Living with and beyond cancer
Depression and other negative emotions
Being diagnosed or treated for cancer can have a major effect on people’s emotions. People living with cancer may experience emotions such as shock, fear, anger, sadness, loneliness or depression. These may occur not just at diagnosis or during treatment, but also when adjusting to life afterwards. Some people we spoke to who had survived five or more years after a cancer diagnosis were still living with changes to their emotions.
Some people said they were easily angered or were more aggressive than they used to be. Trivial problems or situations could annoy them and provoke them to ‘fly off the handle’ without warning. It is natural for people to resent having cancer or to feel frustrated that it restricted what they could do, and some recognised that this was probably the cause of their anger. Others, however, saw their feelings as a side effect of chemotherapy even though many years had passed since their treatment. A man who had breast cancer eight years ago said he was more stubborn than he used to be and that he sometimes said things to his wife that he didn’t mean but couldn’t find the right words to say what he did mean.
She felt angry because she believed she had been 'dealt a wrong card' which had led to her lymphoma; the anger meant she could 'blow' at any time when interacting with other people.
She felt angry because she believed she had been 'dealt a wrong card' which had led to her lymphoma; the anger meant she could 'blow' at any time when interacting with other people.
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Have you made any changes to your lifestyle at all as a result?
A lot. I’m more aggressive now. I never were, I was not, I wasn’t an aggressive person. It made me think about life a lot different, my life’s changed. I had a few words with him upstairs, and I’m not a religious person, but it was all a case of, you know, “Why have you done this to me?” Because I didn’t, I mean I haven’t smoked, right, I mean alright I didn’t have the lung cancer, but I hadn’t smoked or anything, and I just thought, and I didn’t drink a lot, I mean I don’t drink at all now, but I just thought, “Why have you done this to me, what have I done to deserve this?” And it wasn’t until I began to think about, you know, what I’d got, and you’ve a lot to think about. You know, I mean we lost my mum and all I thought was, “Well me and my sister”, and all I thought were, “It must be a family”, it’s got to be hereditary this because my mum has gone, me and my sister wasn’t well, you know, and it just, it does make you angry.
I also remember, and I got a bit nasty, I had to be careful with people because I could just blow at any time, you know. I mean I had some good support but they knew that I could just go off at any time, and I would. And it did, it me a bit nasty because it just makes you think that life, sometimes you’re just dealt a wrong card, you know, and to me you are, it’s whatever you’re dealt right at the beginning of your life. And I just thought, “Well we’re here to be tried all of us”, so I’m being tried. And that, and it did, it opens your eyes quite a lot, you know, at first you’re just plodding on, then all of a sudden there’s a big hiccup in your life and you think, “Why? Why have you done this to me? You know, is it sommat else you wanted me to get through to see if I can do it?” And I did it and, you know, I must think, well, thought, “Well I was strong enough to do it so obviously it’s not my time”. And I still don’t think it’s my time. But yes it does, it makes you think, yeah, whether you’re dealt the right cards a lot of it. Yes, so I had a few words upstairs definitely to just sit there and play pop with him.
Some people said that they felt more emotional since their cancer, saying that certain situations could make them tearful, such as when talking to other people about cancer or watching a sad television programme. A man who had lived six years with pancreatic cancer, and was now terminally ill, said that his life had inevitably become more emotional as a result of his illness progression.
Alan said he had become more emotional since his colorectal cancer. Seven years after his diagnosis, he says 'I'm certainly not me' anymore.
Alan said he had become more emotional since his colorectal cancer. Seven years after his diagnosis, he says 'I'm certainly not me' anymore.
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Do you think that the chemotherapy or the surgery left you with any long term effects at all?
Oh, only this emotion thing I think. I know people do get more emotional as they become older but I feel, I know I suppose everybody does, still feel twenty one from the neck up, just that the brain says, “Go”, and the body says, “No”. But so, I never thought I’d become at least as emotional as what I have become, so I would, I could if I had to say anything I’d say, “Yes, I’ve become very emotional since I’ve had it.” One can only, you can’t tell whether I’d become emotional at this age or not if I hadn’t have had cancer but I’m certainly not me. I’m certainly not me and that’s all I can say really. It’s changed me. Not physically, it’s changed me mentally. And but, you know, I’m still breathing.
