Cancer and depression

When you have cancer, you will feel down at times; this is perfectly normal. Your everyday life has suddenly changed, you face an uncertain future, and you may need treatment that will take several weeks or months. Even the most cheerful person would feel sadness, grief, and worry.

In the beginning

After you are diagnosed with cancer, it’s common to ask, “why me,” or to feel worried about the future. You might find it harder to get on with your daily activities. You may also be stressed by family or financial pressures: you may not have enough (or any) health insurance coverage, or there may be problems with finding childcare.

With cancer-related depression, your moods can change depending on how sick you feel, and how your treatments are going. You may feel very low at first, and better when treatment is going well — but worse if your treatment isn’t working. When the situation changes and your cancer has been successfully treated, the depression should go away, too.

How cancer and treatment can affect moods

Some types of tumors (and how the body reacts to them) can cause your body to make substances that are linked to depression. Cancer affects hormones and the endocrine system, bringing on depression in some people; this is especially true with cancers of the lung and pancreas. Ask your medical team for more information.

Some drugs used to treat cancer may also cause depression and mood problems. And some treatment side effects, like tiredness and pain, can be depressing on their own. These side effects can be treated, though, so be sure to talk them over with your medical team.

Helpful tips for handling depression

While you may feel down sometimes, there are many things you can do to lift your spirits and keep from becoming seriously depressed:

  • Share your feelings: Let your medical team and your family know how you’re feeling, so they can be supportive and make sure that you have the help you need.
  • Learn about available resources: Find out what mental health and support services are available at the hospital, so if you do become depressed, you’ll know where to seek help.
  • Get solutions for stressful problems: Social workers can help you find solutions for everyday life problems, like family and financial issues.
  • Join a support group: Cancer patients can offer valuable suggestions to, and heartfelt support for each other. Many hospitals sponsor support groups; there are also message boards for cancer patients at many web sites, including the American Cancer Society (www.cancer.org, also available in Spanish).
  • Learn about your illness: Getting the facts about your cancer can make you less worried and depressed. You can find information at most major cancer web sites, including the American Cancer Society (www.cancer.org, also available in Spanish) and the National Cancer Institute (www.cancer.gov, also available in Spanish).
  • Seek counseling: Your medical team can refer you to a hospital social worker or therapist who specializes in working with people who have cancer.

Recognizing clinical depression

When depression gets in the way of day-to-day life, it can be a sign of a more serious type of problem: clinicaldepression. The key differences between “regular” and clinical depression are: how bad the symptoms are; how long they last; and whether people are able to deal with their situation or whether they feel helpless. People with a history of depression or substance abuse, and who don’t have a network of support, have a greater chance of becoming clinically depressed while dealing with cancer. This type of depression, which affects 25 percent of cancer patients, is a medical condition. It includes these symptoms:

  • Sadness most of the time
  • A negative attitude
  • Feelings of guilt, self-blame, failure and self-dislike
  • Loss of interest in most activities
  • Feeling sluggish, or – instead — ”jumpy”
  • Fatigue
  • Difficulty sleeping, or sleeping too much
  • Problems with making up your mind
  • Trouble focusing on issues
  • Suicidal thoughts, plans or attempts
  • Weight loss or weight gain

If you or a loved one has five or more of these symptoms for longer than two weeks, it’s important to look for help right away. Depression not only makes it harder to follow the cancer treatment that’s been planned for you, it can also make you more sensitive to pain.

Treating clinical depression

Clinical depression can be treated with prescription antidepressants, psychotherapy, or a combination of both. Most antidepressants are safe to take for people with cancer. Psychotherapy, especially cognitive therapy (which looks at changing negative thoughts into positive ones) can help as you deal with the tough feelings that come with a serious illness.

References

American Cancer Society (2007). Cancer and depression. Retrieved 7/1/08 from www.cancer.org.

Blum, D. (2002). Coping with cancer: tools to help you live. Retrieved 7/1/08 from www.cancercare.org.

National Cancer Institute (2008). Depression. Retrieved 7/1/08 from www.cancer.gov.

National Institute of Mental Health. (2007). Depression. Retrieved 7/1/08 from www.nimh.nih.gov.