Depression in cancer patients

Depression is a common but serious mental health disorder. It’s especially common among people with cancer. The National Cancer Institute (NCI) estimates that 15 to 25 percent of cancer patients are affected by depression. This condition may arise as a result of the emotional toll of living with cancer—the physical, financial and interpersonal stress—as well as from changes in the body caused by cancer and its treatments.

However, it’s important to remember that anyone may experience depression. The root of depression isn’t always easy to know. If you’ve experienced depression or other mental health disorders before a cancer diagnosis, or have a family history of depression or suicide, you may be more likely to face depression again when dealing with cancer.

Other factors that may increase the risk of depression include:

• Being diagnosed with an advanced-stage cancer
• Lacking a good support system of family or friends, or feeling like you’re a strain on others
• Having other health problems in addition to cancer
• Facing financial issues or unrelated stressful life events
• Experiencing significant symptoms such as severe pain that isn’t well-controlled

Certain medicines for cancer have side effects that affect mood and may cause depressive symptoms such as:

• Corticosteroids
• Interferon alfa
• Interleukin-2
• Procarbazine
• L-asparaginase
• Amphotericin B

Additional medical causes of depression in cancer patients may include:

• Thyroid problems
• Adrenal insufficiency
• Hypercalcemia (too much calcium in the blood)
• Electrolyte imbalances
• Vitamin deficiencies, including vitamin B12, folate, and iron (anemia)
• Fever

How do I know if I’m depressed?

Cancer may seriously disrupt your life, and it’s normal to have a strong emotional response. You may feel sadness, fear, grief, confusion, anger and a range of other emotions. However, depression is more than just strong emotions. It’s a mood disorder with a specific set of symptoms.

Ask yourself if you’ve experienced any of the following physical, mental or emotional symptoms for at least two weeks. If the answer is yes, it’s possible that you’re going through depression.

Physical symptoms:

• Have you been feeling a lot more tired than usual?
• Have you experienced pain, headaches, cramps or stomach problems for seemingly no reason?
• Has your appetite changed?
• Are you having trouble sleeping, or find you’re sleeping a lot more than usual?

Mental and emotional symptoms:

• Have you been feeling sad, guilty, anxious or irritable?
• Do you find yourself crying a lot more than usual?
• Are you having trouble focusing, remembering things, or making decisions?
• Have you lost interest in things you usually enjoy, such as spending time with family or friends or taking part in your usual hobbies?
• Have you felt like life has no meaning?
• Have you been thinking a lot more about dying?
• Have you thought about or considered suicide?

Experiencing any of these signs and symptoms consistently over a period of at least two weeks typically signals depression. Keep in mind that not every person with depression experiences all of these symptoms, and the severity of depression symptoms may vary from person to person.

How do I manage depression?

Depression is really tough. It may take an enormous toll on your quality of life. Luckily, many people, including cancer patients, recover from depression with the help of counseling, medication or other supportive therapies.

Your doctor may help you get in touch with a mental health professional, even one who specializes in treating people affected by cancer. These may include psychologists, psychiatrists, other licensed mental health counselors and social workers.

Be open to treatment options, including individual therapy, group counseling and medication. They have been shown to help people cope with the many feelings you may be having right now. Acknowledge your feelings. It may help to write them down.

As with cancer in general, the support of your care team, family, friends and community may make a big difference. Don’t hesitate to speak with your care team about how you’re feeling.

Below are some actions that may help manage depression and cancer:

• Speak openly about how you’re feeling and the fears that you or family members may have
• Look for cancer support groups and counseling
• Practice deep breathing and relaxation exercises several times a day
• Check in with your doctor on appropriate exercise routines

Additional supportive care services may help, too, including:

• Yoga, which has been shown to reduce symptoms of depression in some cancer patients
• Mindfulness, a type of meditation training, which has been shown to help with mood disorders and depression
• Acupuncture and massage therapy, which have been shown to help reduce cancer pain, which may contribute to depression
• Aromatherapy, which may help to ease depression

How do I find support?

Your cancer care team is a good place to start. They may help connect you with other patients and local support groups. You also could ask fellow patients if they’ve tried any support group available at a cancer center, hospital, university or community center.

The NCI, American Cancer Society and CancerCare all offer information on counseling and support groups and other services in your area as well. An online “meeting” or telephone support group may be a good fit for you. These virtual support options may provide a truly convenient way to learn more and gain hope in the comfort of your own home.

Know that you don’t have to face depression alone.

Sometimes, depression may lead to thoughts of suicide. If you or a loved one is having those thoughts, the National Suicide Prevention Lifeline (1-800-273-8255) is a 24-hour, seven-day a week, confidential resource. There’s no shame in asking for help.