Eleven months after being treated for breast cancer, a client reports difficulty sleeping and associated fatigue, while denying any other signs or symptoms. Which of the following issues might this client be experiencing?
a. Situational depression
b. Normal remission symptoms
c. Post-traumatic stress disorder
d. Delayed effects of chemotherapy drugs
A
Survivors' feelings of distress range along a continuum from sadness to disabling depression (Vachon, 2006). The long-term presence of fatigue and sleep disturbances, for example, is often associated with anxiety and depression in many cancer survivors (Barton-Burke, 2006).
Sleep disorders and fatigue would not necessarily be expected at this point in the remission stage.
Post-traumatic stress disorder (PTSD) is a psychiatric disorder characterized by an acute emo-tional response to a traumatic event or situation. Cancer survivors experience symptoms of PTSD (e.g., grief, nightmares, panic attacks, or fear) at a rate of 4% to 19%, as a result of their diagno-sis, treatment, or a past traumatic episode.
While chemotherapy drugs can produce side effects, sleep disorders are not a typical complaint.
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