Online Books > Helping People Cope: A Guide For Families Facing Cancer

Counseling For Severe Depression

Some people think having cancer will automatically lead to severe depression. This is not true. When a cancer diagnosis is first made, people often experience temporary feelings of sadness or depression as they try to adjust to what the illness will mean for them. This is a normal human reaction to bad news. Sometimes feelings of sadness and depression will not surface until after the initial treatment course is completed. These feelings are also common and do not usually require intensive counseling. Most people begin to feel better if they share their feelings with family, friends, or a member of the health-care team.

Chronic, severe depression is a more serious situation and may require the help of a psychiatrist, or other mental health professional. In general, people with serious depression feel so preoccupied with their problems that meeting normal family or work responsibilities seems overwhelming. Other signs of severe depression include:

• Prolonged feelings of sadness and hopelessness that are not relieved by talking with others

• Changes in eating habits, causing significant weight loss or gain

• Problems with sleep, such as not being able to get to sleep or waking up too early

• Changes in sexual desire

Counselors can help by trying to determine, with your help, what led to your depression. The counselor can also help you find ways of feeling better. For some patients, anti- depressant medications will be recommended, which require a physician's prescription. These medications are usually not used indefinitely but can help people feel interested in life again and better able to cope with their problems.

1. Provide counseling and/or medication to help with severe feelings of depression, hopelessness, or anxiety.

2. Provide psychotherapy to help you understand yourself and to find better ways of coping with the stress of illness.

1. Your doctor, nurse, or social worker can refer you to an appropriate mental health professional. Sometimes they may even suggest this. It is always best to get a referral from someone you trust. Services are always confidential.

2. Most hospitals have psychiatrists or other mental health professionals on staff who can be consulted by your doctor. Most psychiatrists, besides being affiliated with a hospital, will also have a private office where they see people as outpatients, as do other mental health professionals. Some insurance companies provide coverage for outpatient psychotherapy. These services are also available at your community mental-health agency, where fees may be adjusted to your income.

• Serious depression is often misunderstood by family and friends. Depressed people are often told things like "Stop feeling sorry for yourself," or "You'll never beat the cancer if you don't stop feeling that way." Depression can be brought on by a change in your life situation, a serious loss, or even by bodily chemical changes. Certain kinds of cancer or medications may also cause depression. Trying to overcome severe depression by yourself most often doesn't work.

• Many doctors don't like to prescribe anti-depressants because these drugs are not especially effective for the sadness or depression that may follow a cancer diagnosis. However, when a person's depression is severe, these drugs may be useful. It takes skill to recognize the difference between expected depression and the more serious, long-lasting kind. Psychiatrists are trained to know when anti-depressants will help.

• Occasionally people with cancer may consider suicide. This is very unusual. However, if a person is depressed enough to seriously think about suicide, a mental health professional must be consulted. If family members think a patient is in danger, they should not wait it out, but instead, tell the health-care team. They will know what to do.

• Some people think seeing a psychiatrist or other mental health professional means they are "crazy" or "falling apart." This is not true. It means you are having temporary problems in coping with your illness or with other problems and you want to find ways to feel better.

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