Rarely talked about by patients, doctors, or worried family members, clinical depression in cancer patients is common, even though it can be successfully treated. Clinical depression occurs in almost one out of every five women diagnosed with breast cancer, not surprising since a diagnosis of breast cancer can abruptly and severely change a woman’s life and the lives of those close to her.
Clinical depression should not be confused with the normal feelings caused by a diagnosis of cancer. People with cancer and their families and friends should be aware of the symptoms of clinical depression, its causes and why it is important to have it treated.
What is clinical depression?
Clinical depression is hard to define because symptoms initially occur as normal feelings, such as emotional upset, sadness, anxiety, poor concentration and withdrawal. These feelings are all quite natural after receiving a diagnosis of cancer, since the patient’s mind is overwhelmed with new medical information, insurance details and thoughts of life and death.
However, there are some specific symptoms of clinical depression to watch out for: persistant sadness; loss of interest or pleasure in everyday activities; irritability or excessive crying; sleeping or eating disturbances; chronic aches and pains; decreased energy and fatigue; thoughts of death and suicide.
These symptoms may vary in severity and duration. If you have five or more of these symptoms and they are persistent, lasting for more than two weeks, a clinical evaluation for depression is a good idea.
What are the underlying causes of depression?
A diagnosis of cancer creates many concerns. Women with breast cancer commonly mention the following: concerns about what the future holds; fears about medical costs; fears for the future of the family; worries about appearance, especially after surgery. These issues should not be minimized; indeed, they are some of the largest issues a woman will face in her lifetime. Left unacknowledged, these worries can grow into symptoms of depression.
Many factors can cause serious depression. For example, research shows that the more severe the condition is perceived to be, the more likely it is that a person will experience clinical depression. A woman newly diagnosed with breast cancer or other forms of cancer may not be depressed about body image changes because she may not anticpate how much treatment will change her body. However, concern may arise later, after treatment. A history of depressive illness, social isolation or financial problems also places a person at greater risk for clinical depression.
Why should depression be treated?
Untreated depression is dangerous. It causes great distress, impairs normal daily functioning and can even interfere with the ability to follow medical treatment. Fortunately, depression is very treatable – up to 80% of all depressed people improve, usually within a few weeks after beginning treatment with drug therapy and possibly, phychological counseling. Sharing one’s concerns in a support group can also be extremely helpful.
There are many benefits to treating depression. Proper diagnosis and treatment of depression in people with cancer may improve their medical status, enhance their quality of life, reduce their degree of pain and disability and improve treatment compliance.
Unfortunately, health care professionals and patients may overlook clinical depression for several reasons. Sometimes symptoms of clinical depression are misinterpreted as a normal reaction to the diagnosis, or they are attributed to the disease itself or viewed as a side effect of treatment.
There is no one time during the cancer experience when depression "normally" occurs. Cancer diagnosis and treatment is a series of ups and downs that may cause acute depression at any time or build to a depressive state. Keep in mind that depression is common and it is treatable. If you, or someone you are close to, is suffering from persistent depression, seek treatment for it. It could make an enormous difference.
Information on cancer and depression can be obtained from the American Cancer Society’s National Information Service by calling 1-800-ACS-2345 or the National Institute of Mental Health’s Depression Awareness, Recognition and Treatment Program at 1-800-421-4211.
Para solicitar información en español, llame al 1-800-ACS-2345. Un especialista en información sobre el cáncer le asistirá en español.
Fall/Winter 1998 Updated 9/18/2004
