03Well, and starting off just with the basic diagnosis, I always tell families if you're going in in something of this magnitude, the patient should never go by themselves. I don't care if they're 25, if they're 50. It's so much your brain is taking in, isn't that right? That the anxiety can overtake all that and you and you're really not going to absorb. Is that what you're talking about?
SPEAKER_04That's exactly right. Because anxiety interferes with the processing of information, we have a simple, um, well-known tool in my field, name it to tame it. And so when you're able to say, I'm anxious, I'm struggling, uh, I'm afraid, you've now involved the part of your brain, the prefrontal cortex, that can problem solve. So having a dedicated notebook that you take every time to your treatment provider is essential, but having that other person with you is also just as important.
SPEAKER_03Are there some tricks you can do to calm yourself? Um, when people are going through a cancer, I know in melanoma I've there's been so many times it's scan anxiety. You know, a CT scan is coming up or a PET scan. Um almost like you don't want to go, because obviously there can be good news, but you're just petrified it's going to be bad news. How can you manage and just make that happen without just getting yourself sick over it? Right.
SPEAKER_04So anxiety is based in what if. What if this happens, what if that happens. So being able to notice and observe where you're going in your brain and drop into what is. What is is today I'm to show up for this scan. Spending time in the what if is going to increase my anxiety and make it more difficult for me to problem solve. And so uh it's a strategy I work with a lot of clients who are managing cancer in their lives. So catching themselves spending time in the what if uh the anxious moment, anxiety, fear, sadness, our our emotions burn out at around 90 seconds, but we attach them to a story. And it's the what if I never get better story? What if the cancer comes back? What if the scan doesn't read the way I want it to? And noticing without judgment, okay, I'm going to a dark place. Let's stay in the here and now. I don't get that answer. What I do know is I'm going with my supportive person and I've got some tools to manage.
SPEAKER_03Staying in the here and now. Staying in the here and now. And then does that help with, let's say, some of the symptoms that can go along with anxiety, like sleeplessness, headaches. I mean, you can say I want to stay in the here and now, but you just have to. Is it like you just um meditate yourself to it that you stay into it?
SPEAKER_04Well, so there's two things. So this first piece of advice is for the caregivers, the people that love and are on the journey with the person who has cancer. Um, empathy is the most powerful human regulator. Right? So you want to give somebody a message, connect before you redirect. I'm noticing you feel anxious, fearful, that has to be hard. Validation actually drops high emotion. When people feel seen and understood, they can be with what is, they can be with the hard stuff. For the person with cancer, there's something called a tip scale, T-I-P-P. And I work really hard to teach these very specifically to everybody. And I do it here in the office, which at times can be a little uh entertaining. So the T is drop the temperature. So I give them a choice. You want to put your face in a shallow bowl of ice water, or you want to put um a cold mask underneath your eye area here. Uh what happens is these nerves underneath your cheeks connect to the vagus nerve. The vagus nerve switches you from fight flight to rest and digest. And that dropping quickly of temperature, cold water regulates high emotion. So that's the T. Okay, that's fascinating. It really is. It really is. The I is intense exercise. So, you know, Marianne, right before I got on with you, I was feeling a little bit of anxiety. I stepped over there and I cranked out 30 jumping jacks. So getting anxiety is extra energy, expelling it. And the last two are really going to help with sleeplessness and tension. Like uh people with cancer, their body can actually hurt because they're so tense. So the first one is progressive muscle relaxation. And there's actually a really specific way to kick off the vagus nerve of you want to have your tongue on the top of your mouth, you want to be able to act like you're biting on a lemon and close your teeth down. And then we move through the rest of the body, all four stages, to do progressive muscle relaxation, tensing for 30 seconds, releasing. Clients do this when they wake up in the middle of the night and they're ruminating. The last P is paced breathing. So always start without or start with out for eight, which is kind of hard to do actually. Most of us are used to take a deep breath, but we're gonna start out for eight, keeping the hand up on your chest as still as possible while pushing your lower belly out. Okay, that's the deep breath. Okay, out for eight, in for four, out for eight. And some clients say I feel a little dizzy. Well, there's been a carbon dioxide exchange, which triggers the vagus nerve and drops high emotion.
