Depression in Blood Cancer Patients
Updated May 11, 2013.
Getting a diagnosis of a life threatening cancer such as myeloma, lymphoma, or leukemia can cause a range of emotions. It is understandable to experience sadness, a feeling of loss, or even withdrawing. But at what point do these feelings become “depression” and what should you do about it?
As with any event, different people will respond differently to a cancer diagnosis. In addition, the amount of distress you feel is often influenced by the type of cancer you have been diagnosed with, treatment options, stage and grade of your cancer, symptoms you are experiencing, and the support network you have in place.
Some common responses experienced by cancer patients include:
These feelings may also come in waves or cycles. For example, you might notice your symptoms are worse at times such as when you are first diagnosed, when your treatment starts, or if your treatment doesn’t work or your cancer recurs, or if you decide to stop therapy altogether.
While it is not abnormal to feel low or depressed from time to time following the diagnosis of a blood cancer, it becomes a “clinical depression” or “major depressive episode” when the symptoms are stronger than normal or persist for too long.
Clinical depression is diagnosed when it lasts for more than a few weeks and when it has a severe impact on your life. It requires treatment when you have experienced at least five of the following symptoms for more than two weeks:
Diagnosing depression in people with leukemia, lymphoma or myeloma can be difficult because many of the physical symptoms listed above can be attributed to their cancer. For example, infection, side effects from your medication or chemotherapy, or anemia can also cause some of these complaints.
It is important that a trained and knowledgeable mental health professional that is experienced in dealing with cancer patients be involved in your care. They are the best ones to do a thorough assessment and make recommendations to help you. Your hematologist/ oncologist, nurse, or social worker can help you connect with one.
Even if you have never gotten a cancer diagnosis before, we have all had difficult times in our lives. How you reacted in those times can tell you a lot about how you will cope now.
Some people are at higher risk of developing depression than others. You may be at higher risk if you:
The best reason for getting treatment for depression is to improve your quality of life. Distancing yourself from your life and your loved ones is the least helpful thing you can do for yourself at this time. If you acknowledge and pursue therapy options, you just might feel better!
If that wasn’t reason enough, the success of your cancer treatment can be impacted by depression. People who are depressed have been shown to be less compliant with their treatment, to be less able to care for themselves, and to be less likely to be able to follow the complex instructions for their cancer care.
There is also a question as to whether or not depression can actually negatively impact the biological course of cancer, allowing it to progress faster!
Depression also makes you less tolerant of pain and discomfort, which in turn, leads to a worsening depression.
Treatment for depression may include counseling, medication, relaxation therapy, or a combination of thereof. For some people, a strong support group or chatting with a mental health profession can do the trick. Others might be surprised at what a difference a mild sleeping pill, or antidepressant can make. Just as each of us have our own responses to stress, each of us respond differently to treatment for anxiety and depression.
A good mental health professional can help you decide what will work best for you and your situation.
You should seek urgent medical attention if you are having serious persistent thoughts about suicide, or if you have attempted to end your life.
Periods of depressed or sad feeling are normal and to be expected for those that are diagnosed with cancer. These feeling become a problem, however, when they start to have an unreasonable impact on your life for a long period of time. Not only does depression make you feel bad, it can actually have a negative effect on your cancer therapy as well.
Recognizing when your normal feelings have progressed into something more serious, and then reaching out for help, can help you manage and move forward.
Sources
Price, L. “Depression and anxiety associated with cancer” in Stern, T., Sekeres, M. (2004) Facing Cancer. McGraw- Hill: New York. (pp. 291- 298).
Snyderman, D., Wynn, D. “Depression in Cancer Patients” Primary Care: Clinics in Office Practice 2009. 36:703-719.
Schwenk, T. “Cancer and Depression” Primary Care June, 1998. 25: 505-513.
Getting a diagnosis of a life threatening cancer such as myeloma, lymphoma, or leukemia can cause a range of emotions. It is understandable to experience sadness, a feeling of loss, or even withdrawing. But at what point do these feelings become “depression” and what should you do about it?
What is Normal?
As with any event, different people will respond differently to a cancer diagnosis. In addition, the amount of distress you feel is often influenced by the type of cancer you have been diagnosed with, treatment options, stage and grade of your cancer, symptoms you are experiencing, and the support network you have in place.
