Since her cancer diagnosis, my mother has seemed very depressed. Does she need professional help?

A fellow caregiver asked...
My 64-year-old mother has seemed depressed and completely overwhelmed since her cancer diagnosis. How can I tell if she's distressed enough to need professional help?

Expert Answer

Michele Francis is a clinical social worker at the University of California, San Francisco, Comprehensive Cancer Center.

Living with cancer is one of the most stressful and destabilizing things that can happen to someone, and depression, mood swings, anger -- even serious mental illness -- are very common. You may feel like you know your mother well, and suddenly she's different. It's very common for serious illness to bring out moods you haven't seen before, such as uncontrollable sadness, outbursts of anger and frustration, or an inability to make decisions. Going through cancer is an emotional roller-coaster -- first there's good news, then bad news -- which can trigger extreme reactions and mood swings. The stress can also worsen certain behaviors, such as hoarding.

If your mother seems sad and distressed, you'll want to figure out if she has clinical depression. This wouldn't be uncommon -- statistics show that one-fourth of all people with cancer suffer from clinical depression. And it's important to get help for her, because studies also show that when cancer patients are depressed, they're less likely to follow their treatment regimen and they have poorer outcomes.

I suggest that you start by carefully observing your mother's behavior -- what exactly is she doing that makes you worry she's depressed? Try to characterize her mood, the way you would if you were talking to a psychiatrist. Is she listless and unable to get moving during the day? Has she lost interest in the things that used to make her happy, such as pets, her garden, or her friends? Does she seem to suffer from anxiety or insomnia? Of course cancer brings with it lots of worries and fears, but depression-related anxiety usually comes out as agitation and the inability to concentrate. Ask yourself whether her depression is impacting her life in a way that interferes with her ability to function and cope.

If so, you'll want to talk to her doctor and ask for a referral to a counselor or social worker trained to deal with cancer-related issues. Your mother's hospital should have social workers available who can help her deal with these feelings. It would also be helpful for her to join a support group where she can share her emotions with other people going through the same experiences. Many hospitals offer cancer support groups led by a trained counselor, who can spot the signs of depression and suggest treatment.

Sources
http://www.cancercare.org/pdf/booklets/ccc_caregiver.pdf
http://www.cancer.org