We look at the signs and symptoms of depression after a cancer diagnosis or treatment, and how to tackle them...
Cancer and depression have one big factor in common – they’re both umbrella terms for a wide range of diseases and conditions. It’s estimated that there are up to 200 different types of cancer and 12 different types of depression, including bipolar disorder and post-natal depression.
As if coping with an unwelcome diagnosis and challenging treatment were not enough, cancer patients often find themselves having to deal with depression too – as many of our Community Forum members have found.
It’s a big topic but, in this article, we’re focusing mainly on what’s known as reactive depression, triggered by a life event or events – such as a cancer diagnosis – and situational depression, which tends to be short-lived and stress related, and develops after a series of traumatic events, for example, after a prolonged period of cancer treatment, and makes it hard to readjust to everyday life.
What do we mean when we talk about depression?
We all have times in our lives when we suddenly feel flat or low – and sometimes we can’t always identify the reason. These feelings can disappear as quickly as they arrived but it’s only when they persist and become more severe, not just for a few days but for weeks or months at a time, that they become a cause for concern. This is known as clinical depression and, as well as psychological symptoms, it can be accompanied by physical and social symptoms, including lack of energy, poor sleep, struggling at work, and avoiding contact with friends.
(The NHS website has a clear, helpful guide to clinical depression and its symptoms.)
How and why does cancer trigger depression?
‘You have so much going on, and emotions and the mind can take a real hit from it.’ Community Forum member
While cancer, in itself, doesn’t cause depression, it can act as a trigger, as a result of:
- the shock of diagnosis
- cancer treatment - which can be invasive, distressing and even life-changing
- chronic (constant) pain caused by the cancer itself or by cancer treatment
- a side effect of treatment, such as hormone therapy
- a terminal prognosis
If you have suffered with depression in the past, you may be more prone to depression when you have been diagnosed with cancer or are having cancer treatment.
What to do if you have cancer and symptoms of depression
Make a list of your symptoms and any questions you may have and book an appointment with your GP or specialist cancer nurse. This is a first step to getting to the root cause. If, for example, the trigger is the hormone therapy you have been given as part of your treatment, it may be possible to switch to different medication or explore an alternative approach. If the trigger is emotional – you may still be reeling from the shock of diagnosis or your prognosis – counselling or a talking therapy called cognitive behaviour therapy (CBT) may help.
Alternatively, you may be prescribed an anti-depressant, provided that this won’t interfere with your treatment or any other medication you are taking.
If you are struggling with depression because of chronic pain, do discuss this with your GP or specialist nurse as they should be able to prescribe or recommend suitable pain relief. Cancer and cancer treatment can often cause muscle or joint pain and, if this is affecting you, do take a look at our expert guide, as this includes a seven-point plan for easing pain of this kind.
Above all, don’t feel guilty about feeling depressed. It’s entirely understandable. As is so often said, cancer is the diagnosis none of us want – even when cancer is diagnosed early and our prospects for recovery are good.
What can help when you have cancer and depression?
While anti-depressants may be helpful, they may not be suitable for you or you may prefer not to take them. We’ve put together some alternative suggestions that could help to ease your depression.
Talking it through
‘My doctor diagnosed me with depression a year ago and advised me to go to Macmillan Cancer Support, who provided me with a counsellor and lots of love and understanding.’ Community Forum member
Several of our members who have experienced depression found that counselling, such as that offered by Macmillan Cancer Support, has given them an invaluable lifeline. It can make a real difference, particularly if you find it difficult to discuss or share your feelings with family or friends. Sometimes it’s easier to unburden ourselves to an experienced and understanding counsellor than to a loved one, whose own feelings we often try to protect.
Reducing stress
Cancer is a stressful business, as is its treatment, and stress can trigger depression . . . so anything we can do to lessen the effects of stress is welcome. The Live Better With online shop has some great products and aids that can help you do just this. They include our own Stress Relief Balm and an Aroma Diffuser to use with calming, fragrant essential oils.
Eating to beat depression
There is plenty of evidence to show that what we eat can help to ease depression. If you can, aim to follow the Mediterranean Diet, which is high in vegetables, fruits, fish, nuts, whole grains and olive oil. This won’t always be possible, especially if you are having chemotherapy, which can affect your appetite and make your mouth sore and painful, but our online shop has an excellent selection of specialist cookbooks and equipment designed to help you eat as well as you can at every stage of your treatment.
Do read our Expert Guide to Cancer and Eating Well
Creativity as therapy
Finding something that you love doing can be an effective way out of depression – it could be painting or drawing, gardening, sewing, woodwork, writing – anything, in fact, that helps to shift your focus and spark your creativity.
Concentrating deeply on something you enjoy doing and that you are able to do, even for short periods, is a form of mindfulness that can lift your mood and give you a sense of achievement. Take a look at the mindfulness section of the Live Better With online shop for ideas and inspiration.
Lightening your mood
If your mood and energy levels start to dip or become worse during the winter months, you may be suffering from a particular form of depression known as Seasonal Affective Disorder (SAD) or ‘winter blues’. If this sounds familiar, try using a special SAD light, which could make you feel brighter in yourself by replicating natural sunlight.
Moving to beat depression
Exercise of any kind, even gentle regular movement, can be an important contributor to beating depression. If you haven’t exercised for a while or if your treatment prevents you from doing anything too vigorous, take a look at the exercise section of our online shop. The range includes easy-to-use home exercise equipment and guides to exercise, yoga and Pilates after cancer treatment.
Do read our Expert Guide to Cancer and Exercise
Connecting with nature to beat depression
Being out in the open air, whether it’s a garden, nearby park, countryside, woodlands or coast, can be a great mood-booster. Going through cancer treatment means spending a good deal of time indoors, often in hospital areas without windows, so try to get a daily dose of fresh air whenever you can – even if it’s just sitting on a balcony, or in your garden. The mental health charity, MIND, has some excellent information on the benefits of nature and you can tailor your outdoor activities to suit your energy and mobility levels.
Connecting with others
Cancer and cancer treatment, which can be very tough, can leave you feeling isolated and alone, even when you are surrounded by a loving family and supportive friends. That’s where our Community Forum can help. It’s free to join and you’ll find that members are welcoming, understanding and happy to share their own experiences. Whatever you are feeling, the chances are that other members have been in that place too.
Many counties, cities and larger towns have their own local cancer support organisations. Ask your local surgery or library for details.
Do read these Live Better With articles on cancer and depression:
Visit the Live Better With Cancer Community Forum – for information, advice, and tips and to share your own questions and suggestions.