Depression and Cancer: A Treatable Condition

Depression is more than feeling down or sad from time to time. It is a medical problem. It brings ongoing sadness and despair, loss of energy, and difficulty dealing with daily life. If you have these feelings most of the day for longer than 2 weeks, it may be a sign of depression.

Other signs of depression include:

• loss of pleasure and interest in activities you used to enjoy
• changes in eating and sleeping habits
• slow physical and mental responses
• feeling restless or jittery
• unexplained tiredness
• feeling worthless, hopeless, or helpless
• feeling a lot of guilt for no reason
• trouble paying attention
• frequent thoughts of death

People diagnosed with cancer may feel other things too. Disbelief or denial. Worry about the future. Grief. The symptoms are not the same for every person.

About 2 out of every 10 people diagnosed with cancer become depressed. The number of men and women affected is about the same. Not everyone reacts to cancer the same way. Some people do not have depression at all. Others have major depression.

A cancer diagnosis brings many stressful issues. Facing your mortality. Changes in life plans. Changes in body image. Worry about money. Cancer-related fatigue, pain and a weaker physical condition can also raise the risk. But two other factors matter even more: a personal history of mental health problems, and a lack of social support.

Some signs of depression can be caused by physical problems. That is important to know. Certain medical conditions can lead to depression in people with cancer. They include pain that does not go away with treatment. Also abnormal levels of certain minerals in the blood, too little vitamin B12 or folate, anemia, thyroid problems, poor sleep, and side effects from certain drugs.

So it helps to talk about your symptoms with your doctor. Your provider may ask about your feelings and your moods. They may ask how long your symptoms have lasted. They may also do a physical exam, or run lab tests to rule out other causes.

Help is available, and depression can be treated. The decision to treat depends on two things: how long it has lasted, and how much it affects your life. You may have depression that needs treatment if you cannot do your usual activities. Or if your symptoms are severe. Or if they do not go away. Treatment may include talk therapy, medicine, or both.

Counseling or talk therapy

Talk therapy helps some people with depression. Your doctor may suggest you see a psychologist or psychiatrist. Most programs are offered both one-to-one and in small groups. A therapy program can help you learn:

• coping and problem-solving skills
• relaxation skills and ways to lower stress
• ways to change negative thoughts
• more about cancer and its treatment

Talking with a clergy member may also help some people.

Physical activity

Being physically active may help relieve depression and its symptoms. At least 150 minutes of moderate-to-vigorous exercise per week has been shown to reduce depression in breast cancer survivors. Ask your doctor what level of activity is safe for you.

Medicine

Antidepressants help some people. If you take them, take them under the care of a doctor. Some antidepressants take 3 to 6 weeks to work. You may be taking several drugs during cancer care. So tell your health care team about all your medicines, herbals and supplements. That way they can help prevent unwanted reactions.

Some people with cancer feel hopeless at times and think about suicide. If you feel hopeless, talk with your doctor. There are ways they can help.

• Call 911 or go to an emergency department if you are thinking of ending your life and feel you might act on it, or if someone you are with has already hurt themselves.
• Call your care team the same day if thoughts of death or suicide keep returning. You can also call, text, or chat 988 to reach the 988 Suicide and Crisis Lifeline. Counselors answer 24 hours a day, 7 days a week, and that includes counselors for people who are deaf or hard of hearing.
• Call your care team within a day or two if low mood, loss of interest, or broken sleep has run for more than 2 weeks, or if a new medicine seems to be dragging your mood down.