Dodging Depression

Know the signs and reduce your risk

by Kathy Steligo

Life isn’t always easy, and sooner or later we all have to deal with unhappy experiences. It is normal to temporarily feel down in the dumps while grieving for a loved one, struggling with financial problems or facing other undesirable situations that are just part of life. It is not normal to stay that way.

Depressed or simply sad?

sad woman

Most people think depression is an uncontrollable feeling of sadness, but it is far more serious than that. Depression is a complex medical condition with biologic origins. It develops when the brain has an imbalance of serotonin and other chemicals that regulate mood and a sense of well-being. People who are clinically depressed feel extraordinarily apathetic, sad, guilty or lonely for no apparent reason. In extreme cases, they may feel unworthy of life. For most of us, these feelings are temporary reactions to life’s downswings. We feel unhappy, but as time passes, we adjust and get on with our lives. Depression is different, and people who are depressed are unable to simply snap out of it. In the long term, sadness doesn’t interfere with a person’s daily life. Depression does.

Depression is one of the most common sources of disability, affecting more than 20 million Americans each year. Anyone is susceptible, although twice as many women are depressed than men. Studies of twins and families confirm that first-degree relatives of depressed individuals are two to six times as likely to develop depression as individuals without a family history of the disease.

How depression affects breast cancer

About 20% of all cancer patients suffer from major depression, compared to about 7% of the general population. When cancer patients are depressed, they have difficulty coping with everyday tasks, making choices about their health care, or following their doctor’s advice. Breast cancer patients who suffer from depression have a higher risk of recurrence and early death than patients who are not depressed. In 2009, Stanford University researchers found that women with metastatic breast cancer who were also depressed had weakened immune systems. The more symptoms of depression the women had, the less their immune systems were able to fight off infection and the progression of the disease. Other studies showed a correlation between depression and faster tumor growth.

Signs of depression

According to the National Institute of Mental Health, symptoms of depression may include:

  • difficulty concentrating, remembering details and making decisions;
  • fatigue and decreased energy;
  • feelings of guilt, worthlessness and/or helplessness;
  • feelings of hopelessness or pessimism;
  • persistent sad, anxious or "empty" feelings;
  • insomnia or excessive sleeping;
  • irritability or restlessness;
  • loss of interest in activities you once enjoyed, including sex;
  • overeating or loss of appetite;
  • persistent aches, pains, cramps or digestive problems that do not ease with treatment.

Depression is diagnosed when these signs are present most or all of every day and cause significant distress or impairment in a person’s normal life.

If you feel depressed…

More than 80% of people who are treated with antidepressants, therapy, or both show improvement. Yet just 51% of people who suffer from depression actually seek treatment, believing their depression will simply go away -- or they view it as a personal weakness, instead of a very real medical condition that needs to be treated.

Left untreated, depression may not improve, and often becomes worse. If you have symptoms of depression, don’t tell yourself that it is all in your head. Talk to your doctor about treatment options that will help you enjoy a better quality of life and live longer.

10 ways to decrease your risk for depression

  • Stay socially engaged. Cultivate healthy social relationships and stay actively involved with people, activities, and work that satisfy you.
  • Get moving. Exercise is an effective antidepressant. A study supported by the National Cancer Institute found that breast cancer survivors who exercised 8.3 hours or more per week were less likely to be depressed than those who did not exercise.
  • Nourish your body. Your body and brain need nutrition. Replace fast foods and processed foods with balanced proportions of whole grains, fruits, vegetables, lean protein, and healthy fats.
  • Nurture the mind-body connection. The link between a healthy body and a healthy mind does indeed exist. Make time during your day for purposeful relaxation. Practice deep breathing, meditation, yoga or tai chi to combat feelings of anxiety, sadness or depression. Visit Loyola University’s website for some excellent online relaxation exercises.
  • Avoid alcohol. Alcohol is a depressant. Drink moderately, only occasionally, or not at all. Never drink when you feel sad or depressed.
  • Know the side effects of your medications. Many common medications increase the risk for depression, including some contraceptives, statins and beta blockers used to treat heart conditions, high blood pressure and migraines. Ask your doctor about the potential side effects, including depression, of your prescribed medications.
  • Don’t smoke. If you do, get help to quit. Smoking increases the risk for anxiety and depression (especially among women) and affects overall health. In a study of more than 60,000 people, British and Norwegian researchers discovered that depression is as much of a risk factor for mortality as smoking.
  • Express yourself. Keeping your feelings and thoughts bottled inside creates anxiety and may lead to depression. If something bothers you, talk it over with a trusted friend or counselor. Try painting, knitting, line dancing or other activities to express your inner aspect. Journaling is an especially effective way to have a heart-to-heart talk with yourself.
  • Align your expectations. Learn not to expect the impossible from yourself, your partner, or your children.
  • Be thankful, be positive. Take time each day to be grateful. Recognize that sadness is a normal part of life, and cultivate ways of reacting positively when life throws you a curve.

Resources: National Institutes of Mental Health and Mental Health America, the nation’s leading nonprofit organization dedicated to helping all people live mentally healthier lives.

Kathy Steligo is a freelance business and health writer who has more than a nodding acquaintance with breast cancer. Diagnosed twice, she has had five biopsies, two lumpectomies, radiation, sentinel node biopsy, genetic counseling, genetic testing, bilateral mastectomies, implant reconstruction, and a second GAP reconstruction. Kathy is the author of The Breast Reconstruction Guidebook, and writes for numerous publications, websites, physicians and health organizations.