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Concerned about side effects? »
Read more about the common side effects associated with breast cancer.
Depression
Do struggles with depression significantly affect the quality of life of diagnosed women? According to Julia H. Rowland, Ph.D., National Cancer Institute (NCI), the answer is, “For most women, No!”
Rowland, a psycho-oncologist who has led the Office of Cancer Survivorship at the NCI since 1999, says that a diagnosis of breast cancer is a shocking diagnosis for anybody to hear. But once the immediate crisis has passed, most women adapt extraordinarily well to this diagnosis — particularly after a treatment plan is put in place.
“While about a third to a quarter of patients at any given time may have symptoms of distress, the seriousness of that stress would be very variable,” says Rowland. “There are very few women who would meet the clinical definition of a full-blown depression secondary to a cancer diagnosis.
"Breast cancer can be a profoundly negative experience for a subset of women, however, and these women need to be given additional help, because it is not typical to be depressed in the wake of this diagnosis. Women with a history of depression, other personal trauma, or those who have multiple additional social stressors, may be at increased risk for distress during illness.”
In the past, the common belief was that depression went hand in hand with cancer, explains Rowland. This attitude was very harmful, because it meant that those who should have gotten help often did not. It also led the public to believe that depression is a normal response to cancer, when it is not.
If you are feeling helpless, or hopeless, or you are too anxious or too tired to do anything, Rowland says, share your feelings with someone on your medical team. It doesn't have to be a physician, but may be a nurse or someone else. Some women develop close relationships with one or more members of their medical team. Helpful medications can be prescribed, if necessary.
Rowland also speaks of recognizing feelings of grief and depression among family members, whom she calls secondary survivors, because they are so integral to the cancer experience.
Family members' mental health can have a profound effect on the cancer survivor. When they are positive, those feelings are likely to help the patient stay positive.
One of the challenges in delivering care to the family, obviously, is that you can only access the family through the woman herself. That's why it is important to ask a woman how her family is taking this diagnosis. Ask her if anyone needs to talk about what is going on, and if she wants help in discussing her illness and care with her husband or children.
Because of the nature of a cancer diagnosis, other questions may concern possible risk factors in passing along a gene and altering the genetic profile of the family because of this experience.
Rowland says that time and time again studies are showing the enormous resilience of individuals in the face of life threatening illness and challenge. The experience of breast cancer can have positive effects as well, she adds, referring to a journal article she and her colleagues published in the Annals of Behavioral Medicine (2005, Vol. 29, No. 3, pages 236-245).
"In response to our questions, women would often say things like, ‘You know, I would like for this never to have happened, but I learned some valuable lessons.' ‘I live life more fully now.' ‘I appreciate my family more deeply.' ‘I don't sweat the small stuff any more.'"
"People seek to find meaning that makes sense out of major life events, and breast cancer is no exception,” says Rowland. "There is that drive to ask what can I learn from this — in a positive way — and not let this experience make me feel like I'm a victim.”
Clinical depression is a psychiatric disorder characterized by an inability to concentrate, insomnia, loss of appetite, absence of pleasure, feelings of extreme sadness, guilt, helplessness and hopelessness, and thoughts of death. If you're experiencing these symptoms, it's very important to discuss them with your health care team. Anxiety and unhappiness are common emotions experienced after a cancer diagnosis. Call the Y-ME Hotline at 1-800-221-2141 to talk about how you're feeling with someone's who's been there.
This article first appeared in Lifeline.