Fighting cancer is a life-long game-changer impacting a person’s physical, emotional and mental well-being. It is a multi-faceted journey that stirs up a myriad of emotions, including depression for some people. Feelings of sadness, grief, anger and denial are all common among patients and family members who are coping with cancer. But when these feelings last a long time or get in the way of daily activities, it may be time to seek medical attention.

Stages of depression

There are typically four stages of depression:

1) Sadness

2) Mild depression

3) Clinical depression

4) Suicidal ideation

Sadness and mild depression are normal responses to a cancer diagnosis and therefore do not raise a red flag. However, clinical depression and suicidal ideation are signs that intervention is needed. According to the American Cancer Society, clinical depression occurs in about one in four people with cancer, and is a treatable condition. The sooner it is diagnosed, the sooner the coping process may begin.

“If you are feeling sad or upset, it’s important to reach out for help,” says Angela Buttimer, LPC, a facilitator at Thomas F. Chapman Family Cancer Wellness at Piedmont. “There are so many resources available today that patients don’t have to turn to medication as their only source of hope.”

Signs of clinical depression

Buttimer has worked with cancer patients for many years and she shares some of the warning signs that may indicate normal sadness and mild depression have turned into clinical depression:

• More bad days than good days, for several consecutive weeks
• Can’t seem to shake the sadness
• Loss of interest in loved ones, friends, hobbies, etc.
• Loss of appetite
• Irrational thinking
• Lack of concentration

People who have had bouts of depression prior to cancer are more likely to have depression after their cancer diagnosis, so Buttimer keeps a careful watch on patients who fall into this category. She has also seen a tendency for patients who do not have a strong support system to fall prey to depression more easily.

Overcoming clinical depression

Cancer patients suffering from any stage of depression can be empowered by many different support programs, including:

• Enrichment programs
• Exercise
• Stress management
• Relaxation techniques (yoga, Tai Chi, meditation) 
• Journal writing

“All of these options are great ways for cancer patients to regain a sense of well-being,” Buttimer says. “Mental and emotional health play an integral part in the healing process, so they cannot be overlooked.”

Signs of suicidal ideation

There are some patients who dive into a deeper state of depression where they are overcome with hopelessness. They lose all hope in the possibility of getting well. They may even have suicidal thoughts and at this point, therapy is the primary intervention.

“A patient suffering from suicidal thoughts is placed in therapy -- usually family, individual and group therapy,” Buttimer says. “All three of these platforms provide a unique perspective on the cancer journey and will help with the healing process.”

A team approach

With years of experience, Buttimer has obtained a keen sense of where people fall on the scale of sadness and depression.

“It is important for cancer patients to have a good health care team that constantly collaborates and shares in the patient’s cancer journey. This team approach can help keep a finger on a patient’s emotional well-being and hopefully prevent the onset of clinical or suicidal depression.” Buttimer says.

Cancer Wellness at Piedmont offers comprehensive, complementary service and programs to anyone affected by cancer at any phase in his or her cancer journey. Professionally-led programs are hosted at Piedmont Atlanta, Piedmont Fayette, Piedmont Newnan and Piedmont Henry. 

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