Risk Factors

Studies also indicate that the more severe the medical condition, the more likely it is that a person will experience clinical depression. Other factors which increase the risk of depression in persons with cancer are: history of depressive illness each year, alcohol or other substance abuse, poorly controlled pain, advanced disease, disability or disfigurement, medications such as steroids and chemotherapy agents, the presence of other physical illness, social isolation, and socio-economic pressures.

Effective Treatment For Depression

With treatment, up to 80% of all depressed people can improve, usually within weeks. Treatment includes medication, psychotherapy or a combination of both. The severity of the depression, the other conditions present, and the medical treatments being used must be considered to determine the appropriate treatment. Altering the cancer treatment may also help diminish depressive symptoms.

Antidepressant Medications
Several types of antidepressant medication are effective, none of them habit-forming. Most side-effects can be eliminated or minimized by adjustment in dosage or type of medication, so it is important for patients to discuss all effects with the doctor. Also, because responses differ, several trials of medicine may be needed before an effective treatment is found. In severe depression, medication is usually required and is often enhanced by psychotherapy.

In special circumstances, low doses of psycho-stimulant can be used to treat depression in cancer patients. These may be used when standard antidepressants produce side effects that, due to the patients physical condition are either intolerable or medically dangerous. Also psycho-stimulants may help alleviate post-surgical pain and their rapid effect (1-2 days) can aid medical recovery.

Psychotherapy
Interpersonal Therapy and Cognitive/Behavioral Therapy have also been shown to be effective in treating depression. These short-term ( 10-20 weeks) treatments involve talking with a therapist to recognize and change behaviors, thoughts, or relationships that cause or maintain depression and to develop more healthful and rewarding habits.

Psychological treatment of patients with cancer, even those without depression, has been shown to be beneficial in a number of ways. These include: improving self-concept and sense of control, and reducing distress, anxiety, pain, fatigue, nausea, and sexual problems. In addition, there is some indication that psychological intervention may increase survival time in some cancer patients.

Electroconvulsive Therapy
Electroconvulsive therapy (ECT) is a safe and often effective treatment for severe depression. Because it is fast-acting, it may be of particular use for depression in cancer patients who experience severe weight loss or debilitation, or who cannot take or do not respond to antidepressant medications.

Medical Management
The benefits from the standard treatments described above are maximized by the effective management of pain and other medical conditions in depressed cancer patients.

The Path To Healing

Depression can be overcome through recognition of symptoms, and evaluation and treatment by a qualified professional. Family and friends can help by encouraging the depressed person to seek or remain in treatment. Participating in a support group may be a helpful addition to treatment.

More on depression and cancer

co-occurence index

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