How to cope with depression after breast cancer

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If you are being treated for breast cancer, you probably know how you are doing physically. But how are you doing emotionally? Many women battling breast cancer are also battling depression whether they know it or not. Dr. Mary Jane Massie, Attending Psychiatrist at Memorial Sloan-Kettering Cancer Center talks to us about breast cancer and depression.

How to cope with depression after breast cancer

Breast cancer patients often suffer from depression at some point during or after treatment. It's important to be familiar with the signs of depression so you can seek help or encourage a loved one to get the help they need. Dr. Mary Jane Massie, Attending Psychiatrist at Memorial Sloan-Kettering Cancer Center, offers some advice on how to recognize and treat depression.

Diagnosing depression:

  • About 25% of cancer patients will experience depression at some point during their illness.
  • Anxiety is often a large component of depression. It’s commonly an initial symptom expressed by a patient to her doctor.
  • A breast cancer patient may also be experiencing sadness, low moods, insomnia and trouble concentrating - the classic symptoms of depression.
  • Sometimes depression hits after the treatment of breast cancer because there is no time for the woman to really sit back and digest what she has gone through.
  • Many women experience physical reactions to breast cancer treatment, such as fatigue, which can often present itself as sadness.
  • Often women think that they should feel elated once they have completed  treatment.  But, as Dr. Massie reminds us, there should not be any "shoulds" regarding our feelings - we feel what we feel.


Telltale signs of depression:

  • Not feeling like the person you used to be.
  • The inability to approach activities, your job or child care with the same enthusiasm.
  • If you can’t bounce back from feeling blue like you used to.


Options for treating depression:

  • Most breast cancer centers have treatment groups that can help you deal with your depression. Here you will be able to talk to other women experiencing depression.
  • Some women prefer talking one-on-one.
  • There are medications to help deal with depression. Some will treat both anxiety and depression.


How the family can get involved:

  • Your family can speak to your doctor or others in the medical field to see how to support the patient, and to see how they are coping.
  • There are also treatment groups for families where they can discuss their issues with other families.


For more information on treating depression and breast cancer go to www.komen.org or call the Komen for the Cure helpline at 1-800-IM AWARE.

Transcript

I'm Lisa Birnbach. If you're being treated for breast cancer, you may know exactly how you're doing physically. But how are you doing emotionally? Many women battling breast cancer are also battling depression, whether they know it or not. With us to discuss depression and breast cancer is Dr. Mary Jane Massie, psychiatrist at Memorial Sloan-Kettering in New York. Dr. Massie, thank you so much for joining us today. Is depression more common in breast cancer patients during the treatment or afterwards?

 

We know that about 25% of cancer patients will have depression at some time during the course of their illness. We don't exactly know when that first might be noticed by the patient or her family or her doctors. But about a quarter of all women with breast cancer is going to be depressed at some point during the illness.

 

How do you identify it as depression, as opposed to anxiety over their disease?

 

We do know that many people who are depressed have anxiety as a large component of their depression. So sometimes people will tell their doctors that they're feeling anxious. But when we have a chance to talk with them, what we really hear is that in addition to anxiety, this woman is experiencing a lot of sadness, a lot of low mood, sleeplessness, insomnia, trouble concentrating. And those are classic symptoms of depression.

 

So why do some women get depressed after they've completed treatment?

 

Some women, when they are told that they have their diagnosis of breast cancer, have so much on their plate, they have so much to do. And there really isn't time simply to let oneself think just about breast cancer. So what we see are some women actually kind of sail through their whole treatment. And it isn't until they've completed their treatment for breast cancer that they really have a chance to sit back and say, my goodness. What's this been all about? So some women really, at the end of treatment, or a year after the end of treatment, first start to experience sadness, depressive symptoms.

 

Dr. Massie, after some patients complete treatment, they feel they should be elated. And that's when they get socked with the depression.

 

And there really shouldn't be any shoulds about this. We feel what we feel. Breast cancer treatment can be very exhausting for many people. And fatigue is often what women talk about. So hard to be elated when you're experiencing physical reactions to treatment.

 

And tired can present as sadness sometimes, can't it?

 

Very much can present as sadness. And women become worried about themselves. They become worried about their moods, because they may never have experienced themselves as so unable to do the things that they wanted to do, that they enjoyed doing in the past.

 

So what are some of the warning signs that, let's say, a loved one who's dealing with breast cancer really may be succumbing to depression?

 

What women notice is that they are not the person that they used to be. They are unable to approach activities or their job or child care with the same enthusiasm or gusto. And sometimes women feel that I've been blue before in the past, but I bounced out of it. And I'm not bouncing out of this anymore.

 

So treatment for these women?

 

Fortunately, we have so many treatments, and treatments that are effective for women who have depression or anxiety or both of those symptoms. I think that most cancer centers and most communities have breast cancer groups, led by leaders or leaderless groups, where women have an opportunity to talk with other women. Some women prefer more individual work, so talking on one-to-one may be the most useful for some patients. We have many medications for anxiety, or many medications for depression. These medications are effective. Sometimes a medication will treat both anxiety and depressive symptoms and help relieve problems with sleep or insomnia.

 

And finally, what can family or loved ones do?

 

We in the medical community welcome the opportunity to get to know families, to talk with families about how they're coping. And in fact, most cancer centers have groups for families. Or there are individual counselors who will sit down with family members, who usually want to talk through how can I do the best job I possibly can in helping my loved one get through this illness. But they may also want to talk about how stressful this is for them. There's good help that's available for people.

 

That's important to know. Thank you so much, Dr. Massie.

 

For more information, please go to Susan G. Komen for the Cure at www.komen.org, or call the Komen for the Cure helpline at 1-800-IM AWARE. I'm Lisa Birnbach.

meet theexpert
  • Dr. Mary Jane Massie

    Dr. Mary Jane Massie Psychiatrist Dr. Mary Jane Massie is an Attending Psychiatrist at Memorial Sloan-Kettering Cancer Center and Professor of Clinical Psychiatry at Cornell's Weill Medical College. She specializes in treatment of women with or at high risk of developing breast cancer. more about this expert »

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