Cancer treatment isn’t easy for anyone—it’s probably safe to say that every single person who gets news of cancer goes through some measure of sadness, anxiety and fear. But for some, cancer treatment can bring on depression, from mild to severe. Fortunately, there’s no need to face it alone.
Kathryn Johnson, PhD, directs the Patient Support department at Providence Regional Cancer Center. Dr. Johnson says that different studies show a range of numbers, but most estimate that rates of depression are about two or three times higher among people in treatment for cancer than in the general population. Anywhere from 10 to 60 percent experience some degree of depression, and approximately 20 percent meet criteria to be said to have experienced a major depressive episode.
“People with prior history of depression are much more prone to experience depression during cancer treatment,” Dr. Johnson says. “Also, younger people tend to be hit harder by a cancer diagnosis and may find it harder to cope. Cancer may profoundly alter their view and way of living at a time when they expect to be healthy. Older people may still be quite affected, though they often have more experience with physical illness.”
Am I depressed?
Many people undergoing cancer treatment don’t realize they’re depressed, perhaps because it’s hard to distinguish treatment-related physical and mental side effects from their emotional experience. Dr. Johnson points out that people in treatment for cancer are going through so many things, many of which can cause depression, such as medications with mood side effects, pain and metabolic changes.
Many people undergoing cancer treatment don’t realize they’re depressed, perhaps because it’s hard to distinguish treatment-related physical and mental side effects from their emotional experience.
Furthermore, many people just don’t recognize the signs of depression. Depression shows up in different ways for different people: inability to sleep, loss of appetite, loss of interest in activities you used to enjoy, a desire to isolate. Dr. Johnson says it is quite common for people in cancer treatment to have brief episodes of depression, but if symptoms persist, or they start to get in the way of normal functioning and relationships, they should ask for help.
When and how to get help
“At the Cancer Partnership, patients can get treatment anytime, even for the mildest symptoms,” Dr. Johnson says. “We encourage people to ask for help sooner than later, and we can help them figure out if they’re dealing with depression or work with their treatment team to determine if it’s possibly something medical.”
Treatment varies, based on what the patient needs. “Some people just need one or two brief conversations with a counselor, to normalize the experience, to get perspective, to hear that they are not alone and that this is a normal experience,” Dr. Jonson says. “We offer holistic care. We’ll consider lifestyle changes, sleep habits, dietary habits, activity level, social support – all the things that can affect depression.” Treatment may also include coordination with the patient’s primary care team or other providers to assess medications or other health conditions.
In addition to one-on-one supportive counseling, which may take place right in a patient’s treatment area or in the Patient Support offices, the Cancer Partnership offers family member/caregiver counseling. “We often treat family members, spouses, kids, other friends and family. It can be very difficult for them to cope with their loved one’s illness. We can help.”
Dr. Johnson believes that one of the most helpful tools for dealing with depression is support from others – often in the form of cancer support groups – where participants share their experience with others who really understand what it’s like. “Support groups help you realize that you’re not alone,” she says. “That brings great comfort to some patients.”
Don’t keep it to yourself
“A lot of people who have symptoms of depression are hesitant to say anything to their doctor,” Dr. Johnson says. “The oncologist is focused on the disease process and medical treatment. Unless a patient is obviously distressed, their mental state often doesn’t come up. And depression isn’t always obvious, to the casual observer or even to the seasoned clinician in oncology practice, so it’s really important to proactively seek help for the best mental and physical health outcomes.”
To learn more, visit the Providence Regional Cancer Partnership at www.cancerpartnership.org and look for the “Support Services” tab, or call 425-297-5520.
Dr. Johnson earned her master’s degree from The George Washington University and her doctoral degree from Seattle Pacific University. She provides counseling for adolescents and adults, and conducts psychological testing. Dr. Johnson specializes in geriatric mental health, grief and loss, adjustment to medical illness, post-abuse syndromes and depression. She is also a credentialed art therapist.