Anxiety and Depression

Starting chemotherapy treatments may make you feel very afraid or anxious. Although feeling anxious is an emotional state, it can have physical effects on your body. Talk to your healthcare team if you are feeling anxious. You can learn to recognize the signs of anxiety.

Signs of anxiety:

• rapid heartbeat
• trouble swallowing
• pressure or tightness in the throat or chest
• rapid, shallow breathing (which can cause dizziness)
• dry mouth
• sweating
• trembling
• upset stomach
• feeling unreal or disconnected
• problems falling asleep or staying asleep

Sometimes feeling anxious can be a symptom of depression.

Understanding depression

Depression is very common in patients who have or have had cancer. Fortunately, depression is an illness that can be treated.

Everyone has experienced feeling blue or being low in spirits at some time. Usually such feelings improve or disappear after a few hours or days. Depression is different. With depression, a person's low feelings do not go away and living a normal life becomes difficult.

There are no tests to diagnose depression. A diagnosis of depression is based on what you tell your doctor about your feelings and how your daily life is affected.

Symptoms of depression

If there is no physical illness of the brain or psychiatric illness, then depression consists of 5 of the following symptoms, lasting for 2 weeks or longer. Item 1 or 2 must be included in your list of 5 symptoms.

1. Depressed mood every day for most of the day.
2. Very little interest or pleasure in most activities nearly every day for most of the day.
3. Noticeable weight loss or weight gain, or a major change in appetite.
4. Sleep changes. Not being able to fall sleep, or waking early, or being very sleepy nearly every day.
5. Feeling agitated or slowed down nearly every day.
6. Feeling overly tired or lacking in energy nearly every day.
7. Feeling worthless or guilty nearly every day.
8. Feeling unable to concentrate or make decisions.
9. Having frequent thoughts of death or suicide.

Depression can be treated both with therapy and medication. Talk to your healthcare team if you think you are depressed. Several types of psychotherapy have been found to help people experiencing depression related to cancer. Individual and/or group sessions can assist people in learning relaxation skills, lowering distress, improving coping skills, and reshaping negative thoughts.

In addition, you may be treated with antidepressant medication. Antidepressants have improved dramatically over the recent years. Your doctor will likely be able to find a medication that is right for you and explain how it works. As with any medication, anti-depressants may not be right for everyone. Anti-depressants can cause dry mouth and drowsiness. Some may have restrictions as to other medications you can take at the same time. Always check with your doctor.

What you can do:

• Talking to someone who has had a cancer experience similar to yours can help you cope with anxiety or depression and reduce your fears.
• Share your worries and concerns with your healthcare team.
• Talk to family members or friends.
• Decide how much you'd like to know about your cancer. Some people become anxious because they have too little information, while others feel better not knowing everything.
• Keep a journal or diary while you are having treatment. This can help to release anxiety and other thoughts and feelings. Remember to write down the positive things too. These may help you when you're feeling low. You may discover new strengths in yourself and those around you. You may find new reasons to appreciate the people and things in your life.
• Learn and practise meditation or relaxation exercises.
• Eat well and be as physically active as possible.

Another potential side effect is bone loss. Find out what you can do about it.