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| Changes
in Mood: A Primer on Depression and Cancer |
By Walter Baile, M.D.
The topic of depression is of concern to many cancer
patients and questions such as the following often arise: How
does one know when he or she is depressed? Is there a
relationship between depression and cancer? Did depression
cause my cancer? How can depression be treated? To address
these important issues, here are the basics on depression and
cancer.
How common is depression?
Depression is the most common psychiatric illness
found in the general population. It is said that as many as 8
percent of Americans will have had a depressive illness
sometime in the course of their lifetime. In cancer patients,
depression seems even more frequent. As many as 10 to 15
percent of patients are likely to experience depression at
some point during their illness.
What is
depression?
The term depression can be confusing
because it actually has several meanings. First of all,
depression is a mood or feeling. When a person looks sad and
dejected we say he is depressed. In this case, depression is a
common emotion that often occurs in response to
disappointment, such as when a person doesn't get a promotion
that was anticipated.
The mood depression is also
closely related to feelings of discouragement and frustration.
To an observer, a person with a depressed mood may mope
around, not feel like socializing or even have no appetite for
a few days. In this instance, depression refers to a normal
variant of mood, which is part of the ups and downs of life.
This mood disturbance may be transient or may last days or
longer. Affected individuals may respond to encouragement from
others. This is the idea behind support groups.
Having
a depressed mood is an unpleasant state, but many individuals
find ways to cope. Using the example of our person who did not
get the promotion, he or she might take positive action to
feel better, such as meeting with a supervisor to determine
how performance could be improved. Of course, there are also
unhealthy ways of dealing with the situation, such as getting
intoxicated or shifting blame to someone else. In any case, to
a great extent we all have some control over how we cope with
this kind of depression that occurs in the course of everyday
life.
Depression may also be associated with grief or
loss of something valued. Grief is a common emotion among
cancer patients who must deal with many losses: psychological
losses such as security about the future; physical losses such
as those that may occur from cancer surgery or hair loss from
chemotherapy;
and financial losses due to the expense of cancer treatment.
As in the case of depressed mood, feelings of grief may be
very short-lived or they may last for days or weeks.
The term depression may also refer to a disorder
called clinical depression or depressive illness. Depressive
illness is more than just a mood or feeling sad. In fact, in
diagnosing the presence of a clinical depression, feelings of
sadness do not even have to be present. Sound strange? Well,
it is. It is also a dilemma because some people who are
clinically depressed do not recognize their problem and
professionals who are in the position of treating depression
may also not recognize it.
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