A cancer diagnosis can shake the foundations of daily life. Sadness, grief, and uncertainty are natural responses when plans feel disrupted and the future looks unfamiliar. But when low mood lingers, intensifies, or begins to interfere with everyday activities, it may be more than a passing emotional response. It may be depression, and it deserves attention and care.
What Is Depression?
Depression can refer to a temporary emotional state, but it is also a medical diagnosis. Among people who have or have had cancer, two forms are most common:
- Major depressive disorder (MDD), also called clinical depression, involves intense symptoms lasting at least two weeks.
- Persistent depressive disorder (PDD), or dysthymia, includes milder symptoms that continue for at least two years.
Depression is rarely caused by a single factor. Research shows it typically develops from a combination of influences, including trauma, grief, stress, genetics, hormonal changes, brain chemistry, other medical conditions, sleep and nutrition patterns, certain medications, and substance use disorders.
When Symptoms Overlap
Several medical conditions can mimic depression, including thyroid disorders, diabetes, anemia, uncontrolled pain, high calcium levels, and anxiety. Treating these issues may relieve depressive symptoms. Because depression often shares physical symptoms with cancer and its treatments, such as fatigue, appetite changes, or sleep disruption, it is essential to evaluate the full picture. Ruling out other causes ensures patients receive the most effective care.
Depression and the Cancer Journey
Depression affects approximately one in four people who have or have had cancer. It can occur at any stage, from diagnosis through survivorship. Some individuals experience symptoms soon after diagnosis, while others develop depression weeks or months after treatment ends.
Certain factors increase risk, including advanced disease, specific cancer types such as pancreatic or head and neck cancers, younger age at diagnosis, social isolation, difficulty with self-care, poorly controlled pain, a history of trauma or substance use disorder, and prior depression.
Recognizing the Symptoms
Depression can look different from person to person. Common symptoms, especially when present nearly every day for two weeks or more, include:
- Loss of interest or pleasure
- Persistent sadness or hopelessness
- Sleep disturbances
- Changes in appetite
- Feelings of worthlessness or failure
- Difficulty concentrating
- Noticeable slowing down or restlessness
- Thoughts of self-harm or feeling better off dead
Behavioral changes may also signal depression, such as frequent crying, irritability, withdrawal from loved ones, quitting enjoyable activities, substance use, sexual problems, or memory difficulties.
If you or someone you care about notices these patterns, seeking support is important. Health care teams can screen for depression and identify contributing medical issues.
If you are in immediate distress or thinking about harming yourself, call 988 for the Suicide & Crisis Lifeline, available 24/7 by phone or text, or go to the nearest emergency department.
Screening and Open Conversations
Many experts recommend routine screening for anxiety and depression in people with cancer. Honest conversations with your care team help guide appropriate support. Providers may ask about your thoughts, physical symptoms, daily functioning, and safety concerns. These discussions are confidential and designed to help.
Treatment Options
Depression treatment is individualized. The goal is to reduce symptoms, ease suffering, and improve quality of life. Treatment may include psychotherapy, medication, or both. In some cases, light therapy, mindfulness practices, or complementary therapies are added to enhance results.
Psychotherapy
Several types of talk therapy are effective:
- Cognitive behavioral therapy (CBT) focuses on identifying and reframing negative thought patterns.
- Acceptance and commitment therapy (ACT) incorporates mindfulness to acknowledge thoughts without judgment.
- Interpersonal therapy (IPT) explores relationships and social dynamics.
- Eye movement desensitization and reprocessing (EMDR) uses guided eye movements to process past experiences.
Medications
Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed. These medications, including fluoxetine, paroxetine, sertraline, and escitalopram, help regulate neurotransmitters linked to mood. They may take four to six weeks to show benefit. Other options include serotonin norepinephrine reuptake inhibitors (SNRIs), norepinephrine dopamine reuptake inhibitors (NDRIs), and less commonly, tricyclic antidepressants or monoamine oxidase inhibitors.
Your care team will monitor for side effects and adjust treatment as needed.
Additional Therapies and Coping Strategies
Brain stimulation therapies may help treatment-resistant depression. Light therapy, particularly in the morning, can improve symptoms within days. Natural sunlight is beneficial when accessible.
Complementary approaches such as yoga, acupuncture, reflexology, and massage have been shown to improve mood and quality of life. Mindfulness practices encourage staying present rather than becoming overwhelmed by past or future worries.
Practical coping strategies also matter. Reflect on past resilience. Take one day at a time. Maintain reliable support systems. Journal your thoughts. Practice slow, deep breathing. Seek assistance for stressors like finances or transportation. Even a brief walk outdoors can make a difference.
Depression treatment is rarely a single solution. Some days will feel better than others. The objective is not to eliminate every difficult emotion but to bring symptoms to a manageable level, allowing space for connection, meaning, and moments of joy.
At Arizona Oncology, we believe caring for the whole person includes addressing emotional health. If you are struggling, speak with your care team. Support is available, and you do not have to navigate this alone.