Depression and Cancer
This is, to me, a really interesting and reinforcing/reassuring study from the UK, written up in the newest Lancet. After more than three decades as an oncology social worker, I know that depression does not inevitably accompany cancer. It is, I think, fair to say that virtually everyone goes through a period of high distress, some combination of depression and anxiety and anger, in the earliest days after diagnosis. Those intense feelings may resurface at other difficult moments: the start of chemotherapy, a recurrence, a need to change treatments. Most people do adapt and adjust and go on with their lives.
I have a memory of asking for a Psych Consult for a man with end stage lung cancer who was very depressed. This was long ago, perhaps a year after I began the work, but I already had enough experience to recognize depression that likely would be helped by medication as different from sadness about nearing the end of life. The psychiatrist came and met with the man for half an hour or so. As he left the room, he shook his head and said: "I'd be depressed, too." No help! That was an empathetic failure, a professional failure, and a lost opportunity to help a man who was suffering.
There are people with cancer who definitely experience major depression and will almost certainly be helped with medications. There is a list of things that make such a reaction more likely: including prior history of depression, family history of depression, other medical problems, other significant life issues. My point is this: considering a possible diagnosis of major/clinical depression is important when someone is struggling, but it is also important to remember that everyone with cancer struggles, at least for a while, and it is appropriate and completely normal to have strong difficult feelings. If these feelings persist for more than a month or so and if they are getting in the way of daily life, it is important to ask for help.
Here is a summary from MedScape and a link to read more:
Depression Not an "Invariable Complication" of Cancer
— Depression — the most extensively studied mood complication associated with cancer — is "less common in patients with cancer than previously thought," according to the authors of a new meta-analysis.
"Substantial uncertainty exists about prevalence of mood disorders in patients with cancer, including those in oncological, hematological, and palliative-care settings," write the authors, led by Alex Mitchell, MRCPsych, from the Department of Cancer Studies and Molecular Medicine at the Leicester Royal Infirmary and Leicestershire Partnership Trust, in the United Kingdom.
For instance, reviews of depression in palliative-care cancer settings have shown prevalences between 1% and 69%, say the authors.
However, the meta-analysis found that depression affects only about 16% of patients in oncological, hematological, and palliative-care settings.
This rate is "modest," and suggests that "depression is not an invariable complication of cancer," write the authors. The analysis was published online January 19 in the Lancet Oncology.