Based on content from the NIH publication, “Overview.”
Depression is a disabling illness that affects about 15 to 25 percent of cancer patients. It affects men and women with cancer equally.
People who face a diagnosis of cancer will experience different levels of stress and emotional upset. Important issues in the life of any person with cancer may include the following:
- Fear of death.
- Interruption of life plans.
- Changes in body image and self-esteem.
- Changes in social role and lifestyle.
- Money and legal concerns.
Reactions Are Always Different
Everyone who receives a cancer diagnosis will react to these issues in different ways and may not experience serious depression or anxiety.
Palliative care begins at diagnosis and continues throughout the patient's cancer care. Patients who are receiving palliative care for cancer during the last six months of life may have frequent feelings of depression and anxiety, leading to a much lower quality of life. During this time, patients in palliative care who suffer from depression report being more troubled about their physical symptoms, relationships and beliefs about life. Depressed terminally ill patients have reported feelings of "being a burden" even when the actual amount of dependence on others is small.
Just as patients need to be evaluated for depression throughout their treatment, so do family caregivers. Caregivers have been found to experience a good deal more anxiety and depression than people who are not caring for patients with cancer. Children are also affected when a parent with cancer develops depression. A study of women with breast cancer showed that children of depressed patients were the most likely to have emotional and behavioral problems themselves.
There are many misconceptions about cancer and how people cope with it, including:
- All people with cancer are depressed.
- Depression in a person with cancer is normal.
- Treatment does not help the depression.
- Everyone with cancer faces suffering and a painful death.
Sadness and grief are normal reactions to the crises faced during cancer, and will be experienced at times by all people. Because sadness is common, it is important to distinguish between normal levels of sadness and depression. An important part of cancer care is the recognition of depression that needs to be treated. Some people may have more trouble adjusting to the diagnosis of cancer than others may. Major depression is not simply sadness or a blue mood. Major depression affects about 25 percent of patients and has common symptoms that can be diagnosed and treated. Symptoms of depression that are noticed at the time of diagnosis may be a sign that the patient had a depression problem before the diagnosis of cancer.
All people will experience reactions of sadness and grief periodically throughout diagnosis, treatment and survival of cancer. When people find out they have cancer, they often have feelings of disbelief, denial or despair. They may also experience difficulty sleeping, loss of appetite, anxiety and a preoccupation with worries about the future. These symptoms and fears usually lessen as a person adjusts to the diagnosis. Signs that a person has adjusted to the diagnosis include an ability to maintain active involvement in daily life activities, and an ability to continue functioning as spouse, parent, employee or other roles by incorporating treatment into his or her schedule.
Be Open About Getting Treatment
If the family of a cancer patient is able to express feelings openly and solve problems effectively, both the patient and family members have less depression. Good communication within the family reduces anxiety. A person who cannot adjust to the diagnosis after a long period of time, and who loses interest in usual activities, may be depressed. Mild symptoms of depression can be distressing and may be helped with counseling. Even patients without obvious symptoms of depression may benefit from counseling; however, when symptoms are intense and long-lasting, or when they keep coming back, more intensive treatment is important.