DEPRESSION
DEFINITION: a mood, state of sadness, gloom and pessimistic ideation with loss of interest in normally enjoyable activities (1)
It’s not simply feeling sad, it’s a disorder with specific symptoms that can be diagnosed and treated. [2]
Depression is common in cancer patients and adversely affects many domains of functioning and quality of life, length of hospital stay, treatment compliance, and ability to care for oneself. It is associated with pain, disability and fatigue. [6]
Research shows that at least 15% of cancer patients experience major depressive symptoms [6]. This means that almost 1 in 4 cancer patients will have depression therefore it is important to identify high risk patients provide support and monitor closely because
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Other life events such as being diagnosed with a terminal illness can start off a depressive illness.[3]
Chemical imbalance in the brain
Depression can be linked to a chemical imbalance in the brain, a chemical imbalance can be triggered by a physical or emotional (psychological) event in one’s life. This usually involves a drop in the level of chemicals in the brain called neurotransmitters (e.g. serotonin, norepinephrine and dopamine) that take messages from your brain to your nerve cells. [3]
Illnesses that cause depression
Some serious illnesses such as cancer and Parkinson’s disease are more likely to cause depression than others. This seems to be because of the physical effect rather than the emotional one. [3]
Changes in hormone levels may contribute to depression in some people. Many treatments for cancer affect hormone levels. These include surgery to remove your ovaries and womb, or hormone treatments for prostate cancer or breast cancer.
A family history of
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20mg 40mg max 60mg/day, sertraline 50mg, 100mg max 200mg/day. They are widely used because their efficacy and side-effect profiles make them attractive agents for patients with cancer.[6] • Tricyclic antidepressants: Medicines that increase the brain chemicals serotonin and norepinephrine-amitriptyline, [2]nortriptyline, and desipramine have been used frequently in the cancer setting. TCAs should be started at a low dose (10-25mg at bedtime) and increased slowly by 10- to 25-mg increments every 1-2 days until beneficial effect is achieved max 200mg/day[6] • Central nervous system (CNS) stimulants: they increase the brain chemicals dopamine and