Is it Depression or Something Else? Part 2

In Part 2, Dr. Wirtz describes one of the common ways in which physical or medical conditions can mimic clinical depression.

In Part 1 of this piece, I very briefly described emotional states related to feelings of depression and depressed mood. I then, even more briefly, described some of the hallmark characteristics of clinical or major depression. You may want to take a look at Part 1 for a review.

As mentioned in Part 1, clinical depression involves a pervasively gloomy mood and a host of physical/cognitive features that are present more often than not over a fairly long period of time. This is where things can often get tricky diagnostically because many conditions may have some of the same physical symptoms. I couldn't possibly tell you about all of the medical and psychological conditions that mimic depression without several more installments to this blog, so I will stick with one of the most familiar to those who work with cancer patients – demoralization.

Chemotherapy is very toxic and attacks lots of 'good' cells as well as the 'bad' cancer cells. One of the prime targets is the red blood cells which are responsible for carrying needed oxygen throughout the body. As chemo progresses, and the body has been battered by these powerful medicines, the patient becomes increasingly more fatigued. As a result, he may sleep more, be less interested in food, find it more difficult to concentrate, and may become more emotionally reactive. As these physical changes take place the individual going through treatment becomes less able to perform their usual duties and roles in the family, community, and at work. This loss of ability to contribute in a meaningful way typically leaves them feeling discouraged, frustrated, sad, and generally less interested in activities that were typically enjoyable. Sometimes the individual feels so useless that he says things like 'I might as well be dead' because, in general, he's 'sick and tired of feeling sick and tired.' Are you beginning to see the picture? It looks very much like clinical depression and it is very difficult for friends and loved ones alike to watch. Everyone wants to do something to make the person feel better and often antidepressants or psychotherapy are recommended.

In next week's blog I'll talk about how demoralization can be improved and offer some useful tips for patients and family members who are struggling with these feelings.

Please feel free to send comments or suggestions about future blogs!