SPEAKER_03Well, because oxygen, and I always tell people um coming from my profession in public speaking and being on camera and stuff, that you when you get nervous, you always hear like the groom that passes out at the wedding. It's because there needs to be and they're not breathing. So one great way just to calm yourself is just to do that deep kind of yoga breathing, right? So you could use that in theory. Let's say if you're waiting in the doctor's office. Oh, absolutely. Unless you have a cold rag you're gonna take with yourself, maybe you should do that too. That's right. I mean, just bring something like a cold pack. Can you just get like a cold pack?
SPEAKER_04So I use a cold pack all the time with my clients. And again, I give them the choice. They, you know, some of them think, oh, I want to dunk my face in in a shallow bowl of ice water, and others are like, there's no way that's happening. It it's about dropping your heart rate, and that's what cold water does. It's actually called the diver response or the diver reflex. And it's a way that we can get into rest and digest. Um, most people, when they're anxious, have a stomach ache. Their bodies in fight or flight, all the blood pulls away from your stomach and to your extremities for fight and flight.
SPEAKER_03Right.
SPEAKER_04Yeah. And so being able to help them feel a little bit of sense of control, this tip scale is something I really work with clients on daily, several times a day, for them to work on. So when they go to those doctors' appointments, when they're ruminating in the middle of the night, when they're about to tell a close friend.
SPEAKER_03Well, and that's one thing I really want to talk with you about because I know obviously one of the big issues for Claire, and I'm not revealing anything too much here, she kept it very, very private. And that was her choice because she felt, well, we thought we were going to get past it right away, just uh physically, not right away, but we it would be a block in her road, but she would recover from this fully. Um, and and and she just didn't want to be a point of gossip as 14-year-olds. I think she was wise in knowing that. But at the same time, she just really, when she needed to share with friends, it was a very hard thing for her to know how to do. And since meeting other people who are young adults um in the dating world, uh, in the job situation, um, trust me, people come up and ask me, Oh, do you have two children? And I have to say, well, I do, but one's not with me any longer. And the room comes to a screeching halt. So, how do you have those conversations that need to be said? How do you decide, make the call for yourself?
SPEAKER_04So I often ask a lot of my clients to think about who it is that they trust and to pick a time and place and not do it by text, not do it in a way that they are now vulnerable to other people sharing what they have decided to share, to share in person and to keep it simple. I I've been diagnosed with cancer and I'm going to begin treatment soon. Here's what I need from you. And it might be I need you to keep this quiet, I need you to check in on me because I don't like to bring it up. It could be a lot of different things. And it's okay to acknowledge the awkwardness. Hey, this is like the hardest conversation I've ever had to have. So be prepared for their reactions. Their reaction could be curiosity and they're asking you to share more than you're comfortable. So to be ready with that one-liner, this is all I'm ready to share today. Know that other people can take care of their own emotions. You don't need to worry about anybody else's sadness or fear. You've got your own journey ahead. And let them again know what you need. I need some privacy, some space, or I need you to keep including me in things and check in on me.
SPEAKER_03Because I think really taking away what you said there, the most important thing is this saying, this is what I need from you. Yes. Instead of saying, I have something to tell you, because a lot of it is anyone who cares about you is going to want to help, but they don't know what to say. That's right. And it upsets them because they love you and care about you. So they have their own set of feelings. So I think it's really important to say, this is what I need from you. But how do you start that if it's someone you've just met? If you're, you know, again, dating. Right. Um, right. When do you bring that up saying, hey, by the way, just so you know, I'm going to, or I have this issue with that. I mean, how awkward is that?
