Spotting depression

Learning you have cancer and undergoing treatment can play havoc with your emotional health. If feelings of sadness or hopelessness become more serious, depression may be diagnosed. Depression is more than feeling down in the dumps, it is a disease that requires treatment.

Depression in the patient

Depression can affect you physically as well as emotionally and, left untreated, may affect your ability to participate actively in your prostate cancer treatment.

It is important to recognize the symptoms of depression. Keep in mind that you may experience some of these symptoms as a result of treatment. However, if you experience at least five of the following symptoms every day for two weeks, please consult your doctor or mental health professional:

  • Persistent sad, anxious or empty feeling
  • Loss of interest or pleasure in hobbies or activities
  • Feelings of guilt, worthlessness or hopelessness
  • Extreme fatigue and loss of energy
  • Difficulty concentrating, remembering and making decisions
  • Sleep problems
  • Unintentional major weight loss or weight gain
  • Thoughts of death or suicide, or suicide attempts
  • Restlessness and irritability
  • Social withdrawal
  • Repeated episodes of crying

Even with this list of symptoms to refer to, patients may not recognize symptoms of depression in themselves, so it is up to caregivers and family members to watch for warning signs. If you think the patient may be depressed, try the following:

  • Suggest that the patient meet with a mental health professional.
  • Offer to make appointments or provide transportation for mental health visits.
  • Encourage patience if the patient sought treatment but is unhappy with his progress. Medication for depression doesn’t work overnight. If there is no change after several weeks, suggest returning to the mental health professional for more options.
  • Promote physical activity, such as daily walks.

Do not:

  • Tell the patient to “cheer up” or “snap out of it.”
  • Force the patient to talk when he is not ready.
  • Blame yourself for the patient’s depression.

Depression in the caregiver

The emotional health of the caregiver is vitally important. Caregivers often focus so much of their physical and emotional energies on the person with cancer that they suffer the consequences, many times in silence. Remember, caregivers are not able to help others unless they take care of themselves.

Treating depression

Depression is treated according to its severity. Mild cases of depression may be treated with counseling. One-on-one counseling, group counseling and support groups offer different benefits. Some group settings focus on the emotional struggles associated with specific types of cancer and its stages, whereas others are more informal and social. Some are strictly for patients with cancer; some are for caregivers; and others include patients, caregivers, family members and friends. See the list of support resources in the back of this guide to learn about groups available to you.

Moderate or severe depression is typically managed with psychological treatment, medication and counseling. Psychological treatment may include psychotherapy (counseling to explore emotional issues that contribute to depression) and cognitive-behavioral therapy (counseling to help a person change his or her negative thought patterns and processes). Two types of medication, antidepressants and psychostimulants, may be prescribed depending on the symptoms, current medications, the response to antidepressants in the past (if applicable) and side effects. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) are common first-line treatments. Most antidepressants help treat depression by changing the levels of chemicals called neurotransmitters in the brain. Psychostimulants are known to help with depression as well as fatigue and often provide an energy boost. Your doctor will work with you to determine the medication and dosage that works best for you. Counseling and support groups are a valuable complement to these treatments.

A cancer diagnosis is traumatic, and depression can occur at any time during the diagnosis or treatment phases and after treatment concludes. Don’t let depression hinder your quality of life. Patients and caregivers are strongly encouraged to seek help at the first signs of depression.

Coping strategies for caregivers

  • Join an in-person or online support group.
  • Seek spiritual support through religion or nature.
  • Take part in a social activity multiple times a month.
  • Use relaxation methods such as yoga or meditation at least 5 times a week.
  • Get at least 150 minutes of moderate exercise (walking) or 75 minutes of vigorous exercise (jogging) a week.
  • Eat a well-balanced diet and be within 10 pounds of your ideal weight.
  • Designate a place where you can go to relax and enjoy “me-time.”

A word of warning: Unhealthy strategies, such as using alcohol, tobacco or other substances to relax, could make an already stressful time much worse. If you find you are self-medicating in these ways, try the coping strategies listed here or talk with your doctor about other options.

Weight gain can be a concern for caregivers, often because they aren’t getting to the gym or doing their usual exercises as they adjust to their new role. It is important to maintain a healthy diet, even as well-meaning friends may provide high-calorie comfort foods.

Additional Resources