|Depression and Cancer...(page 2)|
|How can someone have clinical depression without feeling sad?
Clinical depression is a biological disorder, which affects a number of vital functions. It affects mood (such as happiness, sadness); thinking (such as decreased concentration or having negative thoughts); behavior (such as the loss of motivation to do things) and physical functions (such as sleep and appetite). Even though depression often includes mood disturbance, some studies of depression show that other symptoms may predominate, such as losing our ambition or interest in things we like.
How does clinical depression occur?
There are many things we know about clinical depression. It is clear that there is a genetic or constitutional predisposition to the condition, since it does run in families. In these cases, it may occur several times during an individual's life and may come out of the "clear blue sky" with little or no obvious cause. However, depressive illness can also occur in individuals who have no family history and those who have never experienced depression previously. Often in these cases, the onset of depressive illness is related to stress.
Cancer patients know how stressful the disease is. They must deal with an enormous amount of uncertainty and fear and adapt to changes in family and marriage, deal with economic challenges and endure the hardships of cancer treatment. This stress may somehow affect areas of the brain that control important functions such as mood, motivation, sleep, appetite and ability to experience pleasure. The exact mechanism by which this happens is not exactly known, but there is strong evidence that in clinical depression the brain becomes less able to produce substances called neurotransmitters, which allow the cells of the brain to communicate with each other. When the cells are not communicating, normal mood and other important functions of the body become disturbed.
How can we recognize clinical depression?
Many people who experience depression do feel sad. In fact, they may feel so sad that they cry at the drop of a hat. However, as mentioned previously, not all patients with clinical depression have sadness. Because clinical depression affects many areas of functioning, patients can have many different symptoms. These may be divided into several groups, somewhat arbitrarily.
Group 1: Mood Symptoms
Group 2: Cognitive Symptoms
Group 3: Physical Symptoms
Group 4: Behavioral Symptoms