Depressed Mood

Introduction

Being diagnosed with cancer is a life-changing event that can cause symptoms of depression or low mood. You may feel like shutting people out. You may stop doing things you used to enjoy. You also may find it hard to focus or think.

Some other common symptoms of depressed moods include:

• Negative feelings that don’t go away. You may feel sadness you can’t shake. You may be irritable or anxious. You may feel helpless, hopeless or worthless. And you may have guilt about past or present events.
• Loss of interest or pleasure in life. Things that once brought you great joy may not anymore. Even routine things, such as brushing your teeth or exercising, may be hard to do when you are depressed.
• Physical symptoms. You may have fatigue, loss of energy, headaches, weight changes, and trouble with sleep.
• Thoughts that overwhelm you. You may find it hard to focus. You may have a negative view of yourself, others, and of the future.

Having good mental health is important for healing. Despite having cancer, depressed mood can be treated. Watch these videos and read the following to help you manage symptoms of depressed mood.

You might also find it helpful to set clear goals for managing your depressed mood (this form can help with setting goals) and tracking what seems to help in a symptom log.

Medical therapies

Medication for depressed moods can help you:

• Improve your overall mood and interest in things you usually enjoy.
• Manage anxiety you may have.
• Improve sleep.

Talk to your health care team about medications that may help you manage depression.

Behavior strategies

• Seek out activities that bring you joy.
• Stay connected to others, especially people who bring you joy. Talk openly with your friends, family and your health care team about your cancer and depression. You may feel you don’t want to take part in activities or social gatherings. Avoiding things can actually make depression worse.
• Write a list of activities that have helped you feel better in the past.
• Try strategies to help challenge unwanted thoughts or behaviors. Some are described here. Unwanted thoughts that won’t go away can make depression worse, especially regrets about the past.
• Try cognitive behavior therapy (CBT) skills to help challenge unwanted thoughts, feelings or behaviors. Unwanted thoughts that won’t go away can make depression worse, especially regrets about the past. More information about CBT is available here. There is also a self-guided module, Cognitive Behavior Therapy-Insomnia, which you can cover in 2 to 6 weeks. It includes goal setting prompts, knowledge tests, and informational videos. 

• Work through your fears—don’t avoid them. Unwanted thoughts that won’t go away can make depression worse. It takes a lot of energy to avoid unwanted thoughts, which can add to fatigue.

Common thoughts after a cancer diagnosis may be about fear of the unknown or fear of cancer coming back. As you work through your fears, it’s possible you may feel worse for a little bit before you feel better. Write down your worries. Separate them into those worries you can control and those you can’t control. Focus on problem-solving things you can control. Try to accept what you cannot control.

Other helpful strategies include distraction, belly breathing, music therapy, and guided imagery. These strategies also can help lower stress.

Physical activity

Physical activity, such as walking, exercise classes or yoga, can:

• Ease and speed up your recovery after cancer treatments.
• Improve your mood.
• Help you have more energy throughout the day.
• Help you feel relaxed later in the day.
• Help you sleep better, which may help your depressed mood.

Gentle physical activity is one of the best ways to improve your mood and fight a depressed mood. Even a small bit of activity, such as getting outside and walking to the mail box instead of staying in the house, can be effective. Information on physical activity is available here and here. Also consider the following:

• Each day, do a few short physical activities or one longer activity.
• Have a friend or family member join you.
• Be active in areas that you are comfortable in. For example, walk in a mall or gym on cold days.

If you are interested in trying yoga, the following video may be helpful:

Integrative therapies

• Try daily meditation or mindfulness practice. These practices, described in the following videos, often help you focus on the present moment.

• Mind-body therapies, such as massage, acupuncture, reflexology and reiki, can help you feel less anxious and more relaxed. More information about relaxation skills are available here.
• Art, dance, and music therapies also can help.

Diet

Try to limit alcohol, which can make depression, anxiety, fatigue and concentration worse. Alcohol may help you temporarily relax, but after a few hours it acts as a stimulant. And this makes anxiety worse. Alcohol also worsens sleep quality.

Talk to your health care team if you need help to quit alcohol. They are here to help you.

What friends and family can do

Family members and friends can support you in the following ways. They can:

• Spend time with you, especially during difficult times. Sometimes just having someone with you helps.
• Help you with your daily activities until you are able to care for these on your own. These may be situations or chores that you feel are stressful, such as going to nurse or doctor visits, paying bills or doing household tasks.
• Do relaxation exercises or physical activities with you.
• Assist with symptom tracking (log available here) and action-planning (template available here)

What if I want more help?

There are health care specialists who can help you manage your depressed mood, such as the following:

• Social worker. A Clinical Social Worker is a licensed mental health professional. Social workers can provide counseling and resources related to grief and loss, adjustment to illness, caregiver support, and financial stressors, which can affect your depressed mood.
• Psychologist.  He or she can counsel you as you cope with cancer and symptoms. A psychologist also can help if you struggle with negative self-talk, such as supporting you with mindfulness exercises and cognitive behavioral therapy, called CBT.
• Psychiatrist. A psychiatrist can prescribe medications to help depression or low mood.
• Physical therapist or physical medicine and rehabilitation physician. Cancer and its treatment may make physical activity more difficult. And some people may not be sure about which activities are safe for them. A physical therapist or physical medicine and rehabilitation physician can partner with you to find activities right for you.
• Palliative care provider. Palliative care focuses on supporting your emotional, spiritual, and practical needs, as well as supporting caregivers. A palliative care provider may utilize different techniques to help your depressed mood including supportive counseling and/or medications.

Talk with your care team about helpful resources available in your community.

There also are self-directed materials with more information to help you manage depressed mood. You can get these materials by:

• Going online at cancereducation.mayoclinic.org
• Asking your care team.