Mood disorders

Mood disorders, most notably depression and anxiety, are the second most common side effect of cancer and its treatment. [1] Cancer can have an immense psychological impact, not only following diagnosis, but long-term and even lifelong for some. These mood disorders can have an effect on quality of life and survivorship, which is why it’s so important to address these issues and recognize how common they are.

Cancer survivors have been found to have a significantly higher risk of mood disorders, though this risk did seem to diminish as the number of years since diagnosis and treatment increased. [2] However, many survivors will experience emotional distress that does not meet the clinical criteria for anxiety disorder or major depression. Due to the fact that cancer survivors are at high risk of distress, and in order to reduce negative stigma of mental health terms, this is referred to as “distress”, and can include symptoms from feelings of vulnerability and sadness to disabling panic and fear of recurrence. [3]

Depression

The symptoms of depression can range from mild to severe, and they may interfere with your quality of life, including relationships and day-to-day living. Some symptoms of major depression are: [3]

  • Sadness, feelings of hopelessness or emptiness
  • Loss of interest or pleasure in most activities
  • Significant changes in weight or appetite
  • Sleep disruptions, sleeping too much or too little
  • Fatigue, loss of energy
  • Feelings of guilt or worthlessness, feeling like a burden
  • Difficulty concentrating, indecisiveness
  • Active suicidal thoughts or plans

There are risks that may predispose you to developing depression, such as a previous diagnosis of depression or anxiety, a family history of depression, a lack of support from family and friends and financial problems.

If you experience severe depression, it is important to seek professional help, which might involve both medication and psychological treatment. If you are experiencing mild symptoms of depression, talking to a mental health professional may be helpful.

Anxiety

Anxiety is another mood disorder often faced by cancer survivors. It is described as having feelings of nervousness, being on edge or worried. Cancer anxiety is normal, and it might be related to fears that you have about the treatment and its side effects, or about recurrence and death. The uncertainty that a cancer diagnosis produces is enough to trigger anxiety, and your symptoms can be acute or chronic.

A generalized anxiety diagnosis requires excessive anxiety or worry that is difficult to control and impairs function, along with some of the following symptoms: [3]

  • Restlessness, feeling on edge
  • Being easily fatigued
  • Difficulty concentrating
  • Sleep disruptions
  • Irritability
  • Muscle tension

Acute symptoms can include increase in blood pressure, shortness of breath, trembling, and nausea. Chronic symptoms will resemble those listed above.

Treatment for anxiety is similar to that of other mood disorders. However, relaxation techniques are very helpful. These can include deep breathing, progressive muscle relaxation, guided imagery, meditation, hypnosis, biofeedback and yoga. If your anxiety is severe, it may be helpful to consult a mental health professional.

For information on how to deal with the anxiety of cancer recurrence, watch our webinar: Fear of Cancer Recurrence – 5 ways to lessen your anxiety.


[1] Silver, J. K., Baima, J., Mayer, R. S. (2013) Impairment?driven cancer rehabilitation: An essential component of quality care and survivorship. CA: A Cancer Journal for Clinicians63(5), pp. 295-317. DOI: 10.3322/caac.21186

[2] Huang W. K., Juang Y. Y., Chung C. C., et al. (2018). Timing and risk of mood disorders requiring psychotropics in long-term survivors of adult cancers: A nationwide cohort study. Journal of Affective Disorders, 236, pp. 80-87. DOI: 10.1016/j.jad.2018.04.107

[3] Yi, J. C. and Syrjala, K. L. (2017). Anxiety and Depression in Cancer Survivors. Medical Clinics of North America101(6), pp. 1099-1113. DOI: 10.1016/j.mcna.2017.06.005