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Depression Articles Depression Depression Treatments Types of Depression Online Therapy for Depression

Cancer & Depression: Connection, Risks & Treatment

Headshot of Iris Waichler, LCSW

Author: Iris Waichler, LCSW

Headshot of Iris Waichler, LCSW

Iris Waichler MSW, LCSW

Iris, a social worker with 40+ years of experience, focuses on coping with terminal illnesses, infertility, caregiving, and grief. She offers workshops and counseling to empower individuals.

See My Bio Editorial Policy
Pat F. Bass, MD, MS, MPH

Medical Reviewer: Pat Bass III, MD, MS, MPH Licensed medical reviewer

Published: April 17, 2023
  • ConnectionConnection
  • Challenge of DiagnosisChallenge of Diagnosis
  • SignsSigns
  • Risk FactorsRisk Factors
  • Ways to CopeWays to Cope
  • TreatmentTreatment
  • Get HelpGet Help
  • Tips for CaregiversTips for Caregivers
  • ConclusionConclusion
  • Additional ResourcesAdditional Resources
  • InfographicsInfographics
Headshot of Iris Waichler MSW, LCSW
Written by:

Iris Waichler

MSW, LCSW
Headshot of Pat F Bass III, MD, MS, MPH
Reviewed by:

Pat Bass III

MD, MS, MPH

Cancer patients are especially prone to depression because of cancer’s symptoms and the way it’s treated.1 Depressive symptoms stemming from a cancer diagnosis are treatable when discovered – especially with early interventions. With the right mental health support, a patient’s depressive symptoms can be managed.

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The Connection Between Cancer & Depression

Depression and cancer are linked by their symptoms. There can be overlap between the side effects of cancer and its treatments with depression symptoms, making it hard to distinguish between them. An additional aspect to this diagnosis is how the associated treatment and therapies, including chemotherapy, hormonal replacement, and surgeries, alter the body. Treatment can cause pain, body image concerns, nausea, loss of hair, clouded thinking, and extreme fatigue.

Sharon Cohan, LCSW, Information Specialist, The Leukemia & Lymphoma SocietySharon Cohan, LCSW and Information Specialist for The Leukemia & Lymphoma Society, states, “One of the biggest myths is that everyone diagnosed with cancer will be diagnosed with depression. Only 15-25% of cancer patients get diagnosed with depression. Everyone will have a period of adjustment with some depression and anxiety which usually improves with time and education.”12

The Challenge of Diagnosing Cancer Patients With Depression

Researchers looking at the relationship between cancer and depression addressed the challenges associated with making a clear diagnosis of depression in cancer patients. They found that changes in mood are often difficult to evaluate when a patient is dealing with potential loss of life, is receiving cancer treatments, is fatigued, or is in pain.3

People who have had depression before are more likely to have depression after their cancer diagnosis.2 Depression is not exclusive to cancer patients—family members and caregivers also experience depressive symptoms in conjunction with their loved ones.

Signs of Depression In Those With Cancer

Cohan states, “Family members should be concerned if their loved one’s behavior changes, such as isolating more, decline in personal care, or lack of enjoyment in previous fun activities that lasts for more than two weeks. Caregivers need to be aware of verbal statements such as: ‘I do not want to be a burden,’ ‘I do not want to live like this,’ or, ‘It might be better if I die.’ These statements may indicate suicidal ideation and need prompt professional assessment.”

Risk Factors For Depression In Cancer Patients

The most significant risk factor for depression in cancer patients is a pre-existing history of depression. The cancer site, stage, prognosis, and treatment associated with the cancer influence the patient’s reaction to it. Those diagnosed at a later stage of cancer are generally at a higher risk of developing depression.

There are a series of risk factors that can influence depression in someone with cancer:4,5,6

  • Unemployment
  • High healthcare costs and limited access to healthcare
  • Personality factors such as neuroticism
  • Disputes with family members or their inability to cope with the cancer diagnosis
  • Poor prognosis associated with cancer diagnosis
  • Patients in active treatments (chemotherapy, immunotherapy, radiotherapy, hormone therapy)
  • Women tend to be at higher risk for depression than men
  • Anxiety traits, poor coping strategies, poor perceived social support, and early levels of psychological stress after diagnosis
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8 Ways to Cope With Cancer & Depression

Depression can make coping with cancer more difficult.9 Depression can sabotage treatment by undermining your will to live and compromising the courage, fortitude, and determination that you need to face cancer and endure the necessary medical treatments.10

Here are eight practical ways to take care of yourself while dealing with cancer and depression:

1. Keep Track of How You Feel

Be aware of how your cancer is impacting you physically and emotionally. Seek psychological help as soon as you recognize that symptoms of depression are present. Find a person and place where you feel comfortable openly discussing your feelings regarding your illness and its impact on your life and the lives of your loved ones.

