Depression is a common condition in people with advanced breast cancer. It is estimated that one in four persons with advanced breast cancer are diagnosed with depression during and after treatment.1,2 Since depression is a serious condition that can increase the risk that you will harm yourself, it is important to be aware of its symptoms and to get help as quickly as possible.
The symptoms of depression include1:
Ongoing, overwhelming sadness, and hopelessness
No interest in activities or people you used to enjoy
Difficulty sleeping or sleeping all the time
Feeling worthless or guilty
Thoughts of suicide
If you notice the symptoms of depression in yourself or a friend or family member, alert your doctor and ask for an evaluation. The assessment and diagnosis of unipolar depressive disorders are based on clinical interviews and examinations.3 Although depressive disorders are not diagnosed by laboratory tests, focused tests are often warranted to rule out other medical conditions that can cause or contribute to depressive episodes.
Treatment of depression
The biggest challenge of treating depression is that people are often reluctant to seek help and follow-through with treatment. Some people believe that they need to be strong and stoic about emotional difficulties. Admitting the need for help is difficult and can seem like surrendering. However, real strength is reaching out for help when you need it. By doing this, you’ll be taking charge of your health and welfare.
Mental health experts agree that the best treatment for major depression is a combination of antidepressant medication and psychotherapy or counseling. While each type of treatment can provide some relief for depression, the combination works together and can be highly effective.4
Psychotherapy or counseling for depression can be done individually or in a group by a qualified psychiatrist, psychologist, social worker, or counselor. It generally takes several months of treatment to get the best results. So, be prepared to stick with it for a sufficient amount of time.
You may also consider joining a support group for people with advanced breast cancer. Getting support from a community of people dealing with similar problems can be a useful and powerful experience. While support groups are a useful addition to formal psychotherapy or counseling, they are not a substitute. Speak to your doctor to get a referral to a qualified mental health professional for psychotherapy or counseling.
Antidepressants can help patients with unipolar major depression. Only a qualified healthcare provider can determine which antidepressant medication will be best for you. Additionally, if you are being treated for advanced breast cancer, your doctor will be concerned with the potential for interactions between your cancer treatment and antidepressant treatment.4
Different antidepressants cause slightly different kinds of side effects, and no individual person will react the same to every medication. You will need to work with a doctor to find the right antidepressant for you. It may take up to 6 weeks to find out how well a particular medication will work for you. So, work closely with your doctor and be prepared to give the process some time.
BreastCancer.org. Depression and Metastatic Breast Cancer. https://www.breastcancer.org/symptoms/types/recur_metast/stop_treat/palliative/depression.
Accessed on Sept 12, 2019.
National Institute of Mental Health. http://www.nimh.nih.gov/. Accessed September 13, 2019.
Lyness, J. Unipolar depression in adults: Assessment and diagnosis. https://www.uptodate.com/contents/unipolar-depression-in-adults-assessment-and-diagnosis?topicRef=83887&source=see_link. Accessed September 13, 2019.
Katon W, Ciechanowski P. Unipolar major depression in adults: Choosing initial treatment. Uptodate. Roy-Byrne PP, Solomon D, eds. Accessed at: https://www.uptodate.com/contents/unipolar-major-depression-in-adults-choosing-initial-treatment?topicRef=1721&source=see_link
Accessed September 13, 2019.
US Department of Health & Human Services. Substance Abuse Mental Health Services Administration. https://www.samhsa.gov/find-help/national-helpline. Accessed September 2019.