5 Strategies to manage cancer related depression

Cancer is a life threatening disorder and comes with a lot of distress in patients. Being diagnosed with cancer is a life changing and stressful event which generates feelings of fear, anger, sadness and worries. High levels of distress and worry for a longer period of time can lead to cancer related depression.

Depression is something that makes the entire journey with cancer more difficult and weakens your resilience. It worsens the emotional well being and increases feelings of helplessness and hopelessness. It also hinders cancer treatment and recovery and can reduce the quality of life and survival.

On a whole, depression reduces your will power to live & courage, and determination to face various challenges and endure the additional burden of adverse effects of necessary medical

treatments such as nausea, vomiting, fatigue and hair loss.

Let’s discuss in detail the major signs of cancer related depression and how to cope with it.

Highlights

1. What are the major signs and symptoms of cancer related depression?
2. Who is at risk of developing cancer related depression?
3. How to cope with cancer related depression?
4. Recommendations for Caregivers
5. Conclusion

What are the major signs and symptoms of cancer related depression?

Cancer related depression is common and something more than just normal sadness. The major signs and symptoms of depression observed in cancer patients are:

1. High levels of fatigue and tiredness
2. Lack of interest in activities
3. Significant unexplained weight loss and appetite changes
4. Sense of hopelessness and emptiness
5. Mood changes such as increase in irritability
6. Cognitive decline, reduced memory and concentration
7. Slowed thinking and movements
8. Insomnia (disrupted sleep) or “hypersomnia” (excessive sleeping)
9. Suicidal feelings or recurrent thoughts of death

Who is at risk of developing cancer related depression?

Any cancer patient can develop depression, before as well as after treatment. Cancer research estimates suggested every one in four cancer patients is suffering from depression.

Cancer itself is a major risk factor for developing depression, but several other reasons can increase the risk of developing of cancer related depression:

• Traumatic event such as death of loved one
• Previous history of mental disorders such as major depressive disorder or clinical depression
• Eating disorders such as anorexia and cachexia
• Metabolic disorders and pain
• Chronic stress
• Adverse childhood events
• Recreational use of alcohol
• Being directly related to someone with depression

Facing depression seems daunting and difficult in patients who are battling cancer as well as cancer survivors. Paying attention to your mental health will surely help in coping with cancer related depression. Also avoiding negative thoughts and accepting the reality will help to manage your mental health. Below are some tips to cope with cancer related depression:

#1 Nutrition:

The role of nutrition cannot be overlooked in cancer patients. It is observed that cancer patients at risk of malnutrition are often prone to develop anxiety, depression and pain. It becomes vital to take care of nutrition.

Scientific evidences suggest that a diet rich in antioxidant foods (such as omega-3 fatty acids), probiotics, magnesium/zinc rich foods (such as legumes, nuts, berries, leafy vegetables and avocados), curcumin and dark chocolate may help in reducing anxiety and depression symptoms in cancer patients.

Several herbs (Ashwagandha extract) and herbal supplements with anti-anxiety properties can be beneficial, but you should discuss with your oncologist while taking any supplements.

# 2 Physical activity:

Exercising regularly is helpful in treating depression as it releases endorphins which are helpful in stabilizing mood. The American Cancer Society recommends that adults get at least 150 minutes of moderate-intensity activity (like brisk walking) or 75 minutes of vigorous-intensity activity (like jogging) each week.

It may be difficult for some cancer patients to do exercise, so these patients should practice gentle stretching and deep breathing to increase blood circulation and boost mental health.

# 3 Antidepressant medications:

Treatment options of cancer related depression includes use of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications balance the release of neurotransmitters in your brain, thus stabilizing your mood and emotions.

Some of the commonly prescribed anti-depressants are Citalopram, Escitalopram, Fluoxetine, Sertraline, Duloxetine, and Venflaxine. Your primary care physician can also prescribe a combination of medicines depending on the nature of depression and severity of symptoms.

#4 Emotional support:

Patient suffering from cancer related depression should become aware of his/her emotions. He/ she should openly express these emotions with someone close and seek emotional support. A cancer patient should not blame himself/ herself and look for sources of comfort including pleasant activities he/ she enjoys to do, meditation, and spending time with loved ones.

Whether you’ve been diagnosed with blood cancer or any other cancer type, emotional support from your family and loved ones can help to tackle a variety of challenges.

# 5 Counseling or Psychotherapy:

It is often recommended with prescribed medications to reduce depression in cancer patients. These counselling based practices can be done one on one or in a social support group and helps to raise awareness of cancer related depression and how to address negative thinking in an objective way.

It will also help the patient to deal with difficult situations better. Some of the common evidence based forms of this treatment are cognitive behavioral therapy (CBT), acceptance and commitment therapy and interpersonal therapy.

Recommendations for Caregivers

It is not only the cancer patient that suffers from depression but the caregivers looking after the patients are also affected by depression too. The fear of recurrence in patients, and observing physical side effects of treatment make them susceptible to develop negative emotions or depressive thoughts.

It is also hard to see your loved ones suffering from pain and fighting with cancer. Therefore, caregivers should also follow below discussed recommendations:

1. Express your love and affection to the patient and tell them that you are concerned for their health and well-being.
2. Encourage them to get outdoors and offer to accompany them in doctor appointments and health care counselling sessions.
3. Engage the person in activities they enjoy doing.
4. Avoid telling the person to cheer up as it is unhelpful and will make things worse.
5. Invite the patient to talk about their fears and concerns, but wait until they are ready to do the same.
6. Don't judge the feelings of the patients and listen to him/her carefully.
7. Don’t mislead others by telling them you’re fine, care for yourself and spend time with your friends.

Conclusion

Cancer diagnosis can turn anyone's life outside and no one is prepared for this frightful journey. This situation becomes more painful when cancer patients go through tough episodes of depression. If you are depressed, it does not mean you cannot cope with this tough situation. You should push yourself and reach out for help to soothe the emotional anguish and mental torment.

If you are feeling more depressed, getting suicidal thoughts, have trouble breathing and feeling restless, reach out to a mental health professional immediately. Treatment of depression can make your cancer journey less complicated. Don’t forget, you can cope with this illness and improve your quality of life with a healthy lifestyle and consistent support from your physician and family.

Also explore, 5 mandatory lifestyle modifications for cancer patients to be adopted after-treatment