Low Mood

The diagnosis and treatment of cancer can make people feel a range of strong emotions, such as fear, anger, sadness, grief, low mood, or depression. It is entirely natural to feel these emotions sometimes; however they can be frightening and difficult to deal with.

Sadness
It is completely natural to feel sad and to grieve after you are diagnosed with cancer. Sadness is part of healing; it allows us to emotionally process any loss, grief, or disappointment. Most people need time to be sad and reflect before they adjust to the new situation and start to cope with life again.
Some people feel a pressure to be positive and ‘fight’ the disease. Don’t try to hide your sadness as this can be difficult and extremely exhausting. Don’t be afraid to talk about your sadness to your doctors, nurses, friends, and family. Friends and family can support you by just letting you feel sad and letting you cry, if you need to.
Tell your doctors and nurses about your feelings. They will be able to explain things in more detail or offer you further help with issues you are worried about. Just voicing your concerns or fears will help you feel less alone and less helpless.

Depression
Some people find that the sadness and low mood do not get easier to deal with and may even get worse with time. If you have had feelings of sadness that won’t go away for over two weeks and you are finding it hard to feel good about anything, then you may be depressed. Being depressed does not mean you are weak. Depression is a medical illness (just like having a chest infection or heart condition) and it requires treatment.
Up to two in ten people with cancer may experience depression. Depression can be difficult to distinguish from normal sadness. Depression is defined as having a low mood for more than two weeks (every day and almost all day long) so bad that you are not interested in doing your usual activities, your concentration, sleep, and appetite are affected, and you feel that nothing can make you feel better. Symptoms of depression include feeling sad all the time, loss of enjoyment in things, loss of interest in seeing friends or family, loss of interest in your appearance, difficulty getting to sleep or waking in the early hours each morning, feeling tired all the time, not being able to get out of bed in the morning, loss of appetite and weight loss, feelings of guilt and hopelessness, being unable to concentrate, remember things or make decisions, or feeling that life is not worth living. These symptoms can also be a sign of fatigue so it is important to seek advice from your oncology doctor, clinical nurse specialist (if you have one) or your GP so they can identify the best way to manage/treat your symptoms.
If you feel you may be depressed the first step is to see your oncology doctor, clinical nurse specialist or your GP.
There are medical and psychological (non-drug) treatments available to treat depression.

Medication
People with serious depression may need medications to help them recover. There are many types of antidepressants, you may have already heard about Amitriptyline, Prozac, or Cipramil to name but a few. Many of the newer drugs are more effective with fewer side effects than the older ones. Most antidepressants take a few weeks to begin working. They are not a cure for depression but will gradually help you feel you are getting control over your life. Antidepressants are not addictive drugs, but you will need to take them for a while even after you feel better. Doctors usually recommend them for at least 6 months.
If you have had a previous diagnosis of depression and have been prescribed medications, please take them as prescribed by your doctor. Do not exceed the maximum dose. If you feel they are no longer working, please see your doctor.

Psychological (Non-Drug) Therapies
Counselling and psychotherapy are forms of psychological treatments that can help people get over emotional difficulties. The goal of psychological treatments is to increase coping and problem solving skills, help find support and help to recognise and manage symptoms of anxiety and depression.
The combination of antidepressants and psychological therapy works well for serious depression, as these treatments complement each other to result in a longer lasting effect.
It is not a weakness to see a psychologist or psychiatrist. Quite the opposite in fact, as it takes a lot of strength to admit you are feeling depressed and that you may need somebody to help you feel better.
If you feel low in mood or have symptoms of depression and feel that you may need some help to cope, please contact your oncology doctor, clinical nurse specialist (if you have one) or your GP for further advice as they can refer you for counselling or psychotherapy.
Please go to our Clinical Psycho-Oncology Service page to view information on professional help available.

Tips for Coping with Low Mood
There are lots of things that you can do by yourself or with the help of a friend or relative that may help you to lift your mood. Please consider the advice below:

Physical Activity and Exercise
Physical activity may help improve your mood. If possible, try to take some gentle regular exercise.
Please go to our Physical Activity and Exercise page to view further advice.

Sleep
If you have trouble sleeping at night it may help to change a few things about when and where you sleep. It is important to establish a routine in the evenings to help you relax for bedtime. Be patient with any changes you do make as it may take a couple of weeks to get back into a good sleep routine.
Please go to our Sleep page to view further advice.

Relaxation
Relaxation is a good way to improve your emotional wellbeing. Try simple relaxation techniques that you can learn to do by yourself. Please go to our Relaxation page to view advice on relaxation techniques.
You may also like to try simple massage techniques that you can learn to do by yourself or with the help of a friend or relative. Please go to our Massage page to view advice on simple massage techniques.
Please go to our Distraction and Occupying Your Mind page to view advice on ways to prevent you from ruminating (constantly focussing on negative feelings and problems).

Other Relevant Advice and Information
Complementary Therapies
Local Services You Can Access

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