If You Need: Help With Feeling Sad or Depressed

Some people think having cancer will necessarily lead to feeling depressed or sad all the time. This is not true. When you are told you have cancer, you will probably feel sad or depressed at first, as you try to adjust to what the illness means. This is a normal human response to bad news. Sometimes sad or depressed feelings will not show up until after the first course of treatment is completed. This is also common and does not mean you need psychiatric help. Most people begin to feel better if they share their feelings with family, friends, or a member of their health-care team.

Chronic and severe mental depression is a more serious situation. Persons suffering from severe depression may require the help of a psychiatrist or other persons trained in mental health. Generally, people in this severe depressed state are so concerned with their problems that they cannot meet the needs of their family life or job. They feel overwhelmed. Signs of severe depression include:

Long-lasting feelings of hopelessness and sadness in spite of talking to others
Changes in eating habits causing major weight loss or gain
Problems with sleep, such as not being able to get to sleep or waking up too early
Changes in sexual desire

People trained in mental health can help. They can try to find out, with the patient's help, what led to the depressed state. They can also help the patient find ways of feeling better. For some patients, medication (anti-depressant drugs) will help. These drugs must be prescribed by a doctor. Often this type of medication is used only until a person feels better about life again and can cope with their problems.

How Counseling Services Can Help:

Provide counseling and/or medication to help with feelings of:
* Anxiety
* Depression
* Hopelessness
Provide a trained counselor to help you:
* Learn about yourself (psychotherapy)
* Find better ways of coping with stress

How Do You Find These Services?

Your doctor, nurse, or social worker can refer you to a person trained in mental health. Sometimes they may even suggest counseling for you. It is always best to get a referral from someone you trust.

Most hospitals have psychiatrists or other mental health workers on staff who can consult with your doctor. Besides being part of the hospital staff, psychiatrists and mental health professionals will often have a private office where they can see you.

Some insurance plans provide payment for outpatient mental health treatment (psychotherapy). Counseling services may also be found at your community mental health agency. There, the cost of this service may be adjusted to fit your income.

Helpful Hints

Mental health services are always confidential. You do not need to worry that what you confide to a counselor will be passed on to anyone else. Even the fact that you are in counseling will be kept private.

Family and friends often do not understand serious depression. Depressed people are often told things like "Stop feeling sorry for yourself," or "You'll never beat the cancer if you don't stop feeling that way." Depression is not something you can always control. It can be brought on by many things:

A change in your life
A serious loss
Chemical or hormonal changes
Certain kinds of cancer
Some cancer medications

Trying to get over serious depression by yourself doesn't usually work.

Many doctors don't like to prescribe anti-depressant drugs to cancer patients. The doctors feel that these drugs are not especially helpful in dealing with the sadness and depression that follows a cancer diagnosis. However, when a person is severely depressed, certain drugs may be useful. It takes skill to see the difference between normal, temporary feelings of sadness following a cancer diagnosis and a serious, long-lasting depression. Psychiatrists are trained to know when drugs will help relieve the depression.

Sometimes people with cancer may think about killing themselves. This is very unusual. However, if a person feels depressed enough to seriously think about suicide, a mental health professional must be consulted. If loved ones think the patient is in danger, they should not wait to see if the patient tries to act. They should immediately tell the health-care team. The health-care team will know what to do.

Some people think seeing a psychiatrist or other mental health worker means they must be "crazy" or "falling apart." This is not true. It means the person is having short-term problems in coping with cancer or with other problems. It means he or she wants to find ways to feel better.

This Fact Sheet is adapted from the book, Helping People Cope: A Guide for Families Facing Cancer, written by Joan F. Hernann, ACSW, Sandra L. Wojtkowiak, RN, MSN, Peter S. Houts, Ph.D., and S. Benham Kahn, MD, and supported by the Pennsylvania Cancer Control Program of the Pennsylvania Department of Health; 1990 Revised Edition.

c 1993, American Cancer Society, Inc.

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