Cancer : Depression and Anxiety, Memory

by National Cancer Institute

(Page 10 of 16)

Depression and Anxiety

After treatment, you may still feel angry, tense, sad, or blue. For most people, these feelings go away or lessen over time. For up to one in four people, though, these emotions can become severe. The painful feelings do not get any better, and they get in the way of daily life. These people may have a medical condition called depression. For some, cancer treatment may have contributed to this problem by changing the way the brain works.

Getting Help for Depression

Talk to your doctor. If your doctor finds that you do suffer from depression, he or she may treat it or refer you to other experts. Many survivors get help from therapists who are expert in both depression and helping people recovering from cancer. Your doctor also may give you medicine to help you feel less afraid and tense.

If you find it hard to talk about your feelings, you may want to show your doctor this document. It can help you explain what you're going through. Do not feel that you should be able to control these feelings on your own. Getting help if you need it is important for your life and your health.

How Do I Know If I Need Help With Depression or Anxiety?

If you have any of the following signs for more than 2 weeks, talk to your doctor about treatment.

Emotional signs:

• A sense of being worried, anxious, blue, or depressed that doesn't go away
• Emotional numbness
• Feeling overwhelmed, out of control, shaky
• A sense of guilt or worthlessness
• Helplessness or hopelessness
• Irritability and moodiness
• Difficulties concentrating, or feeling "scatterbrained"
• Crying a lot
• Focusing on worries or problems
• Not being able to get a thought out of your mind
• Not being able to stop yourself from doing things that seem silly
• Not being able to enjoy things any more, such as food, sex, or socializing
• Finding yourself avoiding situations or things that you know are really harmless
• Suicidal thoughts or feeling that you are "losing it"

Body changes:

• Unintended weight gain or loss not due to illness or treatment
• Insomnia or increased need for sleep
• Racing heart, dry mouth, increased perspiration, upset stomach, diarrhea
• Physically slowing down
• Fatigue that doesn't go away; headaches or other aches and pains

Memory and Concentration

"I tell them it is a 'senior moment,' but I notice I have a lot more of them now, and I'm sure [treatment] had something to do with it," one 70-something survivor noted. "Not being able to concentrate the way I used to is the worst effect for me," a younger survivor added. "I worry about how it will affect my work."

Research shows that one in four people with cancer reports memory and attention problems after chemotherapy. More research is needed to learn what causes these changes.

These effects can begin soon after treatment ends, or they may not appear until years later. They do not always go away. If a person is older, it can be hard to tell whether these changes in memory and concentration are a result of treatment or of the aging process. Either way, some feel they just cannot focus as they once did.

Research is just starting to explore who may develop problems with memory and concentration. It seems that people who have had systemic chemotherapy or have had radiation to the head area are at higher risk of having these problems. People who have had high doses of chemotherapy may be particularly affected by memory problems, but even those who have had standard doses have reported memory changes.

Working With Your Doctor or Nurse on Memory and Concentration Problems

Your doctor can help you with memory and concentration problems. Talk with him or her if:

• You think a medicine you are taking could be causing or adding to your problem.
• You think you suffer from depression or anxiety. These problems can affect attention, concentration, and memory.
• You are going through menopause. Some memory and concentration problems can be related to menopause.

Tips: Improving Memory and Concentration

Cancer survivors have found many ways to help improve memory after cancer treatment. See if any of these ideas work for you:

Get a notebook or pocket calendar and use it to plan your day. You can write down each task, how long it will take, and where you need to go. Plan the whole day, including night hours. Keep it simple, and be realistic about how much you can do in a day.

Put small signs around the house to remind you of what you need to do. Use them to remember tasks such as: 1) take out the trash; and 2) lock the door. Hint: use only two or three signs. If you have too many, you may ignore them.

Group long numbers (such as phone numbers and ZIP codes) into "chunks." For example, the phone number 812-5846 can be repeated as "Eight-twelve, fifty-eight, forty-six."

"Talk yourself through" something you need to do to help you stay focused. When doing a task with a number of steps, such as cooking or working on a computer, whisper each step to yourself.

Learn relaxation skills. Learning how to relax can help you remain calm even in stressful moments. Managing stress better can improve memory and attention.

Before you go to family events or work functions, practice saying important information that you want to remember, like names, dates, and key points you want to make.

Repeat what you want to remember. Saying it a couple of times can help your mind hold on to the information.

About the Author

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The National Cancer Institute's research programs are extensive and contain many innovative initiatives. I invite you to explore our Web site to find out more about the exciting work being conducted here at NCI and by NCI-supported scientists throughout the country.