Depression and Cancer

by Jane Ashley

Every cancer patient says that the diagnosis was a shock. After the news settles in and we begin to process our new reality, we may begin to feel many different emotions. Feeling distressed, down, anger or weepy is totally normal when we are first diagnosed, but how long should these deep, dark feelings last? Is it normal to feel this way? Or could our feelings be signs of depression?

Lonliness

What are the symptoms of depression?

It’s normal to experience strong reactions to our diagnosis, but if our feelings are especially strong/severe and interfere with our daily life and with our family relationships, then we should share this information with our oncologist. Here are some telltale signs that you may be suffering from clinical depression.

• Feeling sad, empty or numb almost every day
• Feeling hopeless, worthless or full of guilt
• Unable to concentrate or make decisions
• Memory problems (not the same as chemo brain)
• Loss of interest in your favorite things
• Lack of motivation to perform daily activities (like not bathing or not shaving)
• Fatigue, insomnia and/or loss of appetite
• Sleeping during the day
• Decreased sexual desire
• Negative self-worth or feelings that everyone would be better off without you
• Suicidal feelings
• Wild mood swings/hyperactivity

We might be in denial about being depressed. We might say, “Oh, it’s the chemo that making me feel fatigued.” We might blame our chemo for our loss of appetite. We might blame memory loss and lack of concentration on our treatments.

Yet, deep down, we may realize that there is a difference. We may put up a positive attitude to hide our fear and loss of hope … but untreated clinical depression can lead us down a slippery slope of ever-deepening depression.

Risk factors and causes of depression

Obviously, the diagnosis of any serious disease may cause us to be distressed. However, some people are more likely to become clinically depressed – a serious condition that can adversely affect our treatment and outcome. Who is more likely to become depressed?

• People who have battled depression in the past are at increased risk of suffering from another bout of clinical depression.
• A family history of depression makes it more likely that we may experience depression
• Lack of support from friends and/or family
• Being alone with no support
• Financial burdens/loss of income
• The diagnosis of a particularly aggressive/less treatable type of cancer

Interestingly enough, cancer patients in end-of-life care are not more prone to depression than patients in active treatment. About 20 percent of cancer patients experience depression with another 10 percent experiencing anxiety.

Appetite Loss

Why some people put up a good front …

Some patients experience depression but display an outward positive attitude. Why do cancer patients do that? Most do it to protect their spouse/family – to keep them from worrying. Some patients may be in denial about their diagnosis so they put on a happy face.
Others believe that it’s necessary to have a positive attitude to have a positive outcome from their treatment. Studies show that being happy or positive don’t affect the outcome of their treatment.

Being overly cheerful to protect our loved ones is not in the best interest of either ourselves or our loved ones. Denial can be painful and self-destructive. Loved ones should reach out to each other during cancer treatment to help and support each other.

When to seek help if you or a loved one is depressed

Be sure to ask your oncologist about depression. Some cancer treatment centers include a regular screening to help spot patients who are struggling with depression. But don’t wait to seek help.

Walking Fights Depression

Medications. Antidepressants are miracle makers for most people. Some take up to two or more weeks to fully work. And when they begin working, patients often say that it’s like a black veil being lifted off them.
Counseling. Some patients might be reluctant to share their innermost feelings with a stranger. Psychologists, psychiatrists and licensed counselors are skilled professionals who can teach you coping strategies to help lift your mood. A psychiatrist can also prescribe an antidepressant and anti-anxiety medications.
Exercise. Yes, believe it or not, exercise helps depression. Some patients may not be physically able to walk or exercise. But if you are able, take a nice walk three times a week. I can personally vouch for this – I walked throughout my year of treatment – some days, it was only 1/4 mile (after surgery or the day after chemo), but most days, I walked 1-2 miles daily. I kept telling myself, “I’m trying to stay at least half a mile ahead of any stray cancer cells.”
Routines. Maintaining a routine helps establish good habits. You’ll feel like you’re in control again and regain confidence and self-esteem by having a routine that you can stick with.

Don’t suffer from depression … don’t let your loved one suffer needlessly either. Recognizing depression can be tricky because some of the side effects of treatment are the same symptoms as depression. There’s no need to fall into a deep, dark abyss – get some help for yourself or your loved one. Your treatment will be easier to tolerate and endure if you’re not depressed.

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