2. Be Open & Build Trust With Your Team

Cohan states, “Open communication is key to beginning to deal with a tough diagnosis, treatments, and difficult conversations. It is important to build trust with your treatment team and your family/caregiver support system. Educating yourself on your disease, and what to expect with treatments and how side effects will be managed, can help ease anticipatory anxiety related to treatment.”

3. Educate Yourself

Educate yourself about available resources and programs that can help you strengthen your mind, your body, and your spirit. Allow yourself to be open to opportunities and treatment modalities that can enhance your emotional wellness. Discuss these alternatives with your doctor to ensure they will not be harmful to your recovery or treatment.

4. Find Elements of Your Treatment That You Can Control

Identify things you can do to help feel more in control over your physical and emotional well being. Try to stay engaged in your treatment as much as you can. Ask your healthcare providers questions and gather information that will help you to understand your diagnosis and its implications.

5. Stay Close With Family & Friends

Try not to isolate yourself from people you are close with as much as possible. The love and support of people that you care about can help foster your determination and healing. These ongoing connections and contacts can help patients feel less alone. It can also help alleviate stress and make a medical condition and the associated treatments feel less overwhelming because of their support.

6. Find Ways to Make Meaning

Find healthy coping mechanisms to provide meaning during this difficult time. Cohan suggests, “Some healthy coping mechanisms to deal with a difficult diagnosis include focusing on and participating in things that give your life purpose and meaning. Often, that may be the little day-to-day activities. Make a list of your dreams, your hopes, and people who are important to you. Focus on the things in your life that you are grateful for.”

7. Don’t Beat Yourself Up

Don’t blame yourself for your cancer and depression. This sometimes happens with cancer patients as they try to make sense out of being given a serious or life threatening medical diagnosis.

8. Have Reachable Goals

Set realistic goals for yourself regarding your physical and emotional health and reactions to your diagnosis. Check with your healthcare team to make sure these goals are realistic. Create milestones, like finishing chemotherapy or radiation. Acknowledge and celebrate the moments when you are able to achieve these milestones. Don’t berate yourself if you’re unable to achieve them due to circumstances that are out of your control.

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Treatment of Depression In Cancer Patients

The symptoms from certain cancer diagnoses and some of the necessary treatments can be debilitating. That in combination with the uncertainty of future recovery and lifestyle changes can make it more challenging for people to seek or stay in treatment for depression.

Patients finding themselves feeling increasingly hopeless, sad, isolated, with changes in sleep and mood, should seek mental health treatment if it lasts for more than two weeks. When your mental health is compromised, it impacts your physical ability to recover as well.

There are treatment options available for depression include:

Individual Therapy

Individual depression therapy can be invaluable in terms of identifying feelings and fears related to cancer. It provides a safe space to discuss these issues. Therapists can offer guidance on coping techniques and ways to reframe negative thoughts in constructive ways. CBT for depression is often used.

Cohan observes, “Therapy can be helpful for someone experiencing a cancer diagnosis and depression, as it provides a safe, non-judgmental environment to talk to an objective person about your situation and express your worries, fears and emotions. A therapist can provide active listening, acknowledge what a patient is going through, and help patients find meaning in their cancer experience. Through therapy you can learn stress management techniques and positive coping strategies like relaxation, meditation, journaling, exercise, and so on. These can help with long term quality of life.”

Therapists may recommend close family members participate as well to get additional information on how they are managing and offer them coping and communication skills. Family therapy also can facilitate communication between patients and family members.

Group Therapy

Group therapy is an important treatment tool for people battling cancer. Talking with peers who have similar experiences can help patients feel less alone and isolated. The sharing of experiences and advice with peers on ways to cope and overcome cancer can be empowering for all who participate.

Cohan encourages, “Hearing first hand from other cancer patients on how they are managing their journey can help normalize and prepare patients for the ups and downs of cancer treatment. Connecting with other cancer survivors provides additional support and can reduce feelings of isolation that cancer often brings.”

