Side Effects
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Depression:
During cancer treatment and after it ends, it is not unusual to have persistent feelings of depression or anxiety. These symptoms occur in about 30 percent of patients and survivors. If you have a past history of depression or anxiety, your risk of re-developing the symptoms is higher and prompt treatment is recommended.
Feelings of depression and anxiety may be a temporary result of the cancer diagnosis or changes to your daily work and personal patterns. Depression can develop slowly or swiftly and it is different from the normal feelings of sadness or distress. Anxiety may also develop suddenly and intermittently in response to health-related events (treatment, doctor visits, scans, or tests). Anxiety and depression can involve both physical and emotional symptoms, and both problems can cause difficulty with sleep and rest.
Caregivers may also suffer with depression and anxiety. Similar treatments not only benefit them, but assisting them will also positively impact their loved ones, the patient.
Common symptoms of depression include:
- Profound, persistent sadness with or without crying.
- Feelings of guilt, worthlessness, helplessness, hopelessness.
- Feeling empty, irritable or restless.
- Loss of interest in sources of pleasures including relationships that you enjoy.
- Thoughts of death or suicide.
- Anxiety and depression commonly occur together.
- Physical side of effects of cancer treatment may contribute to depression and anxiety–appetite loss or increase; fatigue, memory changes, difficulty concentrating or focusing.
- Depression may be minor and short-term or situational; and it may be intense and long-term (constant and greater than 2 weeks).
Common symptoms of anxiety are:
- Feeling restless, nervous most of the time – may cause upset stomach, dry mouth.
- Persistent worries, apprehension, fear, and unable to stop such thoughts especially at night.
- Fear of losing control.
- Rapid heart beat, sense of shortness of breath.
Subtypes of anxiety are:
- Panic attacks – sudden sensations including heart palpitations, intense feeling of doom or catastrophe, sweating, trembling, feeling of choking, tightness of chest, intense fear. Symptoms may last minutes to hours. Cancer patients should always report such symptoms to their doctor or nurse practitioner to rule out medical causes.
- Phobias – intense anxious reaction or avoidant response to a specific object or situation (e.g., treatment environment, needles, seeing blood).
- Agoraphobia – intense anxiety about being in places or situations from which escape might be difficult, causing excess avoidance and restriction usually to one's home
- Obsessive Compulsive Disorder – repetitive thoughts that won't stop no matter how hard one tries (obsessions) with repetitive behaviors to try to reduce the obsessions (e.g., hand washing, counting, rituals).
- Acute-Traumatic Stress (recent event and symptoms) and Post-Traumatic Stress (symptoms occur for longer than 3 months or are delayed after the stressor) –traumatic events, including medical events, may cause significant distress involving intense fear, helplessness or horror causing a re-living of the feared experience through images, thoughts, bad dreams, flashbacks and other environmental reminders.
- Anxiety due to medical condition – in this case, illness, medications (e.g., steroids), disfigurement, pain, and so forth may be the underlying cause of anxiety.
Treatment:
For both depression and anxiety, optimal treatment includes some form of talking therapy, and medications are often indicated. Treatment starts with a thorough evaluation of the symptoms by a mental health professional. If you have concerning symptoms, talk to your provider and seek help.
Talking therapy involves:
- Learning about the physical aspects of depression and anxiety (the fight, flight, and helpless/hopeless responses).
- Modification of thoughts and alteration of erroneous perceptions.
- Learning new adaptive means of coping.
- Opportunity to express, validate or work through emotions.
- Problem solving.
- Bolstering one's support system.
- Learning new forms of relaxation and stress management.
- Restoring sleep.
- Dealing with changes to self-image, body image and sexuality.
- Finding new meaning and benefit in life changing survivorship.