At times, you may feel very low when you or someone close to you has been diagnosed with cancer. This may be at the time of diagnosis, or during or after treatment.
For some people, their low mood may continue or get worse, and they may need professional help or treatment.
Depression is a common condition that affects around 1 in 10 people. It can be triggered by a variety of difficult events, including a cancer diagnosis or having treatment for cancer. However, it can also occur by chance or be related to other events that have nothing to do with cancer.
Depression can develop slowly, which can make it difficult for either you or your family to recognise when it started. Depression can also hit you suddenly - one day you wake up and realise that you feel hopeless and helpless, and that you’re engulfed in a ‘cloud’ of depression.
Symptoms of depression include:
waking up early, having difficulty sleeping, or sleeping more than usual
smoking or drinking alcohol more than usual
crying a lot
having difficulty remembering things
having a very low mood for most of the time
being unusually irritable or impatient
getting no pleasure out of life or activities you usually enjoy
feeling a loss of affection or sexual desire
finding it hard to concentrate or make decisions.
Most people affected by cancer will feel low at times. But if this low mood continues or gets worse, then it may mean that you’re depressed. Sometimes, it can be difficult to know if you’re depressed or not. It may be other people who notice symptoms and suggest that you might need help.
Who is most likely to develop depression?
Back to top
Some people are more likely to develop depression than others. These include people who:
have suffered from depression before
have no one to discuss things with - it can help to talk about how you feel with your cancer team at an early stage
have a lot of other concerns or difficulties to deal with at the same time as they are coping with cancer
are being treated with certain drugs that may cause depression in some people.
Dealing with depression
Back to top
The relationship between cancer and depression is complex. A diagnosis of cancer often involves some sort of loss - for example, loss of future plans or loss of income. It’s natural and healthy to feel low as a result of loss.
Depression is not a sign of personal failure or an inability to cope. There’s no need for you to feel guilty about feeling depressed or not feeling positive all the time. It’s important to remember that depression is common, and that it can usually be treated successfully. The first step to feeling better is finding appropriate help.
There are things you can do to help yourself. But if you think you need professional help, speak to your doctor or nurse. They may refer you to a specialist or prescribe medication.
There are also organisations that can help people with depression, including Samaritans and Depression Alliance.
Some people will be prescribed an antidepressant to help lift their mood. Antidepressants are thought to work by affecting certain chemicals in the brain. They take effect slowly. This means you will not usually notice any improvement in your symptoms until about two weeks after you start treatment. There are different types of antidepressants, and your doctors may need to try more than one to find the type that suits you best.
Antidepressants are not addictive, but they may cause symptoms when people stop taking them. Most people only need to take them for about six months to help them through their depression. It’s important to follow the advice of your doctors when stopping antidepressants and to not stop them suddenly.
Like all other medicines, antidepressants have side effects. However, these are usually mild. They tend to be more of a problem during the first few weeks of treatment. They include a dry mouth, drowsiness, feeling sick (nausea), sleeplessness, sexual problems and headaches. These side effects generally improve with time. Let your doctors know if side effects are particularly troublesome.
You can read more about antidepressants on the websites of the Depression Alliance and the Royal College of Psychiatrists.
St John’s Wort
St John’s Wort is a herbal treatment. Some research has shown that it works well as a treatment for depression. Other research suggests it may be less effective than antidepressants, particularly for more severe depression. However, St John’s Wort may cause fewer side effects than antidepressants.
It’s important to talk to your doctor if you plan to try taking St John’s Wort as it can react with a number of other medicines including some cancer treatments. You should not take St John’s Wort if you are taking any other antidepressants.
As with other treatments for depression, it may take several weeks to get the full benefits.
Getting professional help
If you’re very depressed, you may find it helpful to be referred to a psychiatrist or clinical psychologist. They have special expertise in helping people who are depressed.
They will want to know how the depression developed, how it’s affecting you, and
which treatments you have tried so far. They will then be able to suggest other treatments. You may need several visits, or after your first visit they may recommend that you see another member of the team instead, such as a counsellor.
Although recovery from depression may seem unlikely when you are depressed, remember that it won’t continue forever. Even if you have no treatment, there’s a good chance that eventually your mood will improve. Self-help techniques, talking therapies or antidepressant medication can all help to speed up your recovery.
If you are feeling extremely depressed or hopeless, you may feel that life is not worth living. Some people may think about killing themselves. It’s common for people who are very depressed to feel that they are a burden to others and that their family would be better off without them.
Often people who feel this way believe that no one will be able to help them. This is not true. It’s very important to talk to someone, such as a clinical psychologist or psychiatrist, so they can help you.
Suicide can sometimes seem like a welcome escape from whatever you’re feeling,
but try to consider how those you would be leaving behind would feel.
If you have any of the following symptoms, you need to seek help:
Suicidal feelings or plans.
Hearing voices (hallucinations).
Samaritans has a 24-hour confidential helpline on 08457 90 90 90 that provides support to anyone in emotional crisis.
In some situations, your doctor may suggest that you spend a few days in hospital where specially trained staff can support you and help you feel better as quickly as possible. In some areas, specialist psychiatric support teams can visit you at home.