Metastatic Breast Cancer and Depression

by Sheila M. Eldred Health Writer

As a metastatic breast cancer (MBC) patient, you’ve no doubt endured a roller coaster of intense emotions. For most people, facing mortality sparks anger, fear, grief, and sadness. But regardless of your diagnosis, clinical depression and/or anxiety is more than a reaction; it’s a disorder that should be treated professionally.

“It is normal to feel sad or scared” as an MBC patient, Dr. Kelly Irwin — a psychiatrist and director of the Collaborative Care and Community Engagement Program at the Massachusetts General Cancer Center — told HealthCentral in a phone interview. “Depression is not normal. That is something we can treat.”

What is normal is a cycle of coping and adjustment and stress when you’re diagnosed. But those intense feelings should improve within a month or so. If they don’t, that’s a sign to seek help.

Time to Reach Out

Other signs that you’re facing something more than being an MBC patient? If you’re having trouble sleeping after a month, or if your relationships, work, or quality of life are being impacted, then it’s time to reach out. You can also ask yourself: When I do have the energy to do things I usually enjoy, can I enjoy them? Is my energy OK? Do I wake up and get tired throughout the day, or do I wake up without any energy?

In fact, Dr. Irwin told Health Central, “Any time you’re wondering, should I see someone or talk to someone?” err on the side of doing so.

Psychiatric oncologists tend to see lots of MBC patients, especially younger women who are coping with many competing demands, including jobs and children, Irwin said. In fact, over 25 percent of advanced cancer patients are also diagnosed with depression, according to Breastcancer.org. Therapy and/or medication can help patients improve sleep and focus on things they want to.

If your hospital or cancer center doesn’t have psychiatric oncologists on staff, there are other professionals who can help. Your first outreach can be to a nurse, social worker, your oncologist, or another member of your cancer care team. They may be able to help you themselves, or link you to a therapist or someone else who can.

Sorting Out Causes of Depression

Treatments also depend on the cause of the depression or anxiety, which a professional can help sort out. For example, any medications you’re on may need to be adjusted since certain combinations can contribute to depression, Dr. Jesse Fann at the University of Washington told Living Beyond Breast Cancer. Someone with expertise in both oncology and depression can also help distinguish between symptoms that are caused by cancer treatments, like chemotherapy and hormone therapy, and similar symptoms (sleep trouble, loss of appetite) caused by depression.

And when depression is treated, Dr. Irwin said, patients are more likely to complete breast cancer treatment.

Finally, remember that patients without a clinical diagnosis of depression can benefit from various types of emotional or mind/body support as they navigate the challenges of MBC. Some patients may find help through a priest or minister. Others may be able to access therapy through their job. Others may find relief in mind/body practices such as yoga or meditation.

Sheila M. Eldred
Meet Our Writer
Sheila M. Eldred

Sheila Mulrooney Eldred is a graduate of Columbia’s School of Journalism and a former newspaper reporter. As a freelance health journalist, she writes about everything from life-threatening diseases to elite athletes. Her stories have appeared in The New York Times, Nature, FiveThirtyEight, Pacific Standard, STAT News, and other publications. In her spare time, she and her family love running, cross-country skiing, and mountain biking in Minneapolis.