Depression

Approved by the Lineagotica Editorial Board, 10/2017

Listen to the Lineagotica Podcast: Cancer and Depression, adapted from this content.

Some people with cancer may experience depression before, during, or after cancer treatment. Depression is a type of mood disorder. Depression may make it harder to cope with cancer treatment. It may also reduce your ability to make choices about your care. As a result, identifying and treating depression are important parts of cancer treatment. 

The symptoms of depression may appear right after diagnosis or anytime during or after treatment. These symptoms range from mild to severe. Severe depression interferes with a person's relationships and day-to-day life. This is called major depressive disorder. Talk with your doctor if you have the following symptoms, especially if they last 2 weeks or longer.

Mood-related symptoms

  • Feeling down

  • Feeling sad

  • Feeling hopeless

  • Feeling irritable

  • Feeling numb

  • Feeling worthless

Behavioral symptoms

  • Loss of interest in activities that you previously enjoyed

  • Frequent crying

  • Withdrawal from friends or family

  • Loss of motivation to do daily activities

Cognitive symptoms

  • Decreased ability to concentrate

  • Difficulty making decisions

  • Memory problems

  • Negative thoughts. In extreme situations, these may include thoughts that life is not worth living or thoughts of hurting yourself.

Physical symptoms

  • Fatigue

  • Appetite loss

  • Insomnia, which is the inability to fall asleep and stay asleep

  • Hypersomnia, which is feeling very sleepy most of the time

  • Sexual problems, such as decreased sexual desire

The cognitive and physical symptoms listed above may be side effects of the cancer or cancer treatment. As a result, doctors place more emphasis on mood-related and behavior symptoms when diagnosing depression in a person with cancer.

Risk factors for depression

People with cancer are more likely to have depression if they have these risk factors:

  • Previous diagnosis of depression or anxiety

  • Family history of depression or anxiety

  • Lack of support from friends or family

  • Financial burdens

Screening for depression

The American Society of Clinical Oncology (ASCO) recommends screening for depression. Screenings should occur at the time of a cancer diagnosis and at regular periods during your treatment and recovery.

Treatment for depression will depend on your symptoms and how often you have them.

Although it may be hard, try to talk openly with your health care team about depression. Discuss the following:

  • Your feelings

  • Specific sources of concern

  • Physical symptoms

  • The effect on your daily life

This will help them address your concerns and create a treatment plan.

Treatment of depression

People with depression usually benefit from specialized treatment. For people with moderate or severe depression, a mix of psychological treatment and medication is often the most effective approach. For some people with mild depression, talking with a mental health professional may be enough to relieve depressive symptoms.

  • Psychological treatment. Mental health professionals include licensed counselors, psychologists, and psychiatrists. They provide tools to improve coping skills, develop a support system, and reshape negative thoughts. Options include individual therapy, couples or family therapy, and group therapy. In addition, psychiatrists are the mental health professionals who can prescribe medications. Learn more about receiving counseling.

  • Medications. Different types of antidepressant medications are available. Your doctor will select the most appropriate antidepressant based on these factors:

  • Your needs

  • Potential side effects

  • Other medications you take

  • Your medical history

Tell your doctor about all medications and supplements you take. Some may interfere with types of antidepressants.

Some people experience improvement 2 weeks after starting an antidepressant medication. However, it often takes up to 6 to 8 weeks for the medication to have full effect.

Medication is particularly effective for improving mood and the physical symptoms associated with major depressive disorder. Adding psychological treatment to medication may be helpful for managing negative thoughts and low self-esteem and finding better coping strategies.

Follow-up

Keep your health care team up to date about visits with your mental health professional and the treatment you are receiving. Let them know how treatment is working and if you have any new symptoms.

If depression symptoms have not decreased after 8 weeks of treatment:

  • Consider other treatment options

  • Consider adding counseling to your treatment plan

You and your health care team can also talk about these options earlier, if needed.

Related Resources

Cancer, Depression, and Suicide Risk: Signs to Watch For

Managing Stress

Coping With Uncertainty

Anxiety

More Information

CancerCare: Counseling