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Depression is the most common psychiatric illness during treatment and cancer diagnosis. It is a disorder that involves thoughts, moods, and the body (Senra & McPherson, 2021). Depression influences an individual’s feelings and thoughts about themselves, together with their eating and sleeping habits (Senra & McPherson, 2021). A depressive state happens on a continuum from ordinary sadness that escorts life-controlling diseases to a significant emotional disorder (Senra & McPherson, 2021). For instance, it may start with the loss of enjoyment and interest in everyday activities, mood swings, and a selection of physical, cognitive, behavioral, and related emotional symptoms.
Furthermore, a person diagnosed with cancer who has seen people die because of the disease might panic and go into depression (Senra & McPherson, 2021). That is because they fear that they may suffer a similar fate as those who have died because of the cancer disease. Most cancer patients fear suffering from losses of body parts such as hair or breast. According to National Cancer Institute (NCI), cancer can affect human beings at any level and status (as cited in Suh et al., 2020). However, the NCI approximates that one out of three women and one out of two men will be diagnosed with cancer in their life (Suh et al., 2020).
Furthermore, the possibility of having cancer in females is roughly 38%, while in males is approximately 44.85% (Suh et al., 2020). That shows that the possibility of cancer in males is higher regardless of their shorter life span (Suh et al., 2020). However, the harshness and frequency of the cancer conditions or side effects in different gender have not yet adequately been assessed. Nevertheless, depression in a cancer patient is estimated to be there during the initial cancer diagnosis up to the fatal stage, especially those with poorly managed physical symptoms. Persistent and severe depression syndrome is four times frequent in cancer patients than in the overall population (Suh et al., 2020).
A depressed person displays a self-deprecating illustrative style in which they consent to more accountability for bad results than good results. Depression is caused by a wrongful understanding of the patient’s illness or concerns about their diagnosis, mental health problem, stigma, the magnitude of pain, and family history of depression, among others (Suh et al., 2020). The thought is manifested through negative opinions about the future and yourself. The intellectual depression hypothesis contains specific feature schemas that become stimulated and leads to cognitive alterations (Gold et al., 2020). They comprise a negative formation of self-worth, creating a thought content imbalance that produces feelings such as pessimism, loneliness, sadness, and guilt. Such feelings result in the cancer patient blaming themselves for the illness.
Furthermore, due to the patients’ ignorance, they think that cancer means death when they can live and cope quite well despite the disease. The most common raised symptoms of the sleep disorder are exhaustion in the morning, difficulty falling and staying asleep. According to NCI, most patients have abnormal sleep wake-cycle and insomnia before being diagnosed with cancer (as cited in Suh et al., 2020). Sleep disorders can lead to various somatic and psychological conditions such as bad temper, fatigue, cognitive impairments, and aggressiveness. It can also lead to poor coordination, mood changes, reduced pain tolerance, and psychomotor retardation.
Therefore, depression causes amplified mortality, reduced productivity, and life quality. Distress is the negative experience of a psychological, emotional, spiritual, or social nature that affects a person’s capacity to manage cancer and its treatment. It progresses in a scale ranging from sadness, fears, and usual vulnerability feelings to hitches that can be hindering, such as anxiety, depression, social isolation, panic, and spiritual calamity (Suh et al., 2020). Therefore, Persons with cancer treatment and diagnosis regimens might experience diverse distress levels. A high distress level could result from a person’s perception that each situation demands are extraordinary or have scarce resources.
Alteration disorders can adversely affect life quality and hamper a cancer patient’s capacity to function emotionally and socially (Teo et al., 2019). Stress-related to a cancer diagnosis can activate anxiety disorder in a patient without a pre-sullen psychiatry diagnosis. Phobias can affect medical procedures and can lead to the denial of necessary medical tests or intervention. Anxiety can sometimes change a person’s attitude concerning their health, causing neglect or delay in procedures that might stop cancer.
For successful management and treatment of depression in a cancer patient, symptoms must be first recognized (Gold et al., 2020). However, a report on the clinical and social barriers that identifies the central issue of evaluating symptoms is the absence of a physician’s time (Gold et al., 2020). Acknowledgment and normalization of pain can exist on cancer’s somatic anxiety and depression symptoms (Balbir & Moscovici, 2021). However, some patients fail to reveal psychiatric symptoms due to the stigma surrounding mental health illness (Balbir & Moscovici, 2021). Anxiety and depression screening amongst cancer patients are beneficial if it progresses to support and effective treatment to improve patient results.
Patients get reluctant to talk about their mental health requirements if they see the absence of efficacious treatment choices (Balbir & Moscovici, 2021). The general depression treatment option that cancer patients choose from is psychodynamic therapy, interpersonal therapy, and cognitive behavioral therapy. However, the current proof for treating depression amongst cancer patients is restricted and fluctuates in quality. That is because the treatment of a depressed patient is chosen based on their level of depression (Gold et al., 2020). The Hospital Anxiety and Depression Scale (HADS) is a self-administered 25-item instrument that calculates the symptomatology presence of depression and anxiety in adults (Gold et al., 2020). In oncology clinics or primary care facilities, direct procedures such as Hospital Anxiety and Depression Scale (HADS) questionnaire are accessible.
These procedures can assist in pinpointing psychiatric clinical symptoms and differentiating them from overlapping symptoms ascending from the patient’s treatment or tumor. The diverseness of the straightforward approaches such as HADS makes the presence of low-quality studies very minimal (Gold et al., 2020). When examining the depression treatment option, concerns about the potential side effects of drug interactions and antidepressants might affect the cancer treatment effectiveness (Gold et al., 2020). A self-administered structured questionnaire will be used to assess depression among cancer patients. The questionnaire is given after taking transcribed consents from the applicants.
