Depression is closely related to cancer,as it affects roughly 1 in every 4 patients, so it’s important to know how patients slips into depression, but before we need to know how do they feel throughout the whole cancer journey, starting from the very beginning of diagnosis till the hopeful end of survival.
Shortly after diagnosis, patients face what’s called The universal fears or 6 Ds: “ Death, Dependency, Disfigurement, Disability, Disruption of life and Discomfort” all these fears overwhelming their upcoming life.
In her book “On death and dying” Elisabeth Kubler-Ross describes the emotional stages of cancer patients:
1. Anxiety: New symptoms and cancer arises as a possibility
2. Denial: Diagnosis is ascertained, this phase is crucial because of the high risk of suicide!
3. Anger: patients seek explanation, could see cancer as well deserved punishment
4. Negotiation: The most important phase where patients are liable to accept intervention, also willing to make compromises and fight for their survival.
25% of cancer patients get stuck in depression and In this article we’ll be showing how to spot, deal with it, and some false beliefs to be corrected.
Recognition of depression
Normally patients experience ups and downs that corresponds behavioral changes in appetite, sleep patterns and other symptoms that resolve in few weeks, but some patients develop long lasting symptoms that aren't cancer or treatment related, but affect their everyday activities, hence, called “Red flags”
1. Ongoing sadness, hopelessness.
2. Extreme apathy and anhedonia
3. Loss of energy
4. Trouble sleeping
5. Trouble focusing, remembering.
6. Feeling guilty
7. Frequent thoughts of death or suicide attempts
Some symptoms can be due to cancer itself or its treatment, But if 5 or more of these symptoms happen everyday for 2 weeks, the patient must be encouraged to see a specialist.
Also, some factors increase the possibility of developing depression, for example patients with advanced disease, bed-restricted, consistent pain are more liable to be depressed more than early-staged patients who have a support system and can maintain roughly normal life. In addition to the fact that certain types of cancers like pancreatic and lung cancers are more associated with depression than any other types.
False beliefs in cancer “
Putting up a front”
Some patients try to “be positive” even when it’s painful to them, to protect those whom they love or to maintain happy atmosphere that helps fighting cancer, but on the contrary, studies show that being cheerful has little to no effect, Instead Patients should be encouraged to share their feelings whatever they are.
“Cancer related depression only affects cancer patients”
Depression can also reach the caregivers and cancer survivors. Caregivers are expected to live the same emotional experiences of the patient. They feel overwhelmed, worthless because it’s hard for them to see their loved ones suffering. On the other hand, cancer survivors face it too, sometimes long after they finish their treatment because of the fear of recurrence of the disease or as delayed response to their past crisis.
Dos and Don’ts with cancer patients
1. Provide emotional support by showing care
2. Provide instrumental support and services; help with the groceries...etc
3. Facilitate informational support by encouraging seeing a specialist, help making appointment, also provide transportation if needed
4. Promote physical activity such as daily walks.
5. Engage in conversation and activities they enjoy.
6. Provide appraisal support and remind them that it’s OK to grieve over the losses that cancer has brought and reassure with time and treatment things will get better.
1. Force someone to talk when they’re not ready.
2. Blame the patient for feeling depressed
3. Tell severely ill patients to cheer up and try to reason with them
Finally, many voices arose in the past few years trying to establish a platform for supporting cancer patients in various ways, the best of which is to increase awareness about the state and how to deal with it.