Back in the day, the words of a popular song described life as a bowl of cherries.
I don’t know whose life the songwriter was describing. Those words sure don’t describe my life, and I suspect they don’t describe yours either. Life has lots of high points, even days when life does feel like a bowl of cherries. But there are other days, when life is pretty hard, and the challenges overwhelming.
When one down day seems to follow another, when you just aren’t feeling a whole lot of enthusiasm for life… well, that can be a sign of depression.
Depression and Prostate Cancer Can go Hand in Hand
Now, let’s talk about the connection between medical diagnoses like prostate cancer and depression. Recent research has shown that there is a clear connection between conditions like prostate cancer and depression. But I am sure I don’t need to tell you that. Maybe you’fe felt depressed yourself, or have had concerns about a prostate cancer buddy. Depression can result from the limitations that your diagnosis and treatment can impose on your life, the changes you didn’t ask for but have to deal with anyway, the daily responsibilities of handling treatment, the impact of prostate cancer on intimacy with your partner, as well as stress that arises along the way.
In general, individuals who are experiencing depression don’t always feel like taking the best care of themselves, and this can affect self-care and adherence to treatment regimens and self-care.
So why aren’t physicians always identifying and treating depression? There are a few reasons. For one, their patients don’t always tell them about depression symptoms. Patients may feel like it’s “normal” to feel down, given the challenges they are facing. Let’s face it, men are notorious for not reporting how they are feeling, for trying to “suck it up” and pretend everything is okay. And for better or worse, physicians may assume their patients are fine if they don’t tell them otherwise or hide their symptoms at their appointments.
Also, the symptoms of depression and treatment, like lack of appetite and fatigue, can overlap, so that doctors may assume the depression symptoms are the result of the treatment and not depression.
Here’s something else to consider: Patients living with prostate cancer and its treatment may go through times of “distress” when their symptoms and/or their self-care regimen feel especially challenging. Distress, which can lead to feelings of frustration and sadness, is temporary, and may gradually subside when the patient gets some emotional support. Depression on the other hand, just kind of hangs around.
So if patients and their doctors aren’t talking about emotions on a regular basis, it’s easy to see why there may be assumptions on both sides and, as a result, symptoms of depression may be overlooked.
I am not trying to paint a bleak picture here. Instead, I want to inform you and encourage you to keep an eye out for depression in yourself and in others. The good news about depression for people living with prostate cancer is that when depression is treated, quality of life – energy, mood, and relationships – can greatly improve.
How to Get Help for Depression
But to experience that good news, it’s really important to take the first step. If you suspect you could be experiencing depression, here are some ideas to consider:
Be aware of the symptoms. The symptoms of depression are too numerous to list here, but some of the key symptoms include low energy, lack of interest in activities you normally enjoy, difficulty concentrating, changes in eating or sleeping patterns, feeling sad, feeling hopeless, low self-esteem, and other symptoms. As I mentioned previously, depression symptoms don’t go away on their own. If you are experiencing one or more of these symptoms daily, for a couple of weeks or more, then you may be experiencing depression.
Make a list and bring it to your doctor. You might want to consider keeping a journal of what’s going on with you emotionally. Any symptoms you are experiencing, what kinds of thoughts you are having, along with how often you feel or think this way. Make an appointment with your doctor and go through your list with them. Ask your doctor if they are comfortable talking about depression and if they can recommend treatment. And if not, ask for a referral to where you can get help. (Some physicians prefer to refer patients to a psychiatrist or other mental health professional.)
Also consider reaching out to a mental health professional. You may want to make your own connection with a therapist or a counselor. Ask a friend for a recommendation, check out your local community mental health resources, or get a list of mental health professionals through the website of your insurance company, or do a search on Google for a list of mental health providers in your area. Keep in mind that depression tells you how awful you feel, and it tells you that there is no help for you. But that’s only the depression talking and it’s a lie. Depression is treatable!
Most important, get support. Don’t go through this alone. Talk to a supportive friend or family member. Prostate cancer buddies through your local US Too chapter. Or with a member of the clergy. Gather people around you who can listen without judging you or trying to tell you what to do.
Stay involved in your life. A common reaction to depression is to just want to hunker down, to retreat from the things you do day-to-day in life, to isolate from your friends and family. This is the time to “fake it ‘til you make it.” Set small goals for each day. Get up and get moving. Do what you can without pushing yourself too hard. Take the action to live what you define as your normal life. Even when you don’t feel like it. Again, small goals, as much as you reasonably can.
How to Help a Friend or Family Member
My clients often talk to me about how to help a prostate cancer buddy or a family member who they suspect is experiencing depression. By the way, your partner is also affected emotionally by prostate cancer, so keep in mind that they are also at risk for depression. Here are some ideas:
Express concern. Find a time when the two of you can talk alone. Let them know that you are concerned about them and want to offer your help.
Be specific. Make sure the person you are concerned about is aware of what is causing your concern. Tell them what you have observed, any depression symptoms you have noticed, as well as any changes you have seen over time that seem out of the ordinary.
Offer to support them in any way you can. This might include being willing to lend a listening ear. Or to help them find resources for help with depression. You might want to recommend a website, such as mayoclinic.com, that offers information on depression. Or even to accompany them to a doctor’s appointment or to a session with a mental health professional.
Don’t push it. Be careful about being perceived as “diagnosing” the person you are trying to help. You can express the concern that the symptoms you have observed could be related to depression but be careful about being perceived as having diagnosed them yourself. That can result in defensiveness. And if the other person doesn’t want to have this discussion, then respect their wishes, though you may want to say that you are there for them if they want to talk further. When you do see another sign that they may be depressed, gently remind them of your concern and why.
When the going gets tough… Depression is treatable. If you think you may be depressed, reach out for help. If you think someone you care about may be depressed, offer to help them find help. Guys! We’re all in this together.
Gary McClain, PhD, is a therapist, patient advocate, and educator, specializing in helping clients deal with the emotional impact of chronic and life-threatening health conditions, as well as their families and professional caregivers. He works with them to understand and cope with their emotions, to learn about their lifestyle and treatment options, to maintain compliance with medical regimens, to communicate effectively with each other and healthcare professionals, and to listen to their own inner voice as they make decisions about the future. His website is JustGotDiagnosed.com.