SPEAKER_04It is awkward. And I think that if you're deciding to disclose it, you've already decided that this person is somewhat trustworthy. So being able to say, hey, this is hard to share, but I respect you. I enjoy your company. Um, but I've had an unfortunate diagnosis of cancer and I'm about to begin treatment, right? So being able to unapologetically show up for yourself.
SPEAKER_03Because I think the best thing is you have to put yourself forward. And I know Claire found humor worked for her. Yes, indeed. Because she would often, I mean, for instance, uh she had to have surgery on her ankle. They had to do a skin graph from where the mole was removed. And we had a conversation about, she's like, Well, what am I going to say about this? And uh, and I said, with your recommendation, well, what do you want to say? And she said, Oh, I had a fight with a shark. You should see what happened to the shark. And I was like, Okay, you know, because it was summer. And it it it kind of like obviously she didn't, and people would know she didn't, but it was her way of kind of taking the ball and passing it back to them with a joke, which would deflect the comments further.
SPEAKER_04Um that's exactly right. And so when a lot of people go through that tough period of time when they lose their hair, I had one woman tell her friends, um, listen, I'm coming in tomorrow with um a new hairdo. And so she had had her hair or her head shaved uh that evening. And so the next morning, uh, she came into a round of applause.
SPEAKER_03Right. And I think, don't you think it's how you present it that people look to see if you're okay with and you're not always okay, and it's okay to not always be okay. But if but but it's important to show that if you are okay with it, to share that as well. Because you know what? It this is my deal. This is what I'm dealing with. I'm still showing up for work, I'm still coming to the sports team. I may not be running as fast because the drugs are messing me up, but I'm here. So let's, you know, life goes on, right?
SPEAKER_04Well, and and so that's really the cognitive model. And as a CBT therapist, it isn't the situation, but it's your thoughts and emotions that give meaning to an event. And if you are focused on the worst case scenario, then your thoughts and emotions will be very unhelpful to you. And never do we want anybody, do we want to minimize and say that, you know, this isn't as awful of a journey. Of course it is. Nobody's trying to take uh the crappy and make it happy, right? Where we wouldn't do that. But what we want to help them do is this thought, which is very scary, may be true, but is it helpful? And if it's not helpful, let's come up with thoughts that are more helpful. So, you know, oh, oh no, I don't know how serious this cancer is. What if I never recover? That's an honest, true thought, but it's not helpful. Versus I'm on a journey I never wanted to be on. I want to make a list now of all the people who are here to show up for me and love me and support me. And what are some ways I can comfort myself when I'm physically in discomfort or emotionally in discomfort? And that's that's what I help clients try to access is those thoughts that create feelings and behaviors that allow them to cope best with something that they never wanted to handle.
SPEAKER_03No, and and I found, um, and again, with your support, we were trying to parent her, but even obviously through this. And um, there's different ages and different levels of parenting. But then, of course, even if you're a partner of an older young adult, uh, someone in their 20s or 30s, I think it's really important to let them show you the path they wanted. Like we, you know, we had the discussion should she go to a support group? Her choice was no, I just want to be with my friends because her quest was to be normal and to feel and if she was with a bunch of other people who she didn't know and the only thing they had in common was they were ill, that wasn't her vibe. That's great for a lot of people, that was not for Claire. So we had to kind of Of let her do that, and I always remember she set the tone because we weren't allowed to use the C word or the M word. And so when I would be as a 14, 15, you know, until she could drive herself to school, but I would say we do it as a weather report. And I would say in the morning, how how does it look today? And she'd be like, Oh, it's going to be bright and sunny, which I knew, like, okay, she was feeling good. If she said there might be a storm coming in around noon, I knew to be ready that she could only go so far because her physical she the medication was hitting her, or she just wasn't doing well that day. Um and so that was her code to make it as normal. But that's really hard as the person who's trying to help your loved one go through it. Right. Because you're really turning the reins over to them, but isn't that important at any age to let them take the emotional reins?
SPEAKER_04Right. So the question you're asking is how to help them identify where their control is.