Medication

Medication for depression can elevate mood. It needs to be monitored for side effects, mood alterations, and interactions with other medications, chemo, and hormonal therapy treatments. Pharmacist Ebtesam Ahmed, an expert in working with cancer patients, says SSRI antidepressant medications are recommended because “the favorable efficacy and side effect profiles associated with SSRI’s make these agents the most attractive for some patients with cancer who are diagnosed with depression.”8

Medication can be prescribed by a psychiatrist or another medical doctor familiar with cancer treatment and medication interaction.

Mindfulness Techniques

Cancer can make people feel they have lost control over their bodies. Mindfulness techniques like yoga, meditation for depression, deep breathing, and relaxation training can help patients regain a sense of body control again in non-invasive ways. These techniques can enhance quality of life in meaningful ways. They can be used relatively easily at home when patients believe they can be helpful.

Other Natural Options That Can Ease Depressive Symptoms

Other integrative therapies like massage, and acupuncture, and nutritional counseling, are also used as adjunct therapies designed to help heal the body and mind. They help give patients more of a sense of control when they need it the most.

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How to Get Help For Depression In Cancer Patients

If you’re most interested in individual therapy, an online therapist directory can be a great place to start, where you can search by insurance coverage and specialties. Reaching out to a mental health professional or taking advantage of the many allied health programs and services available can help you feel more hopeful in terms of dealing. It’s a great first step towards helping you to feel better.

Patients that experience depression after a cancer diagnosis can also seek out experts in palliative care. Palliative care is incorrectly exclusively associated with end-of-life care. It’s a medical specialty area that focuses on improving the quality of life for patients diagnosed with serious chronic or life-threatening illnesses like cancer.

Palliative care encompasses many treatment areas including pain management, improving communication, emotional and spiritual support, and dietary counseling. It also includes practical support like grocery shopping or transportation. It can be critically important for patients, family members, and caregivers. When all these needs are addressed, patents and family members can feel more supported, less alone, and more hopeful.

Your primary care doctor, surgeon, oncologist, or oncology nurse specialist, can give you referral information. This type of counseling can be done by many types of mental health specialists including psychiatrists, social workers, pastoral counselors, psychologists, and counselors. Most kinds of insurance including Medicare and Medicaid offer partial to full coverage for palliative care depending on your insurance plan.

7 Ways Caregivers Can Help With Cancer & Depression

Family members and caregivers of cancer patients are important members of the caregiving team. They are a critical component to helping in the recovery and the healing of cancer patients.

Here are some suggestions from Sharon Cohan, LCSW: “Family members and caregivers can help their loved ones by gently inviting patients to talk about their fears and concerns, avoiding telling them to cheer up, and making decisions together about how to support one another. Caregivers also need to make time for their own self-care by spending time with friends or doing things they enjoy.”

Here are ways loved ones and caregivers can help those dealing with cancer and depression:

1. Be There For Them

Be present and ready to listen without expressing any judgment as your loved one discusses feelings and fears associated with a cancer diagnosis.

2. Take Care of Yourself

Recognize that a loved one’s cancer diagnosis also impacts you as their caregiver. Get the support you need from friends, mental health, and medical professionals. This will help you cope with the fears, anger, anxiety, and grief and depression, along with other emotions that cancer can bring to your life and the life of your loved one, and help avoid caregiver burnout.

3. Have Fun With Them

Engage in activities that you and your loved one can do together that can create joyful moments between you. Examples include playing music, watching movies, enjoying time outside or visiting with close friends and family.

4. Ask How You Can Help

Ask your loved one what you can do to help them and what you can do together to help each other cope with the cancer and the changes that arise.

5. Educate Yourself

Educate yourself as much as you can about the type of cancer your loved one has so you understand what to expect in terms of prognosis and treatment options. Try to get information from the healthcare team. This will help you to prepare yourself emotionally. It will also aid you in supporting your loved one along their treatment path.

6. Don’t Violate Their Trust

Talk to your loved one about what information they want shared about their condition in terms of family and friends. You want to have a good understanding about what they want to say so you do not violate any wishes for privacy that they may have. If this is not done there could be conflict and misunderstandings that could result in hurt or angry feelings.

7. Don’t Be Afraid to Ask For More Help

If you discover your loved one needs help you cannot give, don’t be afraid to ask for additional help for specific tasks. Don’t view it as a personal failure if you are not able to meet the physical and emotional demands a cancer diagnosis may bring.

Assure your loved one that you want to do what you can to keep them safe and as independent and healthy as possible. This may mean bringing in someone with expertise or skills that you don’t have.

