What is depression?

Coping with a cancer diagnosis can be difficult, especially when beliefs and life goals have been challenged. It is normal to undergo a grieving process or feel sad post-diagnosis, as one will need time to make sense of the situation, evaluate one’s goals in life and emotionally process the losses involved with a diagnosis.

Depression is the persistent feeling of sadness, hopelessness and worthlessness that does not go away. The symptoms differ from person to person, and range from mild to severe. Depression occurs in about 1 out of every 4 people with cancer, and is not a sign of personal failure or weakness. It is a mood disorder that can be treated. You may find it harder to go about your daily activities and follow treatment plans. Seek medical help instead of suffering silently.

It has been found that people with cancer are more likely to develop depression if they have:

• Past history, or family history of depression or anxiety
• Lack of support from family and friends
• Financial difficulties
• Uncontrolled symptoms, especially pain
• Particular types of cancer, for instance those affecting the brain

 

What you need to look out for
Call the doctor if you notice five or more of the following symptoms lasting for two weeks or longer, or are severe enough to affect normal daily activities:

• Sadness or a feeling of emptiness almost every day for most of the day
• Loss of interest in activities
• Eating problems (loss of appetite or overeating) including weight loss or gain*
• Changes in sleep patterns (inability to sleep, early waking or oversleeping)*
• Fatigue or decreased energy almost every day*
• Other people notice that the person is restless or has “slowed down”
• Feelings of guilt, worthlessness and helplessness
• Trouble concentrating or making decisions
• Thoughts of death or suicide, or attempts at suicide
• Wide mood swings from depression to periods of agitation and high energy

*Note that physical problems such as fatigue, poor appetite and sleep changes may be side effects of cancer treatment. Talk to your doctor.

Treatment for depression

Professionals may ask you more questions about your feelings and concerns, physical symptoms and how your daily life is affected. Your treatment plan may include:

• Referral to see a counsellor, psychologist or psychiatrist
• Anti-depressive medications prescribed by your doctor or the psychiatrist. While some people see improvements within 2 weeks, anti-depressive medications usually take up to 6-8 weeks for its full effect.

Do not be worried about seeing counsellors, psychologists or psychiatrists. Psychological problems are very common amongst cancer patients; you are not alone. Seeing them does not mean that you are mentally ill or that you are emotionally not strong enough. Many people see these professionals to help them with day to day psychological difficulties (e.g. phobias, eating and sleeping disorders). They can conduct therapy sessions to help you improve your coping skills and reshape negative thoughts. They will also advise you on relaxation techniques that can be used to help you cope and feel better.

Please inform your cancer care team if you suffer from any of the depressive symptoms as stated above, or if you experience any unexpected or intolerable side effects from the anti-depressive medication that you have been prescribed. It is especially important to speak to your cancer care team early if you feel like harming yourself, so that you can get the help you need as soon as possible.

Tips for coping with depression

See NCCS’ write up at https://www.nccs.com.sg/patient-care/pages/depression-and-cancer.aspx for tips on ways to cope better with your emotions and everyday life.