Depression and Chemotherapy

What Is Depression?

Depression is a persistent sadness that interferes with usual activities and ability to carry out roles at home, work, community, or school.

• Depression may also be known as sadness, feeling "down," despair, or hopelessness. Depression and its side effects affect both men and women.
• There are several risk factors that increase the potential for development of depression in the patient with cancer. Medications commonly prescribed for cancer patients can be one of those risk factors. There are many classes of medications that may have depression as their side effects. Some examples are: analgesics, anticonvulsants, antihistamines, anti-inflammatory agents, antineoplastics, chemotherapy agents, hormones, immunosuppressive agents, and steroids.

Symptoms of Chemotherapy-Based Depression:

Signs of depression: 5 or more of the following symptoms that persist for 1 week or more:

• Change in your mood.
• Decreased interest in your usual activities, family, & friends.
• Inability to enjoy life.
• Agitated or very neutral reactions.
• Profound fatigue & loss of energy.
• Changes in sleeping (sleeping all the time or insomnia).
• Changes in your appetite (weight gain or loss).
• Decreased libido (interest in sexual activities).
• Difficulty concentrating & making decisions.
• Difficulty fulfilling usual roles.
• Feeling guilty or like you are being punished.
• Feeling very dissatisfied.
• Negative when talking about yourself.
• Talking frequently about how "useless life is" or "ending it all."

How to Manage Depression During and After Chemotherapy:

Recognize:

What puts you at risk for depression:

• History of depression in yourself or your family.
• Pessimistic view of life.
• Living with a chronic disease like cancer.
• Stressful events in your life.
• Effects of some medications & chemotherapy.
• Lack of support from family or friends.
• Unrelieved physical symptoms (like pain).
• Alcohol or drug abuse.
• Unrelieved grief (not working through feelings of angry about how cancer & its treatment have affected your life).
• Any persistent change in your mood, with the signs of depression listed above.
• If you have any suicidal thoughts (like "ending it all"), immediately let someone nearby know how you feel and ask for help. Go to the doctor's office or emergency room. If feelings get to that point, it is not safe to be by yourself.

Lower your risk for chemotherapy-based depression:

• CALL YOUR DOCTOR'S OFFICE and describe how you are feeling. Your symptoms may be a signal to your doctor that your cancer medications or treatment need to be adjusted. The sooner you let your healthcare team know how you are feeling, the sooner you can find relief. If un-treated, depression only gets worse.
• Ask for an appointment as soon as possible. Your nurse & doctor can help you find out what is causing the depression.
• Let someone in your family or friends know how you are feeling. If you have suicidal thoughts, you need added support right away for your safety.
• Lower your risk where possible (for example, avoid using alcohol to relieve symptoms of depression).
• Follow your treatment plan & take your medications exactly as prescribed.
• Your doctor may make a referral for you to see a counselor - to help you find ways to cope with your situation. Getting professional help for depression is just as important as taking your medications.
• Keep a diary or journal of how you are feeling once treatment is started. Let your health care professional know if your symptoms are getting better or worse. It usually takes 2 weeks for depression medications (antidepressants) to work the best.

Medications Your Doctor May Prescribe for Depression:

• Citalopram (Celexa®)
• Fluoxetine (Prozac®)
• Paroxetine (Paxil®)
• Sertraline (Zoloft®)
• Amitriptyline (Elavil®)
• Imipramine (Tofranil®)
• Nortriptyline (Pamelor®)

When to Contact Your Doctor or Health Care Provider:

• Call immediately, day or night if you have any suicidal thoughts.
• If you have any questions about your treatment.
• If your symptoms get worse.
• If you have side effects to your depression medication that are severe. These reactions may get better in time. Some common side effects include:
• Nausea
• Diarrhea
• Headache
• Dizziness
• Insomnia
• Agitation
• Tremors
• Sweating
• Sexual difficulties
• Drowsiness
• Weight gain
• Fast pulse
• Rash
• Dry mouth

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.