Depression

Facing a diagnosis of cancer or cancer treatment can be very stressful and may result in depression for some patients. Depression is a persistent sadness that interferes with your ability to complete daily activities. Treatment for depression depends on each individual, but is generally comprised of medication for controlling symptoms and counseling to deal with the underlying thoughts or feelings that led to depression.

What is depression?

Depression is a persistent sadness that interferes with your ability to complete daily activities.

What causes depression?

While the actual causes of depression in cancer patients are not known, there are a variety of factors that can increase your likelihood of becoming depressed. These may include:

• Physical condition
  • Poorly controlled pain
  • An advanced stage of cancer
  • Increased physical impairment or pain
• History
  • Personal history of depression or attempted suicide
  • Family history of depression or suicide
  • History of alcoholism or drug abuse
• Lack of family support
• Other life events that produce stress
• Pessimistic personality

Medications commonly prescribed for management of your cancer may have depression as a side effect, such as:

• Chemotherapy drugs
• Hormones
• Immunosuppressive agents
• Steroids

What are the symptoms of depression?

The symptoms of major depression include:

• Depressed mood for most of the day and on most days           
• Loss of pleasure and interest in most activities 
• Nervousness or sluggishness 
• Poor concentration 
• Feelings of worthlessness 
• Tiredness 
• Changes in eating and sleeping habits 
• Constant thoughts of death or suicide 
• Guilt 
• Feeling dissatisfied 

For cancer patients, the most common symptoms of depression are:

• Guilt
• Worthlessness
• Hopelessness
• Thoughts of suicide
• Loss of pleasure

If you exhibit these symptoms for at least 2 weeks, you may be diagnosed with depression. However, it is sometimes difficult to separate the symptoms of depression from the side effects of treatment or the symptoms of the cancer itself.

How is depression treated?

Depression is most often treated with a combination of counseling and antidepressant drugs. Medication is often used to ease symptoms so that other therapy can continue.

Antidepressant drugs - There are different kinds of drugs available for the treatment of depression. Most antidepressants take 3 to 6 weeks to begin working and may be associated with some side effects. Even after you feel better, your doctor may recommend that you continue to take the medication for 6 to 9 months, or perhaps longer.

Counseling -  Psychotherapy, also known as “talk therapy,” can be an effective treatment for depression. There are several approaches to psychotherapy that have been used to relieve symptoms of depression. All of these involve working with a trained therapist to identify the thoughts or behaviors that are contributing to your depression and figure out ways to solve these problems and cope with depression. Cognitive behavioral therapy is frequently the quickest and most effective type of treatment to deal with this type of depression. In general, psychotherapy takes weeks to months to complete.

What else can I do?

If you have suicidal thoughts, such as wanting to “end it all,” you need immediate assistance to ensure your safety. Tell someone—family, friends, or your doctor—immediately. Although the problems you have seem insurmountable, most patients can be significantly helped with the right treatment(s).

Make sure you are getting enough sleep and try to exercise daily. Being well rested will help you cope with difficult events and emotions. Exercise increases the release of natural chemicals in your body called endorphins, which promote a feeling of well-being. A daily exercise program can be as simple as 20 to 30 minutes of walking.

Also, cancer support groups may be helpful in treating depression. Support groups have been shown to improve mood, encourage the development of coping skills, improve quality of life, and improve immune response. Support groups can be found through your local doctor’s office, CancerCare.org, and the American Cancer Society.

You may wish to try relaxation techniques to help you cope with your depression, such as:

• Meditation 
• Yoga 
• Deep breathing