Is depression normal in someone with cancer?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Chemotherapy and other harsh cancer treatments are not only tough on your body, they can also take a toll on your mind and sometimes cause depression. The depression may arise from the stress of cancer treatments with their unpleasant side effects and disruption of normal life. However, depression can be difficult to correctly diagnose in a cancer patient because symptoms such as fatigue and pain can result from either the mood disorder or cancer drug therapies themselves. Be sure to talk to your doctor or mental health provider if you suspect you have depression. Treatment is available. 

Donna Hill Howes, RN
Family Practitioner

People often believe that depression is a normal part of having cancer or that the mood disorder can't be treated. These assumptions are false. Treatments for depression are the same regardless of whether you have cancer. But some antidepressants and cancer medications may not interact well, so tell your doctor about all the medications you take; he or she should monitor any side effects that may occur.

Depression treatment for people with cancer involves antidepressant medication, psychotherapy ("talk therapy"), or both.

Depression is common among pancreatic cancer patients. It is important to realize that depression is a treatable complication of pancreatic cancer and patients should contact their physician if they believe they may be depressed.

Dr. Stewart B. Fleishman, MD
Psychiatrist (Therapist)

Feeling depressed is common when you find out you have cancer or during treatment. Serious depression can be a serious burden on your quality of life and keep you from getting to appointments, exercising, eating well or having restorative sleep. Pain seems worse with depression as well. Certain types of cancer are associated with a higher than expected chance of depression (pancreatic cancer, gastric-stomach cancer) which some believe is due to proteins that affect the brain.

Certain medications for cancer can increase the risk of depression, says palliative medicine specialist Dr. Stewart Fleishman. To learn which cancer drugs are most likely to bring on the blues, watch the video.

All cancer patients can be expected to have sad feelings. Between one-quarter and one-half of cancer patients suffer from clinical depression. There is evidence that treating depression in cancer patients may reduce their pain and even prolong their life. Be sure to tell your doctor if you are concerned that you or a loved one might have depression.

About 1 in 4 people with cancer, including adults, children and teens, will experience depression at some point after diagnosis. Symptoms can include: lack of sleep; loss of interest in life; anxiety; irritation; loss of concentration; and, in severe cases, thoughts of suicide—all of these leading to an overall poor quality of life. Unfortunately, many people with cancer and their family members believe that it is quite normal to be depressed or sad if diagnosed with cancer; depression is sometimes viewed as being "appropriate" in these patients.

However, it should never be appropriate for cancer patients to suffer with serious depression. Dr Michelle Riba, Director of the Psycho-oncology Program at University of Michigan Cancer Center says, "Often, patients tell me that dealing with the emotions of cancer is actually harder than coping with the other medical problems." Recent studies demonstrate that untreated mental illnesses can prolong the length and increase the number of hospitalizations, hamper effective treatment, and ultimately reduce the chances of survival.

Assessing depression in people with cancer should include:

  • A careful evaluation of the person's thoughts about the diagnosis
  • Medical history
  • Personal or family history of depression or suicide
  • Current mental status
  • Physical status
  • Side effects of treatment and the disease
  • Other stresses in the person's life
  • Support available to the patient

You may feel embarrassed to ask for help if you experience symptoms of clinical depression. Some cancer survivors worry about what people will think. However, these symptoms can occur, and they do not mean that you are crazy. 

You are not alone if you have concerns about asking for help. Studies show that fewer than one in four cancer survivors with symptoms of clinical depression talk with their healthcare team about their concerns. Some think they are bothering their healthcare team; others do not want to be seen as "weak." Do not allow these feelings to stop you from asking for help. Your healthcare team is available to help you manage your symptoms and find solutions.

Possible treatments may include one or a combination of antidepressant medication and counseling, such as individual or family therapy. Often, a combination of therapy and medication is considered to be the best approach.

There are many effective treatments for clinical depression. There is no need to continue to feel this way. If you begin to feel depressed or would like help dealing with sadness, talk with your social worker, doctor or nurse right away. In the case of an emergency, go directly to your hospital's emergency room to get the help that you need.

It can be natural to experience varying levels of depression and anxiety (and anger and frustration) after receiving a cancer diagnosis. Don't downplay what you're feeling by telling yourself that the emotions you're experiencing are inevitable, and not cause for worry. Seeking out a regimen of both talk therapy and behavioral medication can be helpful, especially if you can find yourself a mental health professional that has previously treated patients with life-threatening illnesses, such as a psycho-oncologist.

Look for ways to manage your depression on your own. Talk therapy and the right meds can be a godsend, but throwing yourself into alternative therapies—such as meditation or yoga—or seeking comfort in spirituality and/or faith can radically improve your quality of life. Don't let negativity hijack your life.

Reclaim your life. Throw yourself back into your old routines, as much as you possibly can. This will help you see that your diagnosis doesn't have to derail your life. And take a second look at your long-term goals. Ask yourself: Where do I want to be six months from now? One year? Five years? Ten? Use the answers to these questions to reprioritize and focus on your short-term goals. Throwing renewed energy into accomplishing these goals will afford you a sense of achievement, and underscore the fact that your life is still your own.

Depression is common in cancer patients: Of the 1.2 million people diagnosed with cancer every year in the U.S., 25% experience depression. The more serious the cancer diagnosis, the more likely the individual will be to experience concurrent clinical depression.

Several factors increase the likelihood of depression co-occurring with cancer:

  • advanced phases of the disease
  • uncontrolled pain
  • disability or disfigurement
  • medications (chemotherapy agents)
  • social isolation
  • socioeconomic pressures

Although often co-occurring with cancer, clinical depression is never an expected result of cancer. When present, clinical depression should always be treated. Depression is characterized by a depressed mood, disinterest in favorite things or activities, feelings of hopelessness, trouble sleeping or sleeping too much, and/or thoughts of suicide.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.