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Dealing with Depression and Anxiety

Reviewed by: HU Medical Review Board | Last reviewed: October 2017

Men with prostate cancer, even those who have been successfully treated, can develop depression and anxiety. Prostate cancer and depression can go hand in hand.

Common signs of depression include:

  • Ongoing hopeless, sad, or empty mood for the majority of each day
  • Loss of pleasure or interest in nearly all activities
  • Brain fog (trouble focusing and memory or decision-making issues)
  • Extreme tiredness or lack of energy
  • Sleep disturbances
  • Major weight changes (loss or gain)
  • Signs of noticeable agitation, restlessness, or being slowed down
  • Feelings of helplessness, worthlessness, or guilt
  • Thoughts of death or suicide, plans of suicide, or suicide attempts (if any of these signs are present, seek medical attention immediately)

Common signs of anxiety include:

  • Uncontrollable worrying
  • Irritability, grouchiness, angry outbursts
  • Shaking or trembling
  • Trouble focusing or problem-solving
  • Anxious facial expressions
  • Restlessness or feelings of being “on edge”
  • Dry mouth
  • Muscle tension

This is not an exhaustive list of all potential signs of depression or anxiety. Also, not all men will experience depression or anxiety in relation to their prostate cancer. For those that do experience these emotions, not everyone will require significant medical attention or treatment. How you decide to manage signs of depression or anxiety is up to you. However, if your depression or anxiety leads you to start having suicidal or harmful thoughts, it is important to seek medical attention immediately.1

How does prostate cancer cause depression and anxiety?

It is not uncommon for men to struggle with feelings of anxiety or depression at any point during their prostate cancer journey. Some men may have depression or anxiety that existed before their prostate cancer diagnosis, and it may get more intense as a result of their cancer battle. Others may develop feelings of anxiety or depression upon diagnosis if they are worried about their prognosis or future. Also, some men may develop these mood issues as a result of certain treatment regimens. For example, men on hormone therapy or steroids may have a higher risk of developing mood disturbances.

Additionally, some treatment options, especially surgery or radiation therapy, may leave a man with significant quality-of-life-impacting side-effects, such as urinary incontinence, bowel issues, or sexual dysfunction. These side effects may be difficult to manage at times, and may contribute to feelings of depression or anxiety. Some may even impact a man’s self-esteem or body image, further leading to feelings of anxiety or depression. Even if a man is deemed cancer-free, he still may be scared or concerned about the potential for cancer recurrence or the development of a second cancer. These feelings may also lead to significant mood changes or anxiety.2,3

Concerns about finances, loss of the ability to work, or perform regular activities due to pain, fatigue, or other side effects may also contribute to feelings of anxiety and depression.

How to manage the feelings

The good news about experiencing anxiety or depression is that there are many ways to manage these feelings, as long as an individual reaches out for help. Medications such as anti-anxiety drugs or anti-depressants can be used to clinically manage mood issues, however, using medications may not be desired by everyone. Medication-free treatment options for depression and anxiety include therapy (including cognitive-behavioral therapy, CBT) and counseling (including individual, couples, or family counseling). There are many different types of therapists, psychologists, psychiatrists, and counselors who can provide support during this time. The extent of therapy and type of individual you want to see is completely up to you.

Also, having additional social support may be helpful in combating anxiety or depression, and may be found in friends and family, as well as in local, in-person support groups, or online communities like ours. Additionally, channeling these feelings into other enjoyable activities may help reduce anxiety and depression. Some examples of these types of activities include:

  • Exercising
  • Journaling
  • Religion, spirituality, or prayer
  • Breathing techniques
  • Relaxation techniques or meditation1,4

Ways to talk about it

Despite being common for men with prostate cancer, experiencing anxiety or depression may feel embarrassing, isolating, or frustrating at times. Because of this, it’s common for men to avoid talking about these struggles with their doctors, partners, or families. By not talking about these issues, these feelings may build up, and lead to significant impacts on a man’s overall well-being. Depression or anxiety can become overwhelming enough to impact a man’s desire to live. For this reason, if you are struggling, it is critical to talk with your doctor about potential treatment options that may be right for you, or for specific tips on how to manage what is going on.

How much you share about your depression or anxiety, and who you share with, is completely up to you, however, enlisting the support of friends, family, spouses, partners, or close confidants may help ease the burden and ensure you that you know you are not alone.

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