Anxiety is another natural reaction to having cancer, and several people said they suffered from this. Alan (quoted above) said he worried about things more than he used to and had nightmares due to anxiety. Some people worried that their cancer might return (see also ‘Facing the future’). A man who had hot sweats as a symptom of testicular cancer five years ago said he becomes anxious when he feels sweaty nowadays because it is a reminder of his illness. Anxiety can cause a variety of physical symptoms, including sweating, as well as psychological disturbances such as poor concentration, irritability and sleep disruption.
He suffers from panic attacks that he never had before his testicular cancer.
He suffers from panic attacks that he never had before his testicular cancer.
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Have you had any other long, have you had any long term side effects?
I occasionally now get panic attacks that I never had before, but only very occasionally, and I'm not, depending on how I feel, a room full of people being noisy will mean I'll have to go and stand outside because I'll just start to panic. And I never had that before, so I can only put that down to the chemotherapy and everything, all the sights and sounds and everything that goes with it. But apart from that I don't think so.
It was common for people to say they felt depressed at times or had ‘down days’ since their cancer. These days were characterised by low mood and lethargy. Some said they didn’t feel like doing anything on those days. Janet (Interview 69) has chronic lymphocytic leukaemia, which causes tiredness, and her social life has become restricted as a result. She says she is depressed because she is isolated. Depression may be a particular problem for people who are still living with cancer symptoms or lasting effects of treatment, but it can also affect those who are in remission.
Beverley has had chronic lymphocytic leukaemia for 7 years; she feels depressed on some days and not others depending on the weather and on what is happening in her life.
Beverley has had chronic lymphocytic leukaemia for 7 years; she feels depressed on some days and not others depending on the weather and on what is happening in her life.
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And I actually, I admit some days you have depression because you, well not, I don’t say that I have depression now with it, with the leukaemia, I actually feel down some days, it’s not depression, it is a case of just feeling a little bit down. It’s pouring with rain outside, it’s a horrible grey day and it’s going to be a bad day, it’s a bad day. But tomorrow might be sunny and it might be a bright day or there might be a phone call come through and I speak to my son in Australia or I speak to somebody else and it brightens the day up and then it’s all past, and you’re feeling, you know, you might be absolutely feeling absolute grot but by just accepting what’s going on, and I think it was just that that helped the acceptance. Whether everybody goes through doing something like that or going and doing an art course or, I just think if you can channel your thoughts into something else it helps a lot. I think that you just have to do something.
Since her cervical cancer she has had occasional 'down days' when she worries about what the future may hold; she says that people are entitled to having 'down days' and should not feel guilty.
Since her cervical cancer she has had occasional 'down days' when she worries about what the future may hold; she says that people are entitled to having 'down days' and should not feel guilty.
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How do you view the future now?
I'm very much more optimistic. I'm not saying I'm always positive and always optimistic because nobody can be like that all the time. I do have down days sometimes and I do sometimes have doubts and sort of think, “Oh what if”, and if I get an unexpected ache or pain sometimes I can, you can, your mind will take over and play tricks on you and read more into something than is there. But that's the way it is. I have, I don't have very many really down days but I do have, but it's very difficult sometimes when, you know, you're very conscious of having a down day and yet by the same token you think, “Well I should be more positive”. And I don't like the ‘should’ word because everybody is entitled to have a down day, and I would be one of the first people to tell somebody phoning the helpline if they were having a really awful day or group of days when their partner or whoever is telling them everything is fine and trying to give a boost to their morale or when the consultants said that everything is all clear or whatever, I'd be the first to tell them, you know, everybody gets it and sometimes it's, like, the result of, like, delayed shock, that it comes out like that. But I suppose it's a ‘do as I say’ not ‘do as I do’ syndrome. Everybody gets down days and has doubts and thinks what if. But by the same token I can look around me and think, “Well there's always somebody worse off than I am, I've got a lot to be thankful for, I've got a lot to be grateful for, I'm not as badly off as a lot of people”. So I tend to be quite happy with my lot really.
Many people deal with depression on their own or with the help of close friends and family. Some choose to join a self-help or support group to meet and share experiences with other people who are in the same situation. Others seek professional help. GPs or cancer specialists can refer people to speak to a counsellor or a psychologist. A man who had lived for five years with pancreatic cancer said that talking to a psychologist had been a useful ‘release valve’ to prevent him from bothering his family. Some people may be offered anti-depressant medication; Ian said that he had used anti-depressants periodically since his leukaemia when things were getting him down.
