Depression is a powerful and understandable side effect of a breast cancer diagnosis and treatment. There are a number of reasons why – from the trauma of your diagnosis, to the physiological side effects of the various treatments (hormone fluctuations, fatigue, nausea, pain), to the dramatic changes to your body following mastectomy and reconstruction as well as side effects from radiation and chemotherapy treatments such as weight gain or loss, for example.
Breast cancer is the most common cancer in women and can carry all sorts of stigma around self-image and sexuality. In recent times treatment has advanced significantly and it is no longer the death sentence it once was. The downside, though, is that the aggressiveness of the treatment can expose patients to quite extreme side effects, including depression. This is why recognizing the impact of breast cancer and its treatment on long-term outcomes is so important. Especially with regard to your mental health.
Depression and Breast Cancer
Fear of death, disruption of life plans, changes in body image and self-esteem, changes in social role and lifestyle, and financial and legal concerns are significant issues. That being said, serious depression or anxiety is not experienced by everyone who is diagnosed with cancer. Studies have shown that major depression affects approximately 25% of patients and the good news is it has recognizable symptoms that are treatable (1, 2).
The treatment journey you face as a patient should be looked at holistically by your team of doctors – we have a responsibility not just to treat your body but to take in to account your emotional well-being too. Regular mental health check-ins should be standard. Doctors should be proactive about screening for depression throughout treatment and if there are signs of depression then you should be guided towards suitable support systems – whether that is support groups, private therapy and/or medication.
Our experience has shown that the signs below are indicators of potential depression thus if you are having any of these, it is important to have a discussion about depression with your doctors:
- A history of depression.
- A weak social support system with little supportive human contact.
- Evidence of persistent irrational beliefs or negative thinking regarding the diagnosis.
- Your cancer diagnosis is causing a major disruption or dysfunction in your life.
Further studies have suggested there is also a link between inappropriate coping mechanisms and higher levels of depression, anxiety, and fatigue (3,4). Some of these coping behaviors include avoidance, negative self-coping statements, a preoccupation with physical symptoms, and catastrophizing.
However, it has also been proven (via a study that examined coping strategies in 138 women with breast cancer) that patients with better coping skills – such as positive self-statements – tend to have lower levels of depressive and anxiety symptoms.
The Way Forward
What does this look like in practical terms? There are some practical things you can do that will help you navigate your diagnosis and treatment while minimizing your risk of depression.
- Set realistic day-to-day goals. You need to be gentle with yourself. You should not expect that you will be able to do everything you did in the past.
- Human connection is important, especially if you are an older patient. Try to be with other people for at least an hour a day.
- It is important that you have someone to talk to and confide in. Whether it’s a professional, friend or family member.
- Participation in positive events/actions can be very helpful. Movies, sporting events, playing music, painting, etc.
- Good nutrition is vital. A diet that is rich in fruits, vegetables, whole grains, and lean protein will bolster the immune system and aid your well-being.
- Exercise is proven to reduce stress and ease depression.
- Alcohol should be avoided as it is known to make depression worse and can interfere with antidepressant medicine.
It’s important to note, however, that not all of this will work for everyone. Thus, if you are showing signs of depression, it is essential that you speak to your doctor and get the medical help you need.
Who is the author? 
Dr. Nici Zeeman is a General Practitioner with a special interest in breast and thyroid health at Apffelstaedt & Associates.
Want to read more about how to manage depression naturally, click here.
