General Information About Depression
Key Points for This Section
- Depression is different from normal sadness.
- Some cancer patients may have a higher risk of depression.
- There are many medical conditions that can cause depression.
- Depression and anxiety are common in patients whose cancer is advanced and can no longer be treated.
- Family members also have a risk of depression.
Depression is not simply feeling sad. Depression is a disorder with specific symptoms that can be diagnosed and treated. About one-fourth of cancer patients become depressed. The numbers of men and women affected are about the same.
A person diagnosed with cancer faces many stressful issues. These may include:
- Fear of death.
- Changes in life plans.
- Changes in body image and self-esteem.
- Changes in day to day living.
- Money and legal concerns.
Sadness and grief are normal reactions to a cancer diagnosis. A person with cancer may also have:
- Feelings of disbelief, denial, or despair.
- Trouble sleeping.
- Loss of appetite.
- Anxiety or worry about the future.
Not everyone who is diagnosed with cancer reacts in the same way. Some cancer patients may not have depression or anxiety, while others may have high levels of both.
Signs that you have adjusted to the cancer diagnosis and treatment include being able to stay active in daily life and continue in your roles such as:
This summary is mainly about depression in adults with cancer. There is a section at the end of the summary about depression in children with cancer.
There are known risk factors for depression after a cancer diagnosis. Factors that increase the risk of depression are not always related to the cancer.
- Risk factors related to cancer
Risk factors related to cancer that may cause depression include the following:
- Learning you have cancer when you are already depressed for other reasons.
- Having cancer pain that is not well controlled.
- Having advanced cancer.
- Being physically weakened by the cancer.
- Being unmarried (for certain types of cancer).
- Having pancreatic cancer.
- Taking certain medicines, such as:
- Risk factors not related to cancer
Risk factors not related to cancer that may cause depression include the following:
- A personal or family history of depression or suicide.
- A personal history of alcoholism or drug abuse.
- A personal history of mental problems.
- A weak social support system (not being married, having few family members or friends, having a job where you work alone).
- Stress caused by life events other than the cancer.
- Health problems that are known to cause depression (such as stroke or heart attack).
Medical conditions that may cause depression include the following:
- Pain that doesn't go away with treatment.
- Abnormal levels of calcium, sodium, or potassium in the blood.
- Not enough vitamin B12 or folate in your diet.
- Too much or too little thyroid hormone.
- Too little adrenal hormone.
- Side effects of certain medicines.
- Beliefs about life.
Depressed terminally ill patients feel they are "being a burden" even when they don't depend very much on others.
Anxiety and depression are also common in family members caring for loved ones with cancer. Children are affected when a parent with cancer is depressed and may have emotional and behavioral problems themselves.
Good communication helps. Family members who talk about feelings and solve problems are more likely to have lower levels of anxiety and depression.