The vicious process of cancer, depression, and death

Depression is a treatable illness. This was the resounding message in a recent presentation delivered by Dr. David Spiegel at the Cebu Doctors’ Hospital. The talk was part of the Spiegel Lectures hosted by the Natasha Goulbourn Foundation.

According to the World Health Organization, depression is a common mental disorder that manifests itself with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration.

For individuals who have undergone or is undergoing an adverse life event that causes so much stress, depression is likely to occur. This is true with cancer patients, and as the seriousness of the illness goes up, the more likely would depression occur.

Dr. Spiegel said that 25 percent of cancer patients suffer from one form of depression or another. But in order to effectively treat the disease, the problem of depression must be addressed first.

Studies conducted by Dr. Spiegel at Stanford University School of Medicine, where he serves as associate chair for the Department of Psychiatry and Behavioral Sciences, revealed that recurrence and death are more common among depressed breast cancer patients compared to those who were able to cope with their depression.

Dr. Spiegel said that conventional medicine focuses too much on chemotherapy and radiotherapy, depriving the patient of emotional support which is a vital part in the treatment process.

He believes that in order for the patient’s chance of survival to increase, he must first achieve a more stable emotional state. He must first treat his depression.

There are two complimentary ways for treating depression. First, Dr. Spiegel said, is the use of anti-depressant medications to relieve the first signs of the illness. The drugs would take effect after three to four weeks of continuous use, the reason why the patient should not stop taking it if they would not see any improvement on their condition in the first weeks.

To complement the medication, a series of psychotherapy sessions are recommended. This could either be a one-on-one session or a group session. However, group sessions are more ideal, said Dr. Spiegel, as they help the patient build a network of social support.

Group therapies allow patients to help each other by relating their own experiences and by learning through the experiences of others. Also, group therapy allows for the patient to face and deal with the worst issues of disease like dying, adding that the atmosphere would provide a suitable venue for the patient to air out his fears.

In addition, the family’s role in treating depression is also vital. At times, it is the family that causes the patient to feel depressed. “Many people blame the patient for their illness,” Dr. Spiegel pointed out. Some people, including family members, would say that the reason why the patient has cancer is because of his unhealthy lifestyle.

“We should not judge a person who is depressed,” he said. “Rather, we should see him as someone who has a disease and needs treatment.”

He recommends for the family to talk openly about the disease. “They should handle their own stressors and help the patient to communicate his needs,” he said. “You should not let people suffer in silence, rather cope with the problem actively.”

Another recommendation that Dr. Spiegel made was for the patient to reorder his priorities. “Make more time for your family or write a book,” he said.

Proper sleep and a diet rich in vegetables would also help improve the general well-being of the patient, including his mood. 

Treatment for depression usually lasts for three to six months. This includes one-on-one sessions and group sessions.

“Avoidance coping does not help; active coping, on the other hand, helps you from becoming anxious and depressed,” Dr. Spiegel concluded. “Don’t keep it to yourself. Tell your loved ones and ask for help. Get treatment.”