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March 12, 2009
Depression is a state of emotional dejection and withdrawal. It is marked by
• sadness
• loss of self-confidence
• change in appetite
• change in sleeping pattern
• fatigue
• loss of libido
• loss of interest
• loss of ability to concentrate
• somatic complaints such as a headache or stomachache
Depression after completion of cancer therapy can be due to or worsened by
• chronic pain
• chronic fatigue
• sleep deprivation
• hormonal imbalance
• chemical imbalance
• emotional stress
• feelings of helplessness
• resurfacing of old, unresolved problems
• loss of self-esteem
• unresolved grief or anger
• flare up of an underlying mood disorder
Depression is a symptom, like pain or nausea. Although a positive attitude and a solid faith can often help prevent or offset depression, they cannot always do so. Depression indicates that something is wrong, not necessarily that something is wrong with the way you are handling your situation.
Some women who have uneventful pregnancies and deliveries, and who are prepared and thrilled to receive this addition to their family, suffer from depression after they get home. This so-called postpartum depression is believed to be due to the effect on their brain of the drastic chemical and hormonal changes following delivery. Not all new mothers get depressed. Not all new mothers with depression are suffering from postpartum depression; some may have good reason to be depressed (the pregnancy was not wanted, the baby is not well, and so on). But it helps women who do suffer from genuine postpartum depression to learn that the depression is real, is due to chemical and hormonal changes beyond their control, is not due to their having a bad attitude or adjusting poorly, and is treatable.
Most cancer survivors have legitimate reasons to feel depressed (losses, strains, ongoing problems). However, depression can persist even after the survivor has grieved losses, accepted limitations, and resolved problems. Even if you have an ideal positive attitude and exceptional coping skills, the physical changes caused by chronic stress and/or the aftereffects of treatment may increase the risks of your becoming depressed. Thankfully, this depression usually responds well to treatment (medications and/or counseling). Understanding the physical nature of depression will spare you unnecessary suffering from this treatable aftereffect.
If you feel depressed, remember that you may be doing everything right to maximize your recovery from cancer treatment and yet have undergone physical changes that cause persistent depression. Similarly, someone with diabetes can take every measure to keep his blood sugar under control, can be very well adjusted to the changes and limitations required by his disease, and may nevertheless still need insulin, because his chemistry has been changed by the loss of insulin-producing cells.
Among the many different types of depression are manic-depressive disorder, major unipolar depression, and seasonal affective disorder (SAD). It is important that your doctor evaluate your depression because an accurate diagnosis increases the chance of revealing a reversible cause and beginning effective treatment.
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