comscoreDepression

Depression

When feelings of sadness or hopelessness last for weeks and begin to interfere with your daily life, it may be a sign of depression.
 

It’s normal to feel sad, blue, or let down from time to time, especially after a breast cancer diagnosis. It’s also normal to feel overwhelmed about having to adjust to all the ways breast cancer can disrupt daily life. These feelings usually pass after some time.

When feelings of sadness or hopelessness last for weeks and begin to interfere with your daily life, it may be a sign of depression. A person may feel symptoms of depression at any time before, during, or after breast cancer treatment. 

Symptoms of depression can include:

  • feeling intense sadness

  • crying all or most of the time

  • losing interest in activities you used to enjoy

  • feeling extremely irritable, jittery, or restless

  • feeling worthless, helpless, hopeless, or numb

  • isolating yourself from others or being unable to accept help

  • lacking any motivation to do daily activities

  • having difficulty focusing, making decisions, or remembering information

  • lacking the energy to stay on track with treatments and doctor’s appointments

  • having thoughts of self-harm or suicide

Depression can also cause physical symptoms such as:

  • trouble falling asleep and staying asleep (insomnia) or feeling sleepy most of the time

  • extreme fatigue or very low energy

  • loss of appetite

  • loss of libido

Certain cancer treatments, such as chemotherapy, steroid medicines, and hormonal therapies, can increase the risk of depression — either directly or indirectly because of the following side effects:

  • fatigue

  • trouble sleeping

  • joint pain

  • nerve pain

  • hormonal changes

There are some factors that can increase the risk of depression, such as:

  • a personal or family history of depression or anxiety

  • a metastatic breast cancer or triple-negative breast cancer diagnosis

  • not having a strong support system of friends and family

  • financial difficulties

  • health problems in addition to breast cancer

Certain breast cancer-related factors can also increase the risk of depression, such as:

  • early menopause brought on by breast cancer treatments

  • sudden hormonal changes

  • concerns about infertility

  • stress about major life events happening at the same time as breast cancer treatment

 

Managing depression

If you have symptoms of depression that last for weeks with no sign of improving, it’s important to talk to your cancer care team. Your cancer care team can figure out if one of your cancer treatments is causing your depression symptoms, and see if switching to a different treatment is possible. Your cancer care team can also recommend treatments for side effects such as insomnia, fatigue, hot flashes, and other menopausal symptoms, which can improve depression. 

You may also want to ask your cancer care team to refer you to an accredited mental health professional who has experience working with people diagnosed with cancer. Many cancer centers have psychiatrists, psychologists, psychotherapists, counselors, or social workers on staff or can make referrals to practices near you. 

For some people, an effective way of treating depression is to combine different therapies, such as individual counseling (also known as behavioral or talk therapy) and antidepressant medicines.

A psychiatrist or primary care doctor can work with you to figure out which medicine relieves the symptoms of depression with the fewest side effects. Typically, you begin taking a lower dose at first and, under your doctor’s guidance, increase it if and as needed until your symptoms improve. Doctors prescribe antidepressants for longer periods of time because it can take up to six weeks for the medicine to improve symptoms. Still, although doctors don’t consider antidepressants to be addictive in the traditional sense, it is possible to become dependent on them. Many people need to try a few different types of medicine before their symptoms improve. 

Certain types of antidepressant medicines include:

  • SSRIs (selective serotonin reuptake inhibitors), such as Lexapro (chemical name: escitalopram), Celexa (chemical name: citalopram), and Zoloft (chemical name: sertraline)

  • SNRIs (serotonin norepinephrine reuptake inhibitors), such as Cymbalta (chemical name: duloxetine), Effexor XR (chemical name: venlafaxine), and Pristiq (desvenlafaxine)

  • Wellbutrin (chemical name: bupropion)

Certain antidepressants can interfere with tamoxifen. If you’re taking tamoxifen, it’s essential to ask your doctor which antidepressants are safe for you.

Support groups, one-to-one peer support, or Virtual Community Meetups (where you can talk to members of the Breastcancer.org community) also can connect you with others who can share ways they’ve eased symptoms of depression.

Additionally, some complementary therapies that have been shown to ease anxiety, stress, fear, and depression include:

Some of these complementary therapies may require a practitioner.

 
 
 

Helping yourself through depression

If you have symptoms of depression, you may want to consider postponing making major life decisions — such as changing jobs or moving — until your symptoms improve. Recovering from depression is a gradual process. Patience with yourself is important.

For mild to moderate depressions, some people find the following strategies helpful:

  • setting realistic goals and breaking large tasks into smaller ones

  • trying to spend time with other people for at least an hour a day, whether in person or on the phone, and accepting their offers of help

  • finding someone you can talk to and confide in 

  • doing any activities that you found naturally relaxing before breast cancer, such as painting, playing music, or going on nature hikes

  • being physically active every day, say walking for 30 minutes a day

  • avoiding alcohol and caffeine

Written by: Kristine Conner, contributing writer

Reviewed by 1 medical adviser
 
Stephanie Ross, PhD
NorthShore University HealthSystem, Evanston, IL
Learn more about our advisory board

— Last updated on August 11, 2022, 6:33 PM

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