Depression (PDQ®)–Patient Version

General Information About Depression

KEY POINTS

  • Depression is different from normal sadness.
  • Some cancer patients may have a higher risk of depression.
  • There are many medical conditions that can cause depression.
  • Family members also have a risk of depression.

Depression is different from normal sadness.

Depression is not simply feeling sad. Depression is a disorder with specific symptoms that can be diagnosed and treated. For every 10 patients diagnosed with cancer, about 2 patients become depressed. The numbers of men and women affected are about the same.

A person diagnosed with cancer faces many stressful issues. These may include:

  • Fear of death.
  • Changes in life plans.
  • Changes in body image and self-esteem.
  • Changes in day to day living.
  • Worry about money and legal issues.

Sadness and grief are common reactions to a cancer diagnosis. A person with cancer may also have other symptoms of depression, such as:

  • Feelings of disbelief, denial, or despair.
  • Trouble sleeping.
  • Loss of appetite.
  • Anxiety or worry about the future.

Not everyone who is diagnosed with cancer reacts in the same way. Some cancer patients may not have depression or anxiety, while others may have major depression or an anxiety disorder. (See the PDQ summary on Adjustment to Cancer: Anxiety and Distress for more information on anxiety disorders.)

Signs that you have adjusted to the cancer diagnosis and treatment include the following:

  • Being able to stay active in daily life.
  • Continuing in your roles as spouse, parent, or employee.
  • Being able to manage your feelings and emotions related to your cancer.

This summary is mainly about depression in adults with cancer. There is a section at the end of the summary about depression in children with cancer. (See the Depression in Children section for more information.)

Some cancer patients may have a higher risk of depression.

There are known risk factors for depression after a cancer diagnosis. Anything that increases your chance of developing depression is called a risk factor for depression. Factors that increase the risk of depression are not always related to the cancer.

Risk factors related to cancer that may cause depression include the following:

  • Learning you have cancer when you are already depressed.
  • Having cancer pain that is not well controlled.
  • Being physically weakened by the cancer.
  • Having pancreatic cancer.
  • Having advanced cancer or a poor prognosis.
  • Feeling you are a burden to others.
  • Taking certain medicines, such as:
    • Corticosteroids.
    • Procarbazine.
    • L-asparaginase.
    • Interferon alfa.
    • Interleukin-2.
    • Amphotericin B.

Risk factors not related to cancer that may cause depression include the following:

  • A personal history of depression or suicide attempts.
  • A family history of depression or suicide.
  • A personal history of mental problems, alcoholism, or drug abuse.
  • Not having enough support from family or friends.
  • Stress caused by life events other than cancer.
  • Having other health problems, such as stroke or heart attack that may also cause depression.

There are many medical conditions that can cause depression.

Medical conditions that may cause depression include the following:

  • Pain that doesn’t go away with treatment.
  • Abnormal levels of calcium, sodium, or potassium in the blood.
  • Not enough vitamin B12 or folate in your diet.
  • Anemia.
  • Fever.
  • Too much or too little thyroid hormone.
  • Too little adrenal hormone.
  • Side effects caused by certain medicines.

Family members also have a risk of depression.

Anxiety and depression may occur in family members who are caring for loved ones with cancer. Family members who talk about their feelings and solve problems together are less likely to have high levels of depression and anxiety.