Breast cancer and depression

Being treated for breast cancer can be challenging for the body and mind. You and your loved ones and caregivers are likely to feel sad and scared sometimes. It’s completely normal for these feelings to come and go after a breast cancer diagnosis and during treatment. But if you feel sad all the time, you may be experiencing depression.

Depression can be a combination of sadness, despair, and loss of energy that interferes with daily life. Fifteen to 25% of people diagnosed with cancer will be affected by depression at some point.

There are two kinds of depression:

• Situational depression: This kind of depression occurs in response to something stressful that happens in your life. A breast cancer diagnosis can trigger situational depression.
• Clinical depression: This is similar to situational depression, but the symptoms are likely to be more severe and can last longer. Clinical depression is more likely to affect work or school. Sometimes, clinical depression happens because of a stressful event, but not always.

At LBBC, we know that a breast cancer diagnosis can bring many intense feelings such as sadness and emptiness, and it can change the way you feel about your life and your future. If you believe you may be experiencing depression, know that there are many ways to treat and manage depression so you can feel better. No matter what you are feeling, we’re here with resources and information to help and support you.

On this page, we’ll walk you through common symptoms of depression, risk factors, treatment options, and management strategies.

Symptoms of depression

Symptoms of clinical depression include:

• Continued sadness, depressed mood, or crying
• Trouble getting motivated
• Loss of interest in favorite activities
• Feeling guilty, hopeless, helpless, or worthless
• Difficulty feeling pleasure or having fun; this is one of the most common symptoms for women
• Fatigue
• Sleeping too much or too little, or trouble falling or staying asleep
• Lack of energy
• Change in appetite or weight
• Less interest in sex or intimacy
• Problems with concentration
• Irritability
• Feeling restless
• Thoughts of death or suicide

A depression diagnosis is more likely if some of these symptoms have persisted most of the day, almost every day, for at least two weeks. You don’t have to have all of these symptoms to be diagnosed. Still, depression is treatable, so if you’re suffering and think you may be depressed, there are many resources that can help.

If you have a loved one diagnosed with breast cancer, and you’re concerned that they might have depression, encourage them to ask for help from healthcare professionals.

It’s important to know that depression also can be a side effect of breast cancer treatment. Some medicines, such as hormonal therapy, may trigger these feelings directly. Medicines can also indirectly lead to depression for some people if they cause pain, tiredness, or changes in appetite.

Meanwhile, some physical symptoms of depression — like fatigue or weight loss — can also be symptoms of the cancer itself.

If you are feeling any of these symptoms, let your healthcare team know. They can help you figure out what may be causing your symptoms. If it’s a certain treatment, your team can work to make adjustments to your treatment plan so symptoms can be reduced. If symptoms seem to be caused by the emotional stress of breast cancer, your team can help you find relief that works for you, whether it’s a licensed counselor, antidepressant medicine, or other strategies we’ll talk about on this page.

Risk factors for depression

Depression is common, especially for people who have cancer or other health-related issues or chronic conditions. Other things that increase risk of depression include a personal or family history of depression or other mental health issues, using drugs or alcohol, certain medicines, lack of social support, financial burdens, and traumatic life events such as the death of a loved one or physical or sexual abuse.

Treatment options

Your oncologist can talk with you about any emotional symptoms you are having and make a diagnosis. If you are diagnosed with depression, your care team can help you figure out which treatment option or combination of options is right for you. Options include:

• Talking to a mental health professional: There are many kinds of mental health support you can get. You may need to try more than one professional to find one that feels like a good fit for you. Types of professionals who can help include oncology social workers, oncology nurses, psychologists, and psychiatrists. Learn more about seeing a professional.
• Medicine: Many different medicines can be used to manage depression. The medicine a doctor may prescribe depends on your unique needs and other medicines you take. There are possible side effects for all of them, but some side effects may lessen over time. If the first medicine you try isn’t helping, or if multiple medicines become part of your depression management plan, your oncologist may refer you to a psychiatrist for more specialized care. It’s important to know that one type of medicine used to treat depression, called SSRIs, can interfere with how well the hormonal therapy tamoxifen works. If you are taking tamoxifen and considering an SSRI, or taking an SSRI and considering tamoxifen, talk to your doctor. There are many other antidepressant options that do not interfere with tamoxifen. Learn more about SSRIs and other medicines for depression.

Tips for managing depression

In addition to treatment, there are other things you can do that can help reduce symptoms of depression:

• Try a support group. Your care team can help you find a support group for people diagnosed with breast cancer. Connecting with others sharing the same experiences as you can help you feel less alone. Ask your team for information about groups available through your hospital or community, and visit our Where to find support page to learn more, including links to LBBC private Facebook support groups.
• Connect online or by phone with others who have been diagnosed and have had experiences similar to yours. LBBC offers a helpline for one-on-one support, staffed by trained volunteers who have personal experience with breast cancer.

There are also things you can do in the day-to-day to take care of yourself:

• Talking with trusted friends and family
• Staying active and exercising
• Yoga, which can help reduce stress
• Trying complementary therapies, such as acupuncture, expressive writing, art therapy, or mindfulness-based stress reduction
• Setting realistic goals and expectations for yourself
• Breaking larger goals into smaller ones

When to get help

Depression can have a big impact on your life. It’s important to tell your care team and get professional help if you:

• Are not eating, sleeping, or participating in daily activities for several days
• Have trouble breathing
• Feel very restless

If you have thoughts of suicide, this is an emergency. Go to the nearest emergency room immediately.

If you are a caregiver, you can play a key role in recognizing these warning signs, too, and urging your loved one to seek immediate help.

National Suicide Prevention Lifeline: 988

If you feel hopeless, overwhelmed, or empty, or you think you are in danger of hurting yourself, we strongly encourage you to call the National Suicide Prevention Lifeline at 988.  This hotline provides free and confidential emotional support 24 hours a day, 7 days a week.

The previous number,  (800) 273-8255, is also in service.