Information on simple demographic facts, such as gender, age, education, locality, occupation, and income is collected. Cancer interrelated variables, such as current treatment, cancer type, history, and illness duration of surgical intrusion connected to the disease are obtained from the patients’ medical records (Gold et al., 2020). Behavioral factors incorporated in the questionnaire to establish their union with depression are physical activity and smoking, which are self-reported. Patients branded smokers are those who have smoked for more than a year. Physical activity is the exercise done for more than 4 hours per week (Gold et al., 2020). Depression and anxiety are assessed using the Hospital Anxiety and Depression Scale (HADS). The data from the questionnaire is then entered as clear-cut data on the cutoff basis for analysis.
A meta-analysis and systematic review concentrating on cognitive behavioral therapy (CBT) found that it helps lessen depression (Gold et al., 2020). In the short run, it helps cultivate a cancer patient’s life quality. However, in the end, the CBT effects become persistent for life quality (Gold et al., 2020). There is a possibility that collaborative care interventions comprised of partnership among primary clinical care, psychology, and psychiatry, supervised by a care manager become efficient in treating and managing depression (Gold et al., 2020). The patient’s preference and side effects contribute to their treatment selection. Qualitative studies illustrate that patients do not frequently talk about their feelings with nurses throughout cancer treatment (Gold et al., 2020). Nevertheless, patients appreciate having the choice to speak concerning their emotions comfortably with a person they can trust.
The psychological distress self-management amongst cancerous people might be advantageous and help avoid distress among anxiety or clinical depression (Senra & McPherson, 2021). Self-management is a person’s capacity to handle treatment, symptoms, psychosocial and physical consequences, and lifestyle adjustments from living with a chronic disease. Effective self-management involves observing a person’s condition and affecting the emotional, behavioral, and cognitive responses essential to uphold a suitable life quality. Hence, a continuous and dynamic process of self-regulation is developed. Cancer, self-management, and psychological distress studies have concentrated on the treatment stage, with fewer investigative interventions behind treatment or death.
There is a proof that states that psychological distress’s self-management in cancer empowers families and patients to care for themselves the way they desire (Gold et al., 2020). Self-management involvements that demonstrate promise comprise monitoring, education, and counseling. It also assists patients in handling the long and short-term psychosocial and physical cancer effects. The importance of early psychiatric intervention on cancer prognosis mainly happens through overall improved diet, health, and better treatment agreement which might influence the physiological process manipulating cancer cell growth.
Modern cancer care entails a multidisciplinary team comprising surgeons, general practitioners, psychiatrists, oncologists, and nursing staff. The role of the oncology nurses in managing depression is to advise patients and their families to develop treatment and recognition of depression and depressive symptoms by working together with mental health experts in safeguarding comprehensive care. The cancer patient is likely to contact specialist oncology nurses and general practitioners for treatment (Gold et al., 2020). That presents them with the best opportunity to spot patients with psychiatric clinical problems. That is done by educating healthcare professionals since they interact daily with customers. Stigma is connected to a psychiatric disorder is grouped into two, self-perceived stigma, which entails stigma that an individual with mental illness suffers from, and Social stigma, which entails the discriminative attitudes people have concerning mental illness (Balbir & Moscovici, 2021). Some patients might feel that experiencing depression treatment means that cancer symptoms such as disability and pain are not candid.
In conclusion, depression is a disabling illness that affects almost a quarter of cancer patients. Depression is highly treatable, but failure to identify or undervalue its importance implies that many patients will not receive treatment that benefits their recovery results or life quality. Therefore, doctors or nurses who treat cancer patients should first try to identify whether their patients suffer from depression. They can do that through the Hospital Anxiety and Depression Scale (HADS), available in primary care facilities to assess the patients and determine their level of depression or if they are depressed. That has helped make the doctor and nurses’ work easier since they can choose the best depression treatment option for their cancer patients.
References
Balbir-Gurman, A., & Braun-Moscovici, Y. (2021). Mood problems and depression in systemic sclerosis. In Practical Management of Systemic Sclerosis in Clinical Practice Editors: Matucci-Cerinic, Marco, Denton, Christopher P. (Eds.) (pp. 55-66). Springer.
Gold, S. M., Köhler-Forsberg, O., Moss-Morris, R., Mehnert, A., Miranda, J. J., Bullinger, M., & Otte, C. (2020). Comorbid depression in medical diseases. Nature Reviews Disease Primers, 6(1), 1-22 doi.
Senra, H., & McPherson, S. (2021). Depression in disabling medical conditions–current perspectives. International Review of Psychiatry, 1-14.
Sharpley, C. F., Christie, D. R., & Bitsika, V. (2020). Depression and prostate cancer: implications for urologists and oncologists. Nature Reviews Urology, 17(10), 571-585.
Suh, J., Williams, S., Fann, J. R., Fogarty, J., Bauer, A. M., & Hsieh, G. (2020). Parallel Journeys of Patients with Cancer and Depression: Challenges and Opportunities for Technology-Enabled Collaborative Care. Proceedings of the ACM on Human-computer Interaction, 4(CSCW1), 1-36.
Teo, I., Krishnan, A., & Lee, G. L. (2019). Psychosocial interventions for advanced cancer patients: A systematic review. Psycho‐oncology, 28(7), 1394-1407.
Quality and Accreditation Unit LAT-PN2M-09:1
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