DEPRESSION AND CANCER

Get Treatment for Depression
At times it is taken for granted that cancer will induce depression, that depression is a normal part of dealing with cancer, or that depression cannot be alleviated for a person suffering from cancer. But these assumptions are false. Depression can be treated and should be treated even when a person is undergoing complicated regimens for cancer or other illnesses.

Prescription antidepressant medications are generally well-tolerated and safe for people being treated for cancer. There are, however, possible interactions among some medications and side effects that require careful monitoring. Therefore, people undergoing cancer treatment who develop depression, as well as people in treatment for depression who subsequently develop cancer, should make sure to tell any physician they visit about the full range of medications they are taking.
Specific types of psychotherapy, or “talk” therapy, also can relieve depression.

Treatment for depression can help people feel better and cope better with the cancer treatment process. There is evidence that the lifting of a depressed mood can help enhance survival.8 Support groups, as well as medication and/or psychotherapy for depression, can contribute to this effect.

Treatment for depression in the context of cancer should be managed by a mental health professional-for example, a psychiatrist, psychologist, or clinical social worker-who is in close communication with the physician providing the cancer treatment. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as cancer may be available.

While there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family. Recovery from depression takes time. Medications for depression can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted. No matter how advanced the cancer, however, the person does not have to suffer from depression. Treatment can be effective.

Williams JW Jr, Mulrow CD, Chiquette E, et al. A systematic review of newer pharmacotherapies for depression in adults: evidence report summary. Annals of Internal Medicine, 2000; 132(9): 743-56.

DEPRESSION AND DIABETES

Get Treatment for Depression
While there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family. Prescription antidepressant medications are generally well-tolerated and safe for people with diabetes. Specific types of psychotherapy, or “talk” therapy, also can relieve depression. However, recovery from depression takes time. Antidepressant medications can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted.

In people who have diabetes and depression, scientists report that psychotherapy and antidepressant medications have positive effects on both mood and glycemic control. Additional trials will help us better understand the links between depression and diabetes and the behavioral and physiologic mechanisms by which improvement in depression fosters better adherence to diabetes treatment and healthier lives.

Treatment for depression in the context of diabetes should be managed by a mental health professional-for example, a psychiatrist, psychologist, or clinical social worker-who is in close communication with the physician providing the diabetes care. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as diabetes may be available. People with diabetes who develop depression, as well as people in treatment for depression who subsequently develop diabetes, should make sure to tell any physician they visit about the full range of medications they are taking.

Anderson RJ, Lustman PJ, Clouse RE, et al. Prevalence of depression in adults with diabetes: a systematic review. Diabetes, 2000; 49(Suppl 1): A64.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Web site: http://www.niddk.nih.gov

DEPRESSION AND HEART DISEASE

Get Treatment for Depression
Effective treatment for depression is extremely important, as the combination of depression and heart disease is associated with increased sickness and death. Prescription antidepressant medications, particularly the selective serotonin reuptake inhibitors, are generally well-tolerated and safe for people with heart disease. There are, however, possible interactions among certain medications and side effects that require careful monitoring. Therefore, people being treated for heart disease who develop depression, as well as people in treatment for depression who subsequently develop heart disease, should make sure to tell any physician they visit about the full range of medications they are taking.

Exercise is another potential pathway to reducing both depression and risk of heart disease.
A recent study found that participation in an exercise training program was comparable to treatment with an antidepressant medication (a selective serotonin reuptake inhibitor) for improving depressive symptoms in older adults diagnosed with major depression.7 Exercise, of course, is a major protective factor against heart disease as well.

Blumenthal JA, Babyak MA, Moore KA, et al. Effects of exercise training on older patients with major depression. Archives of Internal Medicine, 1999; 159(19): 2349-56
National Heart, Lung, and Blood Institute (NHLBI)

DEPRESSION AND PARKINSON’S DISEASE

Treating depression can help people feel better and cope better with their Parkinson’s treatment.
While prescription antidepressant medications are generally well-tolerated and safe for people with Parkinson’s, more research is needed to determine which antidepressants work best for people with different subtypes of Parkinson’s. Specific types of psychotherapy, or “talk” therapy, also can relieve depression. Studies have demonstrated the improvement of Parkinsonian symptoms in patients receiving electroconvulsive therapy. Although there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family.

Treatment for depression in the context of Parkinson’s disease should be managed by a mental health professional-for example, a psychiatrist, psychologist, or clinical social worker-who is in close communication with the physician providing the Parkinson’s disease treatment. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as Parkinson’s disease may be available. People with Parkinson’s who develop depression, as well as people in treatment for depression who subsequently develop Parkinson’s disease, should make sure to tell any physician they visit about the full range of medications they are taking.

Cognitive and emotional aspects of Parkinson’s disease. National Institute of Neurological Disorders and Stroke, National Institute on Aging, and National Institute of Mental Health working group meeting, January 24-25, 2001. Unpublished summary

National Institute of Neurological Disorders and Stroke (NINDS).