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Symptoms
The two most prevalent symptoms of depression are a depressed mood and
loss of interest or pleasure in normal activities. Other symptoms of
depression may include the following:
- Insomnia or other
sleep disturbance
- Change in weight (gain
or loss)
- Changes in appetite
- Fatigue (extreme
tiredness) and loss of energy
- Feelings of irritability
or agitation
- Feelings of
worthlessness or guilt
- Feelings of hopelessness
or helplessness
- Thoughts of self-harm or
suicide
- Preoccupation with death
- Difficulty with memory
or concentration
- Social withdrawal
- Crying spells
- Feeling slowed down
Generally, if a person experiences either a depressed mood
or loss of interest in activities he or she once enjoyed and at least
four of the other symptoms mentioned above for longer than two weeks, it
is recommended that he or she talk with a doctor about seeking treatment.
Diagnosis
The following may increase the chance that a person with cancer will
experience depression:
- History of depression
before the cancer diagnosis
- History of alcoholism or
drug abuse
- Increased physical
weakness or discomfort from cancer or cancer treatment
- Uncontrolled pain
- Medication (certain
drugs can trigger depression)
- Advanced cancer
- Imbalances of calcium,
sodium, potassium, vitamin B12, or folate
- Nutritional problems
- Neurologic difficulties, from
cancer that started in the brain or has spread to the brain
- Hyperthyroidism (an
excess of thyroid hormone) or hypothyroidism (not enough thyroid
hormone)
Doctors may use a number of tests to diagnose depression,
most of which include a series of questions about your behavior,
feelings, and thoughts, such as "Are you depressed most of the
time?" Because research has shown that suicide among people with
cancer who have depression to be higher than people without cancer who
have depression, it is important to consult a doctor about treatment for
depression.
Managing depression
Treatment for depression helps a person with cancer better manage both
diseases and often involves a combination of psychological treatment and
antidepressant medication. Almost all depression is treatable.
Psychological treatment methods focus on increasing coping and
problem-solving skills, increasing support, and learning to reshape negative
thoughts. The most common methods include individual psychotherapy and
cognitive-behavioral therapy (changing the person's thought patterns and
behaviors). In addition, cancer support groups may be helpful for some
people with cancer who experience depression.
Medication
Your doctor may recommend drugs called antidepressants. Most
antidepressants treat depression by changing the chemistry of the brain.
If you and your doctor decide that medication is the next step, keep in
mind the following:
- Different types of
antidepressants have different side effects, including sexual side
effects, nausea, insomnia, dry mouth, or heart problems. Some drugs
also can help with anxiety, or take effect more quickly than others.
Side effects can usually be managed by adjusting the doses of
medications, or, in some cases, switching to a different medication.
- Many people with cancer
take many different medications. Sometimes medications can interact
in ways that lower the effectiveness of a drug or cause harm. Tell your
doctor about each medication you are taking, including herbal
therapy and over-the-counter medications.
- Although nearly 15% to
25% of people with cancer experience depression, only 2% receive
treatment in the form of antidepressants. It is important for people
with cancer who are prescribed antidepressants to remember that
antidepressants do not offer a "quick fix" and usually
take up to six weeks to start working.
More Information
PLWC: Mental Health and Cancer
PLWC: Managing Side Effects
PLWC Feature: Getting Help for Depression
Cancersymptoms.org: Depression
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