Some common responses experienced by cancer patients include:
- Shock, disbelief, and doubt
- Guilt
- Anger
- Decreased ability to carry out daily activities
- Anxiety
- Difficulty sleeping
- Irritability
- Sadness
- Loss
- Disrupted bowel function
These feelings may also come in waves or cycles. For example, you might notice your symptoms are worse at times such as when you are first diagnosed, when your treatment starts, or if your treatment doesn’t work or your cancer recurs, or if you decide to stop therapy altogether.
How is Depression Different?
While it is not abnormal to feel low or depressed from time to time following the diagnosis of a blood cancer, it becomes a “clinical depression” or “major depressive episode” when the symptoms are stronger than normal or persist for too long.
Clinical depression is diagnosed when it lasts for more than a few weeks and when it has a severe impact on your life. It requires treatment when you have experienced at least five of the following symptoms for more than two weeks:
- A sad, low or depressed mood for most of the day almost every day
- Changes to your eating habits or weight such as eating too much or losing interest in food
- Losing interest or enjoyment of activities that used to bring you happiness
- Change in your sleep patterns, either sleeping too much or too little
- Having low energy or fatigue most days
- Feeling helpless, worthless, or guilty
- Thinking excessively about death or considering suicide
- Difficulty focusing on tasks or making descisions
- Severe mood swings
Diagnosing depression in people with leukemia, lymphoma or myeloma can be difficult because many of the physical symptoms listed above can be attributed to their cancer. For example, infection, side effects from your medication or chemotherapy, or anemia can also cause some of these complaints.
It is important that a trained and knowledgeable mental health professional that is experienced in dealing with cancer patients be involved in your care. They are the best ones to do a thorough assessment and make recommendations to help you. Your hematologist/ oncologist, nurse, or social worker can help you connect with one.
Are Some People at Higher Risk for Depression Than Others?
Even if you have never gotten a cancer diagnosis before, we have all had difficult times in our lives. How you reacted in those times can tell you a lot about how you will cope now.
Some people are at higher risk of developing depression than others. You may be at higher risk if you:
- Adjusted poorly to your cancer diagnosis or severe stress in the past
- Have a history of depression or mental illness
- Are female
- Are experiencing financial difficulties
- Do not have a strong social support network
- Have other conditions or circumstances which affect your ability to function fully
- Have pain that is poorly managed
- Are diagnosed with cancer that involves your brain such as CNS lymphoma
Why Should I Get Treatment for Depression?
The best reason for getting treatment for depression is to improve your quality of life. Distancing yourself from your life and your loved ones is the least helpful thing you can do for yourself at this time. If you acknowledge and pursue therapy options, you just might feel better!
If that wasn’t reason enough, the success of your cancer treatment can be impacted by depression. People who are depressed have been shown to be less compliant with their treatment, to be less able to care for themselves, and to be less likely to be able to follow the complex instructions for their cancer care.
There is also a question as to whether or not depression can actually negatively impact the biological course of cancer, allowing it to progress faster!
Depression also makes you less tolerant of pain and discomfort, which in turn, leads to a worsening depression.
Treatment for Depression
Treatment for depression may include counseling, medication, relaxation therapy, or a combination of thereof. For some people, a strong support group or chatting with a mental health profession can do the trick. Others might be surprised at what a difference a mild sleeping pill, or antidepressant can make. Just as each of us have our own responses to stress, each of us respond differently to treatment for anxiety and depression.
A good mental health professional can help you decide what will work best for you and your situation.
You should seek urgent medical attention if you are having serious persistent thoughts about suicide, or if you have attempted to end your life.
Summing it Up
Periods of depressed or sad feeling are normal and to be expected for those that are diagnosed with cancer. These feeling become a problem, however, when they start to have an unreasonable impact on your life for a long period of time. Not only does depression make you feel bad, it can actually have a negative effect on your cancer therapy as well.
Recognizing when your normal feelings have progressed into something more serious, and then reaching out for help, can help you manage and move forward.
Sources
Price, L. “Depression and anxiety associated with cancer” in Stern, T., Sekeres, M. (2004) Facing Cancer. McGraw- Hill: New York. (pp. 291- 298).
Snyderman, D., Wynn, D. “Depression in Cancer Patients” Primary Care: Clinics in Office Practice 2009. 36:703-719.
Schwenk, T. “Cancer and Depression” Primary Care June, 1998. 25: 505-513.
Source...