Depression

Depression is more than just feeling down in the dumps or sad for a few days. Feelings of depression don't go away and can interfere with your everyday life. Symptoms of depression can include:

• sadness
• loss of interest or pleasure in activities you used to enjoy
• change in weight
• difficulty sleeping or sleeping all the time
• energy loss
• feeling worthless, helpless, or hopeless
• thoughts of death or suicide

More than 20 million people in the United States have depression each year.

Breast cancer treatment may make you feel sad, tired, or depressed. These feelings are complex conditions, resulting from and affected by many factors: your cancer diagnosis and treatment, aging, hormonal changes, your life experiences, and your genetics.

Sadness is a natural part of your breast cancer experience, something you need to express and move through. If you don't allow yourself to feel sad and grieve, the unresolved grief gets in the way of feeling better and getting better. Fatigue, the most common side effect of cancer treatment, may hit you hard. You also may be having hot flashes and trouble sleeping. You may be feeling overwhelmed or even debilitated. All of these factors can make you feel depressed.

Several breast cancer treatments may contribute to depression:

• chemotherapy
• hormonal therapy:
  • Arimidex (chemical name: anastrozole) 
  • Aromasin (chemical name: exemestane)
  • Femara (chemical name: letrozole)
  • tamoxifen
  • Evista (chemical name: raloxifene)
  • Fareston (chemical name: toremifene)
  • Faslodex (chemical name: fulvestrant) 
• ovarian shutdown or removal

Some pain medications, especially opiates, can cause depression.

Managing depression

If you think you're depressed, talk to your doctor. Together you can sort out if what you're feeling is depression or extreme fatigue. You also may want to talk to an accredited psychotherapist. Therapy can help you feel supported and allow you to talk about what's bothering you. Antidepressant medicines can help ease feelings of sadness and anxiety and help you feel better.

It's also important to find out what's causing the depression. If one of the medicines you're taking to treat breast cancer is contributing to your depression, you may be able to switch to another medication. If early menopause is contributing to your depression, medicines are available to help.

Some complementary and holistic medicine techniques have been shown to ease anxiety, stress, fear, and depression, including:

• aromatherapy
• guided imagery
• hypnosis
• journaling
• massage
• meditation
• music therapy
• progressive muscle relaxation
• prayer
• support groups
• tai chi
• yoga

Helping yourself when you feel depressed

If you're depressed, you may feel exhausted, helpless, worthless, and hopeless. All of these thoughts can make you feel like giving up. It may seem hard, but don’t believe your negative thoughts and don't let these feelings get in the way of your treatment and your healthy future. If you feel overwhelmed by negative thoughts, try to:

• Set realistic goals. Don't expect to be able to do everything you did in the past.
• Break large chores into small ones and do what you can as you can.
• Try to be with other people for at least an hour a day.
• Find someone you can talk to and confide in. This can be a friend, a religious figure, or a therapist.
• Participate in activities that make you feel happy or relaxed. Going to a movie, a sporting event, playing music, painting, or volunteering to help others can take your mind off your troubles.
• Eat a healthy diet that's rich in fruits, vegetables, whole grains, and lean protein. Good nutrition can bolster your immune system and make your body as healthy as it can be.
• Exercise can reduce stress and help ease depression. Try to walk for 30 minutes every day. Gardening, tai chi, or gentle yoga are other ideas. If you feel up to it, go longer or do something more strenuous.
• Remember that your mood will improve gradually, not immediately. Feeling better takes time. Don't get discouraged if you don't feel better right away. Try to find joy in whatever you achieve each day.
• You may want to postpone important decisions until your depression has lifted. Before making a decision about changing jobs, getting married or divorced, or moving to another city, talk to people who know you well and have an objective view of your situation.
• Let your family and friends help you.
• Avoid alcohol. Alcohol can make depression worse. Alcohol can also interfere with antidepressant medicine.