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Depression and Anxiety PDF Print E-mail

Sadness and Depression

Sadness and Depression

It's normal to feel sad. You may have no energy or not want to eat. It's okay to cry or express your sadness in another way. You don't have to be upbeat all the time or pretend to be cheerful in front of others.

Pretending to feel okay when you don't doesn't help you feel better. And it may even create barriers between you and your loved ones. So don't hold it in. Do what feels natural to you.

Depression can happen if sadness or despair seems to take over your life. Some of the signs below are normal during a time like this. Talk to your doctor if they last for more than 2 weeks. Some symptoms could be due to physical problems. It's important to tell someone on your health care team about them.

Signs of Depression

  • Feeling helpless or hopeless, or that life has no meaning
  • Having no interest in family, friends, hobbies, or things you used to enjoy
  • Losing your appetite
  • Feeling short-tempered and grouchy
  • Not being able to get certain thoughts out of your mind
  • Crying for long periods of time or many times each day
  • Thinking about hurting or killing yourself
  • Feeling "wired," having racing thoughts or panic attacks
  • Having sleep problems, such as not being able to sleep, having nightmares, or sleeping too much.
  • Your doctor can treat depression with medicine. He or she also may suggest that you talk about your feelings. You can do this with a psychologist or counselor. Or you may want to join a support group.


We all cope with loss or the threat of loss in different ways. You may feel sadness, loneliness, anger, fear, and guilt. Or you may find the way you think changes from time to time. For example, you may get easily confused or feel lost. Or your thoughts may repeat themselves over and over again. You may also find yourself low in energy. You may not want to do things or see people. These are all normal reactions to grief.

What you grieve for is as varied as how you think and feel. You may be grieving for the loss of your body as it used to be. You may grieve for the things you used to be able to do. You also may grieve losing what you have left: yourself, your family, your friends, your future.

It's okay to take time for yourself and look inward. It's also okay to surround yourself with people who are close to you. Let your loved ones know if you want to talk. Let them know if you just want to sit quietly with them. There is no right or wrong way to grieve.

Often people who go through major change and loss need extra help. You can talk with a member of your health care team, a member of your faith community, or a mental health professional. You don't have to go through this alone.


It's hard to accept the news that your cancer has spread or can no longer be controlled. And it's natural to need some time to adjust. But this can become a serious problem if it lasts longer than a few weeks. It can keep you from getting the care you need or talking about your treatment choices. As time passes, try to keep an open mind. Listen to what others around you suggest for your care.


The feeling of "No, not me!" often changes to "Why me?" or "What's next?" You have a lot to deal with right now. It's normal and healthy to feel angry. You don't have to pretend that everything is okay. You may be mad at your doctor, family members, neighbors, and even yourself. Some people get angry with God and question their faith.

At first, anger can help by moving you to take action. You may decide to learn more about different treatment options. Or you may become more involved in the care you are getting. But anger doesn't help if you hold it in too long or take it out on others. Often the people closest to us are the ones who have to deal with our anger, whether we want that or not.

It may help to figure out why you are angry. This isn't always easy. Sometimes anger comes from feelings that are hard to show, such as fear, panic, worry, or helplessness. But being open and dealing with your anger may help you let go of it. Anger is also a form of energy. It may help to express this energy through exercise or physical activity, art, or even just hitting the bed with a pillow.


Everyone has stress, but most likely you're having a lot more now. After all, you're dealing with many changes. Sometimes, you may not even notice that you're stressed. But your family and friends may see a change.

Anything that helps you feel calm or relaxed may help you. Try to think of things that you enjoy. Some people say it helps to:

  • Exercise or take a walk.
  • Write thoughts and feelings in a journal.
  • Meditate, pray, or do relaxation exercises.
  • Talk with someone about your stress.
  • Do yoga or gentle stretching.
  • Listen to soothing music.
  • Express yourself through art.

