Is it fatigue or depression?


Question from Sylvia: I am so tired because of my treatments that I can't be bothered to do anything at all. My sister keeps saying I am depressed and that is why I feel the way I do. I never thought I'd have to deal with a mental illness in addition to the breast cancer. How can I find out for sure who is right?
Answers - Diane Thompson For many patients—up to 60 percent, in fact—depression can occur for the first time after a diagnosis of cancer. This is true of any cancer, from breast to prostate. Sixty percent is a big number, but that isn't everyone. If you are experiencing episodes of irritability, tearfulness, difficulty with sleep, appetite, energy or feelings of hopelessness, it is very important to discuss this with your doctor.
Rosalind Kleban, L.C.S.W. In response to the previous question, Dr. Thompson urged patients to be gentle with themselves. In many cases it's really normal to feel depressed after being diagnosed with breast cancer. It needn't be looked upon as a mental illness, but as an expected response to a crisis. Part of taking care of oneself is to discuss it with the medical team, to get a better understanding of what's happened and what can be done about it.
Jennifer Griggs, M.D., M.P.H. Even though breast cancer treatments can lead to overwhelming fatigue, there should be some "breaks" in that fatigue where you feel like you're starting to feel like yourself again before the next treatment. If you feel fatigued 100% of the time and it's interfering with your functioning, it's a serious problem and needs to be addressed.

There may be a medical cause for overwhelming fatigue; if you're not anemic, depression may be causing your fatigue. Bringing this to your doctor's attention is the best first step. I also recommend you let the doctor know what kinds of treatments you'd consider for depression. Some people tell me they think they're depressed, but they never tell me they don't want medication or that they're opposed to antidepressant medication. As a result, I think they're asking for an antidepressant. Don't hesitate to tell your doctor what you think should be done for your depression. You and your doctor are a team.

On Wednesday, March 19, 2003, our Ask-the-Expert Online Conference was called Overcoming Depression. Rosalind Kleban, M.S.W., Diane S. Thompson, M.D., and Jennifer Griggs, M.D., M.P.H. answered your questions about medication and lifestyle changes that can ease depression along with to put hope, fun, and pleasure back into your life during and after breast cancer treatment.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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