With the tragic and untimely death of Robin Williams last week, the topic of depression is in the public spotlight. According to the American Cancer Society, about 1 in 4 people fighting cancer are clinically depressed. And while most people who battle depression are able to find relief that Williams didn’t, it’s a wake-up call for all of us to be more aware of the symptoms, and get help for ourselves or loved ones.
Dr. Carla Denham, a psychiatrist at our hospital in suburban Phoenix, shares the signs of depression and answers important questions about depression and cancer.
What are the common symptoms of depression?
Clinical depression lasts for more than two weeks and interferes with daily life. People who are clinically depressed experience multiple symptoms, including:
- Ongoing sadness
- Feeling guilty, worthless, helpless or hopeless
- Loss of interest or pleasure in normal activities
- Sleeplessness/sleep disturbances
- Poor concentration and forgetfulness
- Restlessness, irritability or agitation
- Loss of appetite or overeating
- Fatigue, decreased energy, feeling “slowed down” or unmotivated
- Social withdrawal
- Extreme mood swings
- Frequent thoughts of death or suicide
Can depression affect the course of cancer?
Although often thought of as only a “low mood,” depression is actually a medical condition that affects multiple complex body systems and processes, including sleep regulation, energy, pain control and even the immune system. Without these systems operating at top capacity, cancer gets an unfair advantage, and overall quality of life suffers as well.
Can depression have an impact on how a patient responds to cancer treatment?
In addition to making it very difficult to maintain a positive attitude, untreated depression can weaken the body’s natural defenses and healing capabilities. A true holistic approach to treatment is optimal. A depressed person can receive chemotherapy, surgery or radiation, but isn’t going to be able to benefit nearly enough without restful sleep, a healthy appetite, spiritual reflection or social interaction.
Why is it important for cancer patients who have depression to get treated?
Treatment for depression can help break the vicious cycle that worsens pain, anxiety and fear, and replaces it with a much more positive cycle of comfort, calm and hopefulness. This in no way diminishes the seriousness of cancer; but although it is almost always hard, it doesn’t have to be terrible. There’s a difference!
What steps should cancer patients take if they are depressed?
The first and most important step: Give yourself the same care and concern you would give a loved one. We tend to be hardest on ourselves, and many people feel they aren’t strong or faithful enough if they accept treatment for depression. However, most of those same people, if asked whether they would want a loved one to accept treatment if they were depressed, say “of course!”
There are many different treatment programs for depression; most involve medication or psychotherapy, or some combination of those treatments. There are herbal and vitamin-based treatments as well, and often aromatherapy, massage or acupuncture can be helpful. Talking with your oncologist or primary care provider is a great place to start. Or if you or a family member is working, many employers have excellent employee assistance programs that can get you started.
How can depression treatments help?
A rule of thumb: Medications treat symptoms, but they don’t teach you anything. They work primarily by balancing neurochemical levels and can be invaluable for insomnia, anxiety or energy levels. However, unless new coping strategies and healthy habits are adopted, the symptoms can creep back. If medications are indicated, use them as a springboard to work in therapy and support groups. Or through reading and reflection, learn ways to maintain progress.
Learn more about depression and cancer.