Revised May 2007
"Mom cried a lot when she lost her hair. We expected her to be upset. But we started to notice she was crying all the time, even once her hair started to grow back."
For many people, the experience of living with cancer involves real or possible losses of health, independence, roles and relationships. These losses can often create deep sadness, which is normal and expected.
Sadness
People talk about feeling sad that their family is in so much distress. Others experience sadness when they can no longer work or do what they want to do. It can be hard for those who love you to see you sad, but it's important to share how you feel with those that you identify as your supports. Expressing your emotions is one of the best ways to maintain your emotional health.
Normal sadness:
- is common during your illness as you experience losses
- can impact sleeping and eating
- can decrease ability to concentrate
- may create temporary withdrawal from social activities
- disrupts your usual patterns or routines (time-limited)
- can increase your irritability or impatience
- is usually connected to a particular loss
- is experienced in waves that come and go
- doesn't stop your ability to look forward to the future
- doesn't stop your ability to enjoy parts of your life
The important thing to remember is that any impact that is connected to sadness is brief and time-limited.
Depression
Depression is different from sadness. It lasts longer and has more symptoms. You can have many symptoms or just one or two. Depression can begin to interfere with your ability to live your life in a way that is healthy, enjoyable and meaningful to you. This is what we mean when we say "quality of life". This is different for everyone.
Cancer and its treatment may increase your risk of depressive symptoms.
The type of cancer, stage of disease, severity of symptoms you experience, the quality of your support systems and any history of mental health issues can all impact whether depression may be something that you experience before, during or after your treatment.
When might I need help?
Here is a brief checklist (Symptoms of Depression
) that may help you decide if you are experiencing depression.
Symptoms of depression in people with cancer
Remember that some of these symptoms can be connected to the treatment you are undergoing, the treatment side effects or the medications used. They may not always be reliable indicators of depression in people with cancer. For example, decreased energy is a common symptom of treatment and does not necessarily indicate you are experiencing depression. That is why it is important to discuss your symptoms with your doctor and health care team.
Treatment
The negative effects of unrecognized or untreated depression include:
- reduced quality of life
- impaired ability to fully enjoy life
- worsening of pain and other symptoms
- delayed recovery and healing time
Depression is treatable. No one has to suffer endlessly. Most people with depression feel a sense of relief when they learn the facts about this illness. You realize depression is not a personal weakness, and most importantly, you learn you are not alone.
Each case of depression is unique, so people may require different methods of treatment. There is a range of treatment options for depression including counselling, antidepressant medications, or a combination of the two. Support from family, friends and self-help groups can also make a big difference.
What can friends and family do?
It is important to know that depression is an illness and no individual or family member is responsible for the depression. Telling the person to "pull themselves up by their boot straps" or "just think positive" is not useful.
Listen and offer support rather than trying to contradict or talk someone out of it. It is important that you let them know that it is all right to talk about their feelings and thoughts.
Don't try and support them on your own. Just as you would if they had a constant or continual pain that isn't improving, help them seek out professional support that will give you and them the information and solutions that will treat the depression.
Ask them how you can help and go with them to their family doctor or a mental health professional.
What's available in the cancer centre I go to?
Some of the resources that might be useful for you include:
What's available in my community?
One of the best resources will be your family doctor. They can discuss the symptoms, the treatment options and community supports available.
Mental health professionals in your community such as psychiatrists, psychologists and counselors may also be a support you choose to access. Your local health authority is a good starting point to discover what is available.
General information and support:
- BC Mental Health Information Line - 1.800.661.2121 or 604.669.7600 in the Lower Mainland. The information line provides free information 24 hours a day about symptoms, causes, treatments, support programs and publications.
- BC HealthGuide Program - http://www.bchealthguide.org/kbaltindex.asp
- Canadian Mental Health Association (BC) - 1.800.555.8222 or 604.688.3234 for Lower Mainland or http://www.cmha.bc.ca/
- Antidepressant Skills Workbook (a workbook that focuses on managing depression) - www.carmha.ca/antidepressant-skills/adult/