Cancer and Depression

May 20, 2013
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In this podcast, we talk about what depression is, including its causes and symptoms, and how it can be treated.


You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors that care for people with cancer.

Today we’ll talk about what depression is, including its causes and symptoms, and how it can be treated.

About ten percent of Americans will experience depression at some point during their life. However, depression is more common for people with cancer who often struggle with the uncertainty, challenges, and fear that a cancer diagnosis can bring. As many as fifteen to twenty-five percent of people with cancer experience depression. It’s important to remember that although depression is more common in people with cancer, it should never be considered an acceptable part of living with cancer. Identifying depression and managing it are important parts of cancer care, and a wide variety of treatments are available.

First, let’s talk about what depression is and some of the symptoms. Depression is generally a collection of symptoms that are grouped into four categories: mood-related, cognitive, physical, and behavioral. Because cancer and cancer treatment can cause similar cognitive and physical symptoms as depression, more emphasis is placed on the mood-related and behavioral symptoms for people with cancer. Now, let’s discuss specific symptoms within each of these groupings.

  • Mood-related symptoms include feeling of sadness, hopelessness, irritability, numbness, or worthlessness.

  • Cognitive symptoms are related to a person’s thought process. Symptoms in this grouping are a decreased ability to concentrate, difficulty making decisions, memory problems, and negative thoughts, which in severe depression can include thoughts of suicide.

  • Behavioral symptoms of depression include crying often, social withdrawal, loss of interest in activities you previously enjoyed, and a loss of motivation.

  • And, the physical symptoms of depression can be fatigue or low energy, a poor appetite, sleep problems, and a lowered sex drive.

Clinical depression ranges from mild, with a few of the symptoms previously mentioned, to more severe, called major depression. Major depression interferes with a person’s relationships and ability to carry out life’s usual responsibilities.

People with milder forms of depression are better able to carry out daily activities, but they may not recognize depression or seek treatment, which makes it harder to diagnose. Some people with milder forms of depression are reluctant to ask for help because they may blame themselves for not being able to improve their mood. It’s important to recognize that most people with depression cannot improve their mood without treatment and support.

So, how does depression affect cancer treatment? First, clinical depression can worsen the physical effects caused by cancer, sometimes increasing the losses experienced by the patient. For example, fatigue caused by depression can worsen the fatigue caused by cancer treatment. Indecision is often a symptom of depression that affects a person’s ability to make choices about cancer treatments. In addition, depression affects a person’s quality of life and undermines the emotional and physical strength often needed after a cancer diagnosis.

Now, let’s discuss some common ways that doctors treat people with depression. Emotional and social support can help people better cope with the daily challenges that cancer brings, but depression needs specialized treatment. It’s important to talk with a doctor to find the most appropriate treatment. Just as there are specific tests needed for diagnosing cancer, there are specific questions and tests used to diagnose depression and guide a doctor’s treatment recommendations.

The main treatment options for depression are counseling and medication, sometimes in combination. For people with milder depression, simply talking with a counselor may be helpful. The main goal of counseling is to enhance coping and problem-solving skills, help find support, and reshape negative or self-defeating thoughts. Counseling options include individual counseling, couples or family counseling, and group counseling.

In addition to counseling, the doctor may recommend antidepressant medication as part of a treatment plan for some people with depression. Antidepressants can take up to six to eight weeks to start working, although some people notice that they start to work within just a couple weeks. There are several types of antidepressants, and your doctor will select the most appropriate antidepressant based on your needs, medical history, and possible side effects and interactions with other medications you are taking. Be sure to tell your doctor about all medicines and supplements that you take when you talk about which anti-depressant is right for you.

It’s important for people with cancer to recognize the signs of depression, and talk with a doctor about any symptoms they experience. By seeking help, they will be better able to maintain their overall health and well-being, and prevent depression from affecting their ability to cope with their cancer diagnosis and treatment.

For more information on coping with a cancer diagnosis, talk with your doctor or visit Cancer.Net is supported by the Conquer Cancer Foundation, which is working to create a world free from the fear of cancer by funding breakthrough research, sharing knowledge with physicians and patients worldwide, and supporting initiatives to ensure that all people have access to high-quality cancer care. Thank you for listening to this Cancer.Net podcast.