Fear and Worry

Facing the unknown is very hard. At times, you may feel scared of losing control of your life. You may be afraid of becoming dependent on other people. You may be afraid of dying.

If you struggle with these fears, remember that many others have felt the same way. Some people worry about what will happen to their loved ones in the future. Others worry about money. Many people fear being in pain or feeling sick. All these fears are normal.

Sometimes patients or family members worry that talking about their fears will make the cancer worse. This is not true. Thinking about getting sicker or dying is not going to make your health worse. But it's good to be hopeful and positive. It's better for your health to express your feelings, rather than hold them in.

Some people say it helps if you:

  • Know what to expect. Learn more about your illness and treatment options by asking questions of your healthcare team.
  • Update your affairs. If you have not already done so, make sure your will and other legal paperwork are in order. Then you won't have to worry about it. (See Advance Planning.)
  • Try to work through your feelings. If you can, talk with someone you trust.

If you feel overwhelmed by fear, remember that others have felt this way, too. It's okay to ask for help.

Guilt and Regret

"I couldn't stop thinking about what I could have done to slow down my cancer. Maybe I should have gone to the doctor sooner, maybe I should have given up sweets, maybe I should have done this, maybe I should have done that. After talking about it with my social worker, she helped me see that this is no one's fault, especially mine." - Erika

It's normal for people with cancer to wonder if they did anything to add to their situation. They may blame themselves for lifestyle choices. They may feel guilty because treatment didn't work. They may regret ignoring a symptom and waiting too long to go to the doctor. Others worry that they didn't follow the doctor's orders in the right way.

It's important to remember that the treatment failed you. You didn't fail the treatment. We can't know why cancer happens to some people and not others. In any case, feeling guilty won't help--it can even stop you from taking action and getting the treatment you need. So, it's important for you to:

  • Try to let go of any mistakes you think you may have made.
  • Focus on things worthy of your time and energy.
  • Forgive yourself.

You may want to share these feelings with your loved ones. Some people blame themselves for upsetting the people they love. Others worry that they'll be a burden on their families. If you feel this way too, take comfort in this: many family members have said it is an honor and a privilege to care for their loved one. Many consider it a time when they can share experiences and become closer to one another. Others say that caring for someone else makes them take life more seriously and causes them to rethink their priorities.

Maybe you feel that you can't talk openly about these things with your loved ones. If so, counseling or a support group may be an option for you. Let your health care team know if you would like to talk with someone.


"I know my friends try to understand. It doesn't matter what I say though--they just don't get it. I can't even begin to explain to them how I feel or what's going on. I'm not saying it's their fault or anything. It's just hard." - Jennifer

You may feel alone, even if you have lots of people around you who care. You may feel that no one really understands what you're going through. And as the cancer progresses, you may see family, friends, or coworkers less often. You may find yourself alone more than you would like. Some people may even distance themselves from you because they have a hard time coping with your cancer. This can make you feel really alone.

Although some days may be harder than others, remember that you aren't alone. Keep doing the things you've always done the best you can. If you want to, tell people that you don't want to be alone. Let them know that you welcome their visits.

More than likely, your loved ones are feeling many of the same things you are. They, too, may feel cut off from you if they can't talk with you. You may also want to try joining a support group. There you can talk with others who share your feelings.

Finding Humor

Laughter can help you relax. Even a smile can fight off stressful thoughts. Of course, you may not always feel like laughing, but other people have found these ideas can help:

  • Enjoy funny things children and pets do.
  • Watch funny movies or TV shows.
  • Read a joke book or look at jokes on the Internet. If you don't own a computer, use one at your local library. Or ask a friend to print some for you.
  • Listen to comedy tapes.
  • Read the comics in the newspaper or the cartoons and quotes in magazines.
  • Look in the humor section in the library or book store.
Educational information provided by The National Cancer Institute (NCI) Internet site.
Last Updated on Tuesday, 24 February 2009 03:12
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