Depression (PDQ®)–Patient Version

Depression is different from normal sadness.

Depression is more than feeling down or sad from time to time. It is a medical problem marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with daily life. If you have these feelings most of the day for longer than 2 weeks, it may be a sign of major depression.

Other symptoms of major depression include

People diagnosed with cancer may also have other symptoms of depression, such as

Symptoms of depression are not the same for every person.

Cancer-related risk factors such as cancer type, stage, and treatment may contribute to depression, but having a personal history of mental health issues or a lack of social support are more important factors. Cancer-related fatigue, pain, and weaker physical condition can also increase depression risk.

Depression can be treated.

It's important to know that help is available for people with depression. Tell your health care team how you are feeling and discuss your treatment options with them. Getting the help you need is important for your life and your health.

If you have thoughts of suicide, dial 911 in an emergency or call, text, or chat 988 to reach the 988 Suicide and Crisis Lifeline. Counselors are available 24 hours a day, 7 days a week, including for people who are deaf or hard of hearing.

Some people with cancer may have a higher risk of depression.

A person diagnosed with cancer faces many stressful issues, which may increase the risk of depression. These may include

About 2 out of every 10 people diagnosed with cancer become depressed. The number of men and women affected are about the same.

Certain risk factors may increase your chance of developing depression after a cancer diagnosis. Risk factors related to cancer that may cause depression include

Risk factors not related to cancer that may cause depression include

Not everyone who is diagnosed with cancer reacts in the same way. Some people with cancer may not have depression or anxiety, while others may have major depression or an anxiety disorder. For more information on anxiety disorders, see Adjustment to Cancer: Anxiety and Distress.

There are many medical conditions that can cause depression.

Medical conditions that may cause depression in people with cancer include

Family members of people with cancer are also at risk of depression.

Anxiety and depression may occur in family members who are caring for loved ones with cancer. Family members who talk about their feelings and solve problems together are less likely to have high levels of depression and anxiety.

If you are a caregiver, watch for signs of depression or anxiety in yourself and talk with your doctor even if you think what you are feeling is normal. It's important that you take care of your own health and seek help when you need it. For more information, see Support for Caregivers of Cancer Patients.

Your health care provider will talk with you to find out if you have symptoms of depression.

Your health care provider may want to discuss the following:

Your health care team will continue to monitor your symptoms to keep your depression from getting worse.

Physical exams and lab tests are also used to diagnose depression.

In addition to talking with you, your doctor may

The decision to treat depression depends on how long it has lasted and how much it affects your life.

You may have depression that needs to be treated if you are not able to perform your usual activities, have severe symptoms, or the symptoms do not go away. Treatment of depression may include talk therapy, medicines, or both.

Counseling or talk therapy helps some people with depression.

Your doctor may suggest you see a psychologist or psychiatrist because

Most counseling or talk therapy programs for depression are offered in both individual and small-group settings. These programs include crisis intervention, psychotherapy, and cognitive-behavior therapy.

More than one type of therapy program may be right for you. A therapy program can help you learn about

Talking with a clergy member may also be helpful for some people.

Physical activity may help relieve depression symptoms.

Being physically active may help relieve depression and its symptoms. At least 150 minutes of moderate-to-vigorous exercise per week has been shown to reduce depression in breast cancer survivors.

Antidepressants help some people with depression.

Antidepressants may help relieve depression and its symptoms. When you are taking antidepressants, it's important that you use them under the care of a doctor. Some antidepressants take 3 to 6 weeks to work. To avoid side effects, you usually begin at a low dose that is slowly increased to find the right dose for you.

You may be treated with a number of drugs during your cancer care. Some anticancer drugs may not mix safely with certain antidepressants or with certain foods, herbals, or nutritional supplements. It's important to tell your health care providers about all the drugs, herbals, and nutritional supplements you are taking, including drugs used as patches on the skin, and any other diseases, conditions, or symptoms you have. This can help prevent unwanted reactions with your antidepressant.

There are different types of antidepressants.

Most antidepressants help treat depression by changing the levels of chemicals called neurotransmitters in the brain, while some affect cell receptors. Nerves use these chemicals to send messages to one another. Increasing the amount of these chemicals helps to improve mood. The different types of antidepressants act on these chemicals in different ways and have different side effects.

Several types of antidepressants are used to treat depression:

Other antidepressants include mirtazapine, trazodone, and monoamine oxidase inhibitors.

Sometimes, other drugs, such as benzodiazepines or psychostimulants, are given along with antidepressants to decrease anxiety or improve energy and concentration.

The antidepressant that is best for you depends on several factors.

Choosing the best antidepressant for you depends on

You may have to try different treatments to find the one that is right for you.

Your doctor will watch you closely if you need to change your antidepressant.

You may need to change your antidepressant if severe adverse effects occur or your symptoms are not getting better. Check with your doctor before you stop taking an antidepressant. Your doctor will reduce the dose slowly before starting another antidepressant. This is to prevent side effects that can occur if you suddenly stop taking your antidepressant.

People with cancer may feel hopeless at times and think about suicide.

Some people with cancer feel hopeless. Talk with your doctor if you feel hopeless. There are ways your doctor can help you.

Feelings of hopelessness may lead to thinking about suicide. If you or someone you know is thinking about suicide, get help as soon as possible. You can get help from the National Suicide Prevention Lifeline, 1-800-273-TALK (8255). The Lifeline is available 24 hours a day, 7 days a week. The deaf and hard of hearing can contact the TTY Lifeline at 1-800-799-4889. All calls are confidential. More information about depression and suicide prevention is available from the National Institute of Mental Health.

Certain factors may increase the risk of suicidal thoughts in people with cancer.

Higher rates of suicidal thoughts, suicidal behaviors, and suicide attempts have been noted in patients with cancer.

Some factors that may increase the risk of suicide include older age, being male, and

The health care team will ask if you have thoughts of suicide and help manage the cause of the thoughts.

Talk to your doctor if you have thoughts of hopelessness and are thinking of suicide. You may feel more in control of your emotions once you describe your feelings and fears.

People with cancer may feel desperate to stop any discomfort or pain they have. Keeping pain and other symptoms under control will help to

Ask your doctor what may be done to help relieve your emotional and physical pain. Treatment may include antidepressants. Some antidepressants take a few weeks to work. The doctor may prescribe other drugs that work quickly to relieve distress until the antidepressant begins to work. For your safety, it's important to have frequent contact with a health care professional and avoid being alone until your symptoms are controlled. Your health care team can help you find social support.

Your child will be examined for signs of depression.

Your health care team may ask the following questions:

The symptoms of depression are not the same in every child.

A diagnosis of depression depends on the symptoms and how long they have lasted. Symptoms of depression in children may include

Treatment may be talk therapy or antidepressants.

Talk therapy is the main treatment for depression in children. The child may talk to the counselor alone or with a small group of other children. Talk therapy may include play therapy for younger children. Therapy will help the child cope with feelings of depression and understand their cancer and treatment.

Antidepressants may be given to children with major depression or anxiety. In some children, teenagers, and young adults, antidepressants may make depression worse or cause thoughts of suicide. The Food and Drug Administration has warned that people younger than age 25 who are taking antidepressants should be watched closely for signs that the depression is getting worse and for suicidal thinking or behavior.

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about cancer-related depression and suicide risk in both the adult and the pediatric population. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

The best way to cite this PDQ summary is:

PDQ® Supportive and Palliative Care Editorial Board. PDQ Depression. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/about-cancer/coping/feelings/depression-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389474]

Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

Disclaimer

The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

Contact Us

More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.