SPEAKER_03Yes. Because they have no control over the biggest aspect of their life, right? That's right.
SPEAKER_04That's right. But they have control over lots of small things. And that's one of the things you were able to do that brought Claire a tremendous sense of power. Let her decide how and when to talk about this. Let her decide whether she wanted to do more than individual therapy. And that was a hard no. Um and and that's okay because group therapy um often benefits more the caregivers. Oh, does it really? Absolutely, because they're all in the same lot of somebody I love dearly is going through something and I can't make it not happen. Support groups um are great for caregivers. And even for people with cancer, some some people really lean into them and like them. Um, but I don't know many um older teenagers that love them, but that's that sense of control. So I have a make-a-list on where is your sense of control? What is it that allows you to feel some sense of agency when all of a sudden you're not playing lacrosse, you're going to your oncologist, you're getting another blood draw, you're getting another scan. And that's hard.
SPEAKER_03It is. It is very hard. And um it is something that's so individual and something that's so important because again, the biggest thing in their life is out of control. And particularly when they're striving towards independence and you still have to. Uh, I have friends, uh, a very good friend of ours, uh, their daughter actually is going through melanoma treatment, and she's in her early 40s, right? Clearly an adult on her own. But at the same time, the instinct is to mother that person and that child, if you would, that 42-year-old child. Yes. And to help her through it. And yet you have to realize this is her life. Like, she's what do you do? How do you help them? How do you advise and be there? And yet make them feel like, oh, come on, I don't need my mommy now. I'm a grown-up.
SPEAKER_04So so the question for that mom is what does love look like to you? Does it look like me flying out there and staying with you? Does it look like me coming in for visits, uh, taking you to appointments? What does it look like for you?
SPEAKER_03And that's the big key love and support, because that's what we have to offer them. And if nothing else, when the world gets scary, that's what you know you have from the account so much. Um, April, thank you just you know so much. I have to laugh because I see you have Claire's Claire's painting behind you. I do. That painting Claire had done, just for listeners, uh that was her junior year art project. And uh posthumously, it was chosen for the rock and roll marathon in New Orleans one year. So we were able to print up a lot. And I I just it's Charleston. Claire just absolutely loved Charleston.
SPEAKER_04That's right.
SPEAKER_03It looked enough the battery down there, but it looked enough like uh New Orleans that I guess they thought it was one of theirs. So I didn't say no. Go ahead, take it. You know, she would have gotten a last. Oh my gosh. Do you have, without obviously disclosing any privacy, but do you have a I always like to think of her and smile at the end, a little Clarism that you can share in your time with her?
SPEAKER_04One of the funnier things that helped her cope, and and that was really humor. You know, Claire loved her phone. Oh my goodness, yes. Right. And so she would keep it by her side always. And I would always say to her, you know, this is your session. So like you get to actually say to me, give me a second, I'm getting a flood of texts. And um you get to decide sort of how you use your time here. And it was really freeing because she was like, could I get that in writing for my parents that I get to tell them that I get to use this anytime I want when I want? And and it was that sort of sense of humor that um helped her manage the really hard days.
SPEAKER_03It certainly did. And you did so much to help her again. And I just, you know, it's an honor. Thank you so much. And for all you do for other young people and and striving forward to make the best of their life. And and it just this is just such a great honor to have you join me, Tay, and to share this information because I know we talk about it and how important it is to get it out there. And we've been talking about this for a long time. How are we gonna do it? And here we are, look at us doing the podcast together. Thank you, April. And of course, thank you. Thank you. And if you'd like more information about what we've talked about here today, obviously, you can go uh to our website, ClaremarieFoundation.org. The link will be in our episode notes, along with any information uh that we can forward to you about this topic. I want to offer a big, big thanks to our mission sponsors who make this happen for us with this podcast, Castle Biosciences and Children's Cancer Foundation. Thank you so much. Go forth, everybody. Have a wonderful day. Celebrate the joy, color, and beauty of the world, and live life like Claire. We'll see you next time.
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