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Is it Depression or Something Else? Part 3

Dr. Wirtz provides a comprehensive explanation of the differences between clinical depression and demoralization due to chemotherapy or other medical conditions in Part III of this series.

In Part II of this series, I described the notion of demoralization among individuals receiving chemotherapy. When individuals are demoralized, they are experiencing many symptoms that are shared by clinical depression, e.g. fatigue, loss of interest, decreased appetite, loss of motivation, difficulties with concentration, and feelings of worthlessness. In fact, the picture may look so much like depression that these individuals may be placed on antidepressant medication and referred for psychotherapy. However, there are several telltale signs that might help you differentiate between depression and demoralization. The first of these is that you may actually enjoy the event or interactions that you are participating in but simply not have enough energy to be involved for very long. When individuals are suffering from clinical depression they typically don’t enjoy what they are doing, no matter how briefly they are involved. The second big difference is that when you begin to feel better physically, following the end of treatment, most of the other symptoms disappear. By comparison, when you are suffering from major depression, feeling better physically is not enough to propel you into activity or cause you to enjoy what you’re doing. In fact, most of the other symptoms remain intact after your body has recuperated from the assault of chemotherapy.

Since demoralization is largely about fatigue, loss of strength, and inability to participate in meaningful activities, there are a number of strategies that you can employ that you may find helpful. First of all, keep track of the daily rhythm of your energy. Are there certain times of the day when you have more energy or feel better physically? If so, plan activities, visits with friends, and outings for those times of the day when you feel best. Secondly, set time limits on activities so as not to exhaust yourself. This will help prevent the absolutely drained feeling that is so disturbing to most people. Another suggestion is to rest often in anticipation of activities or visits so that you will feel as well as possible at those times. Finally, keep in mind that there is no reason to believe that you won’t start feeling much better when chemotherapy is completed. Feeling this way is time-limited and you can begin counting off the days until you are likely to feel better again.

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