Cancer patients with depression are “being overlooked” says leading Priory psychotherapist

Men and women are struggling with depression after treatment for illnesses such as cancer because there is insufficient emotional support for them, a leading Priory psychotherapist says.

Julia Cole, senior psychotherapist at the Priory’s Wellbeing Centre in Southampton, said she was seeing an increasing number of people whose depression followed cancer treatment.

She said many suffered from disrupted sleep, anger, stress, and fear and sometimes even Post-Traumatic Stress Disorder (PTSD). Much of the stress was connected with financial concerns and fear of the illness recurring. Sometimes personal and professional relationships had gone into freefall.

Speaking ahead of World Mental Health Day in October, which provides an opportunity for all those working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people, Julia Cole said: "The analogy I often use - which patients seem to identify with - is that they have felt like a storm-tossed ship during diagnosis and treatment, and then they land on a kind of island and think 'what now?'

"They feel like strangers to themselves. The road ahead is suddenly different. Frequently they say that doctors, with good intentions, tell them to 'go off and live your life' but it can be harder to do than you might think. The shock of the diagnosis lingers, the fear of a recurrence, worrying about families, mortality, all can be extremely draining."

Depression is a common side-effect of cancer treatment.

According to the Breast Cancer Care charity, more than a quarter of patients it surveyed (26%) said dealing with chemotherapy or radiotherapy was not as hard as coping with life after being discharged from hospital treatment. Only one in 10 say they felt positive and ready to move on when treatment was over. More than half (53%) struggled with anxiety once hospital treatment had ended.

In addition, three studies by researchers at the Universities of Oxford and Edinburgh in the UK in 2014 revealed that three-quarters of depressed cancer patients were not receiving treatment for depression.

The research in The Lancet said cancer patients who were clinically depressed did not get the psychological therapy they needed, partly due to a focus on physical symptoms at the expense of good mental healthcare.

Of 21,000 cancer patients, they found 6% to 13% of people had clinical depression, compared with just 2% of the general population at any time. Depression was most common in people with lung cancer, affecting 13 per cent of patients, followed by gynaecological, breast and colorectal cancer and finally genitourinary cancer, for which six per cent of patients were diagnosed as depressed.

Julia Cole said: "Women who have had breast cancer in particular are unprepared for how they feel after chemotherapy and there is the medication and issues around body image, confidence and anxiety about the road ahead."

Some breast cancer treatments can affect the way the ovaries work, causing an early menopause for some women.

"A person will probably be concerned that the cancer might come back," said Julia. "Their outlook may have been transformed. If a couple chooses to separate during this time - perhaps the partner has had an affair - managing the personal loss can present another huge challenge. Even years after treatment, certain events may stir up the health worry again, such as follow-up visits."

According to the World Health Organisation (WHO), depression is now the leading cause of ill health and disability across the globe with more than 300 million people suffering from it.

The rate of depression has increased by more than 18 per cent since 2005, WHO said.

Priory's high street Wellbeing Centres across the UK offer support for stress, anxiety and depression, delivered by leading experts in their field, including psychotherapists, psychiatrists, in a relaxed environment.

There are centres in Southampton, Oxford, Birmingham, Greater Manchester, Edinburgh, Aberdeen, London, Canterbury, and Norwich. The Priory also manages a hospital chain across the UK.

The Priory Group is the leading provider of behavioural healthcare in the UK, treating 30,000 people a year for conditions including depression, stress, drug and alcohol addiction, eating disorders and self-harming.

For those struggling with depression after cancer treatment, Julia Cole said:

1 - It's common to want to protect others from anxiety about cancer, but your family and friends can support you and help you, often in unexpected ways. Talk to the people you trust about your feelings - positive and negative.

2 - Each day write one positive thing that has happened to you or you initiated during the day. Simple things such as appreciating nature, the smile of a stranger or a meal enjoyed can help you feel life is worth living after treatment.

3 - Listen to your own needs. Don't be afraid to rest if you need to, or be a bit more active if you feel ready. Pushing yourself to work too hard or meet the demands of others can cause low mood and stress.

4 - Think about doing one thing you have put off - a trip away, studying a subject that interests you, learning a language or seeing a film you may have missed. Aim to undertake this in the coming weeks. If you achieve your goal, set yourself another desire. Setting goals and achieving them (or at least trying) can allow you to feel less lost and more at ease in the world.

5 - Ask yourself what you learnt about yourself after treatment. You may be surprised at your resilience, or need to grieve for the change in your life. This is natural, and can help you decide what you want in the future.

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