David is terminally ill with pancreatic cancer; he has recently decided to take anti-depressants to try to help him steer a steady path through the highs and lows of his emotions.
David is terminally ill with pancreatic cancer; he has recently decided to take anti-depressants to try to help him steer a steady path through the highs and lows of his emotions.
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You said that now you’ve reached this stage, of course you feel a bit low at times. How are you managing that with the nurses?
Well, again the sort of, the emotional side has so many, in the last, say, since Christmas, has become a lot more apparent. And I think my wife has sensed that, and it’s been emotional, or there’s been periods where it’s been apparent from the way I’ve spoken.
And again that’s through my wife and through the Macmillan nurse there’s been discussion about how we can manage that. And again when I met the palliative doctor yesterday there was, it was quite a, I mean it was my birthday yesterday, which in potentially your final year is not a joyful occasion. And there was a discussion as to whether I should go on anti-depressant tablets, which for me is just like, seems to be a taboo. I said “Why would I need those?”
But I’ve kind of reflected and it’s been discussed with Macmillan’s nurse prior to this, and it’s been discussed with the specialist hospital. Again I think there’s been a noticed that, I’m a lot, not as strong in character as I’ve been, and then I’ve decided that there does seem to be some more benefit in going on an anti-depressant. On a low level, just to, I think it was described, “Create an even keel”. So to try and manage the highs and the lows, and try and get a more steady path through, which I think makes sense.
Why, why, well I’ll tell you in the future when I’ve taken the tablet, but if it does make a difference and carries me through this stage better then that’s probably an advantage really than just being up and down.
Others had rejected conventional medication in favour of herbal products. There is evidence that St John’s Wort can help people with depression and although it may cause fewer side effects it may also be less effective than conventional anti-depressants. Herbal medicines can interact with conventional medicines, so people considering using them should consult their doctor. A man who had testicular cancer took a herbal remedy that has since been banned in the UK because of a rare but serious risk to health. He was offered an antidepressant medicine by his GP but chose to try alternative therapies instead.
Counselling and hypnotherapy are helping him to deal with anxiety and depression after having testicular cancer.
Counselling and hypnotherapy are helping him to deal with anxiety and depression after having testicular cancer.
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And to be honest with you I'm now at the stage where it's probably as bad as it has been and I'm having some counselling for it and I've even started with hypnotherapy to try and put all this behind me. I went to see my GP and, you know, he prescribed some medication. And I don't want to take medication, I want to do it a different way and I want to try and put that sort of thing behind me because it's all a reminder of what happened, you know, 5 years ago nearly now.
Can the National Health Service provide hypnotherapy?
Well when I went to, I've also got, can I say this private health cover.
Yes.
And they won't cover it. But I'm in a situation where I went to see the GP and I'm having 3 or 4 sessions locally. I don’t know whether it's available on the NHS but I don't know what the waiting list would be like as well.
So you're having to pay for that?
I'm paying for it, I want a quick fix to get this sorted because it's…
Have you started that yet?
Yeah I've had about 3 weeks of that now, yeah.
Have you noticed any difference yet?
Yeah I've noticed quite a big difference, I'm a lot more positive about things and, you know, a lot less anxious as well, I was starting to become anxious about things and it has made a difference.
Do you mind explaining what hypnotherapy is like?
Yeah, well I started off by describing things that had, sat down with the lady and described the things that had gone on over the past, you know, 4 years, not only the cancer but other events that had happened, you know, deaths and, you know, divorces etc. etc. And I told her one of the main things that bothers me, that I've become anxious about is the sweating issue and it bringing back all the memories. And the sort of thing that we do is we sit down and for probably three quarters of an hour she talks me into a relaxed state where I'm still in control of everything that I do but it's in effect getting through to your subconscious and relaxing you and teaching you things to do if you're becoming stressed. Then we talk through various images, relaxing images, laid by the beach etc. and remembering to do this sort of thing and think about these things if you start to feel as though you're becoming a bit anxious and you find that, you know, it does relax you.
So if you start to sweat and you start to remember how you first found that you had cancer, then you, start to think of nice things, other images?
Yeah, I just try and take a few deep breaths and relax a little bit and think of different things, things that, you know, make me feel happy, as opposed to the things that remind me of what had happened previously.
And that's beginning to help is it?
Yeah, it is, yeah.
For more resources on depression and anxiety please see our Resources and Information page.
Last reviewed October 2018.
Last updated August 2015.
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