Final Thoughts On Dealing With Cancer & Depression

What you are feeling as a cancer patient is unique to you, but remember that you are not alone. Patients that are diagnosed with cancer displaying symptoms of depression need to receive counseling after being diagnosed, during their treatment, and after treatment is over.11 Depression may develop at any of these stages.

Additional Resources

To help our readers take the next step in their mental health journey, ChoosingTherapy.com has partnered with leaders in mental health and wellness. ChoosingTherapy.com is compensated for marketing by the companies included below.

Online Therapy

BetterHelp – Get support and guidance from a licensed therapist. BetterHelp has over 30,000 therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free online assessment and get matched with the right therapist for you. Free Assessment

Therapy for Depression & Medication Management

Brightside Health – If you’re struggling with depression, finding the right medication can make a difference. Brightside Health treatment plans start at $95 per month. Following a free online evaluation and receiving a prescription, you can get FDA approved medications delivered to your door. Free Assessment

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For Further Reading

  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov
  • Elavil (Amitriptyline) Dosage Guide

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Best Online Therapy for Depression

Depression is a very common mental health concern. To find the best online therapy for depression, we spent hundreds of hours personally using and researching over 50 platforms. Our resulting list offers options with easy access to appointments, affordable pricing, coverage for major insurance plans, and some of the best therapist availability in the industry. Read on to see our top picks for the best online therapy for depression.

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Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.

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Cancer & Depression Infographics

Connection Between Cancer and Depression Ways to Cope with Cancer and Depression Ways Caregivers Can Help with Cancer and Depression

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Sources Update History

ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Rachel Roos Pokorney, LCSW, Gleneara E. Bates, MS, MSW (2017) JAMA Oncology Patient Page. JAMA Oncol. 2017;3(5):715. doi:10.1001/jamaoncol.2016.5851. Retrieved from https://jamanetwork.com/journals/jamaoncology/fullarticle/2597280

  • American Cancer Society. Depression. Retrieved from https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/emotional-mood-changes/depression.html

  • Mary Jane Massie, MD. (2004) Prevalence of Depression in Patients With Cancer. Journal of National Cancer Institute Monograph Volume 2004, Issue 32, pgs 57-71 doi,org/10.1093/jncimonographs/lgh014.  Retrieved from https://academic.oup.com/jncimono/article/2004/32/57/1021822

  • Claire L. Niedzwiedz, Lee Knifton, Kathryn A. Robb, Srinivasa Vittal, Katikireddi, Daniel J. Smith, (2019). Depression and anxiety among people living with and beyond cancer: a growing clinical and research priority. BMC Cancer, Article number 943 (2019) Retrieved from https://bmccancer.biomedcentral.com/articles/10.1186/s12885-019-6181-4

  • R. Caruso, M. G. Nanni, M. Riba, S. Sabato, A. J. Mitchell, E. Croce, L. Grassi, (2017). Depressive spectrum disorders in cancer: prevalence, risk factors, and screening for depression: a critical review. Acta Oncologia, Volume 56, Issue 2. doi.org/10.1080/0284186X.2016.1266090. Retrieved from https://www.tandfonline.com/doi/full/10.1080/0284186X.2016.1266090

  • R. Caruso, M. G. Nanni, M. Riba, S. Sabato, A. J. Mitchell, E. Croce, L. Grassi, (2017). Depressive spectrum disorders in cancer: prevalence, risk factors, and screening for depression: a critical review. Acta Oncologia, Volume 56, Issue 2. doi.org/10.1080/0284186X.2016.1266090. Retrieved from https://www.tandfonline.com/doi/full/10.1080/0284186X.2016.1266090

  • Ebtesam Ahmed, PharmD, MS (2019) Antidepressants in Patients With Advanced Cancer: When They’re Warranted and How to Choose Therapy. Oncology Journal Vol. 33 No2. Retrieved from https://www.cancernetwork.com/view/antidepressants-patients-advanced-cancer-when-theyre-warranted-and-how-choose-therapy

  • Andrew M. Kneier, Ph.D. (2020) Coping With Depression. Stanford Medicine Surviving Cancer. Retrieved from https://med.stanford.edu/survivingcancer/coping-with-cancer/cancer-coping-with-depression.html

  • Jennifer Byrne (2020) Depression, anxiety in cancer survivors: An underrecognized emotional ‘crash.’ Hematology/Oncology Today. Retrieved from https://www.healio.com/news/hematology-oncology/20200825/depression-anxiety-in-cancer-survivors-an-underrecognized-emotional-crash

  • Cohan, Sharon. (2021). Personal Interview.

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We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

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Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.
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