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Depression and cancer

Being diagnosed with cancer can be very distressing. With the uncertainties and stress brought about by the illness, it is not uncommon for people with cancer to feel sad and hopeless about their future and other aspects of their lives. Depression is the persistent feeling of sadness, hopelessness and worthlessness that does not go away. The symptoms of depression differs from person to person, and ranges from mild to severe.

Depression is not a sign of personal failure or weakness.
It is a mood disorder that can be treated. As having depression makes coping with cancer and its treatment more difficult, you are encouraged to seek help early if you notice any depressive symptoms in yourself or your loved one, especially if they last for more than 2 weeks.



Risks for depression

It has been found that people with cancer are more likely to develop depression if they have:

  • Past history, or family history of depression or anxiety
  • Lack of support from family and friends
  • Financial difficulties
  • Uncontrolled symptoms, especially pain
  • Particular types of cancer, for instance those affecting the brain

  

What you need to look out for

  • Symptoms of depression include
  • Feelings of persistent hopelessness, sadness or crying easily
  • Feelings of helplessness, worthlessness or uselessness
  • Feelings of deserving punishment or inappropriate guilt
  • Wanting to harm oneself
  • Unable to enjoy life or experience pleasure
  • Changes in appetite, sleep, energy or ability to concentrate which are not directly related to cancer treatment side effects
  • Loss of interest in almost all activities most of the time
  • Low sexual desire
  • Major weight changes

  

How depression can be treated

Your doctor or nurse may ask you more questions about your feelings and concerns, physical symptoms and how your daily life is affected. Your treatment plan may include:

  • Referral to see a counsellor, psychologist or psychiatrist
  • Anti-depressive medications prescribed by your doctor or the psychiatrist. While some people see improvements within 2 weeks, anti-depressive medications usually take up to 6-8 weeks for its full effect.

Do not be worried about seeing counsellors, psychologists or psychiatrists. Psychological problems are very common amongst cancer patients; you are not alone. Seeing them does not mean that you are mentally ill or that you are emotionally not strong enough. Many people see these professionals to help them with day to day psychological difficulties (e.g. phobias, eating and sleeping disorders). They can conduct therapy sessions to help you improve your coping skills and reshape negative thoughts. They will also advise you on relaxation techniques that can be used to help you cope and feel better.

  

What you can do

Alongside your treatment for depression, here are some ways that may help you cope better with your emotions and everyday life:

  • ​Talk to your doctor or nurse openly about how you are feeling. Sometimes, sharing is all it takes to make you feel better. Your doctor or nurse can also initiate treatment early if necessary
  • Inform your doctor or nurse promptly of any discomfort you are experiencing. Active management of side effects from cancer and its treatment prevents it from worsening and affecting your mood
                     
  • Try to go outdoors if you can. Do light exercises to keep yourself moving and distract yourself from negative thoughts
                     
  • Keep yourself occupied with activities that you enjoy

  • Socialise with positive and supportive people. Some patients find joining support groups helpful
  • ​Avoid keeping things to yourself if possible. Share your feelings with your doctor or nurse, or someone you trust
                     
  • Avoid alcoholic beverages. These have depressant effects and may worsen your mood

 

When to call your cancer care team

Please inform your doctor or nurse if you suffer from any of the depressive symptoms as stated above, or if you experience any unexpected or intolerable side effects from the anti-depressive medication that you have been prescribed. It is especially important to speak to your healthcare team early if you feel like harming yourself, so that you can start the appropriate treatments as soon as possible.

If you are a patient with NCCS, you may also call +65 6436 8417 or +65 6436 8088 to book an appointment to speak to an NCCS counsellor if you need to talk to someone about your emotions.

If you have any questions regarding the above information, please call Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.

  

Useful resources

You may consider visiting the following websites for more information and assistance.

The above contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers.