I Just Got Diagnosed. Now What Do I Do?

The First Reaction: No Reaction

“I just got diagnosed. Now what do I do?”

Regardless of the specific diagnosis, what I have learned is that how you cope during those first few days and weeks after your diagnosis, and what decisions you make — even though you may feel totally unprepared to think or do anything — will have a profound impact on your future. But most newly diagnosed patients — regardless of how much information they have — are emotionally unprepared to face the impact that their condition may have on their life or to make decisions about their treatment.

When I am sitting across from someone who has been newly diagnosed with a health condition, whether catastrophic or chronic, they almost invariably describe their reaction with one word: shock, which is often associated with disbelief. While there are of course exceptions, for example, when a condition from the past is recurring, or when symptoms over time have rendered the diagnosis inevitable, it is only human nature to cling to that possibility that “it won’t happen to me.” This belief is mainly unconscious; after all, most of us don’t go around assessing our chances of getting hit with a medical diagnosis.

Here’s how someone whom I’ll call Carole described her reaction when she was first diagnosed with cancer.

It was like the world suddenly stood still. I mean, all I could hear was my own breathing, and the thumping of my heartbeat. At first, I was completely numb, and I wasn’t thinking anything. And then I started saying the word ‘cancer’ over and over. Still, no feelings. But deep inside, I realized that, no matter what, my life was never going to be the same.

The initial shock may last moments, hours, days or longer, as your emotional side and your rational side are both struggling with the news. If you have been through the experience of a diagnosis, you might remember how you first reacted, or didn’t react, to the news, or maybe you have seen someone else go through it and felt your own helplessness as you watched them struggle.

In a way, being faced with a diagnosis, while not usually a death sentence, is similar to hearing about a death. As Carole, in my example above, described her diagnosis, nothing will ever be quite the same. We are left with the knowledge that, yes, bad things can happen. We really aren’t invincible after all… and we’re getting older. And the diagnosis — whether it requires extensive treatment that essentially interrupts normal life for months or longer, or whether it requires medication and alterations in diet and lifestyle — requires our acknowledgement and full attention.

Ironically, accepting that life is going to change is the first step toward coping with the emotional impact of the diagnosis and making decisions.

Experience with clients has taught me that we don’t all come to this realization at the same time and in the same way, and some do not face it at all. Yet, while each individual goes through their own process of dealing with a medical diagnosis, I have learned that our reactions are rooted in the earliest days of the human race when, anthropologists tell us, a predatory beast might appear at any moment. In the 1920s, psychologists began using the term “flight or fight” to discuss how humans react to a threat, and when stress emerged as a concern in the 1970s and 1980s, a third reaction — freeze — came into use.

These three basic reactions — flight, freeze, and fight — are also relevant in describing how we react to medical diagnoses.