Cancer is stressful for patients, families, and doctors and because it’s painful and potentially deadly, many people assume that it’s normal for patients to be depressed. Cancer patients, they think, have every reason to suffer low mood and lack of motivation. What many overlook, though, is that cancer and depression aren’t inherently linked. In fact, one meta-analysis of cancer patients showed a mean prevalence of only 8-24%. In other words, the majority of cancer patients aren’t depressed.
When doctors encounter cancer patients with depression, then, it should not be treated as normal; it’s important that they thoroughly address the issue. By providing holistic treatment options, cancer patients can experience improved quality of life, regardless of their physical prognosis.
Americans with depression and anxiety are prone to hide their problems because of stigma around mental illness, so the first step toward supporting cancer patients with mental health needs is to be direct. For example, some patients think that treating their depression will require delaying cancer treatment. What many don’t understand is that “Depression can affect recovery and your ability to fight illness,” according to Dr. Glenn Currier.
If doctors provide mental health assessments a standard part of cancer treatment, then, they make it clear that all bodily processes work together. This ensures that patients receive professional care and treatment as needed and aren’t left to suffer mental distress because they’re preoccupied with managing cancer treatments.
See The Whole Patient
Though depression is inherently a chemical process, certain personal inclinations can make some people more likely to experience it or worsen the severity of the conditions. That’s why The Gawler Cancer Foundation emphasizes the power of the mind when working with patients. When patients participate in programming at Gawler, they’re asked to evaluate their core beliefs and values so that the mind can fully aid the body in the healing process without negative, subconscious hindrances.
Doctors should also be encouraged to be mindful of the emotional challenges of depression and not assume that all sadness is depression. Depression and low mood are not the same thing and people with cancer naturally tend to experience some sadness or anxiety about their prognosis shortly after diagnosis. Doctors need to look for extended signs of mood alteration, including irritability, loss of pleasure in favorite activities, and trouble sleeping. Just as grief isn’t the same as depression, sadness about a cancer diagnosis is a natural part of adjustment so long as it isn’t persistent.
In addition to assessing patients’ beliefs and attitudes, doctors should also be attentive to social supports and community engagement. This can include small details like what family members attend appointments with them to whether or not they visit with friends or continue attending religious worship or community group meetings. While abandoning some activities may be a side effect of pain and fatigue, losing touch with friends and family can be a clear indicator of depression.
Many cancer patients respond well to traditional antidepressants, but that shouldn’t be the only course of treatment offered – and this applies to all individuals with depression. In the UK, for example, some doctors recommend specific books as part of a broader depression treatment protocol in a process called bibliotherapy. Typically fiction titles, the books are intended to provide a venue for identification and emotional catharsis. Cancer patients may benefit from an even more specific subset of books.
Another alternative or supplement to antidepressants is art therapy, which has been used for many years in hospitals and by psychologists. Recently, though, Florida Hospital launched an art therapy program for cancer patients through their Cancer Institute’s Integrative & Creative Arts Therapies program. This new program embraces a broad set of arts programs, including visual arts, choir programming, and writing. Patients find that creative outlets help them process emotional issues and communicate their needs more effectively to loved ones.
Finally, all cancer patients can benefit from talk therapy, cognitive behavioral therapy, or support groups, so all treatment centers should be certain these services are available on site. The easier it is for patients to access mental health services, particularly those designed for cancer patients, the more likely it is that they will actually take advantage of them.
For the quarter of cancer patients who are likely to suffer from depression, addressing emotional needs is as important as treating the physical illness and can inform everything from how much social support they receive to what treatment options they pursue. We don’t ignore other co-occurring illnesses in cancer patients; why do we ignore depression?