Is Depression a Normal Reaction to a Terminal Illness?

Clinical depression is common in people who are living with a terminal illness. According to an article by medical ethicist Robert Fine, M.D., in the journal Baylor University Medical Center Proceedings, between 25% and 77% of terminally ill patients experience clinical depression at some point during the course of their disease. What’s more, the presence of depression often increases their suffering by contributing to anxiety and feelings of hopelessness, helplessness, guilt and despair. People who are depressed may also feel worthless, lack self esteem and have no interest in things they once enjoyed. Depression may also make the physical symptoms of the underlying disease, such as fatigue, sleeplessness, lack of appetite and pain, significantly worse. 

Depression is more likely to occur in seriously ill patients with advanced disease, since the burden of symptoms is likely to be higher and their psychological resources worn thin. Interacting with the outside world also becomes more difficult as physical challenges become more severe as the illness progresses, which can contribute to feelings of loneliness, isolation and despair. A history of depression, prior suicide attempts or substance abuse also make it more likely that a person will become depressed when they are seriously ill. A family history of depression (sometimes multigenerational) is often a contributing factor as well. 

Certainly, medication cannot “fix” a terminal illness, and moving through the grieving process is an important part of coming to terms with death. However, if a terminally ill person is clinically depressed, appropriate medication combined with psychological counseling may help ease their suffering and allow them to experience more joy during the time they have left. 

If you or a loved one is terminally ill and showing signs of depression, don’t assume that this is a response to the underlying disease. Speak with your healthcare provider about your concerns. They may want to add a psychotropic medication and/or involve a mental health professional in your care. 

Sources

 “Depression, anxiety, and delirium in the terminally ill patient”. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1291326/

“What Are the Causes and Symptoms of Depression?” WebMD. http://www.webmd.com/depression/guide/depression-symptoms-causes#1 

“Mental Health Medications”. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml