How do people describe depression and sadness?
People describe depression as the darkest time in their life. Many people report crying spells, or problems with sleep (either sleeping all day or not enough sleep). Others describe problems with eating (too much or not enough), feeling hopeless, helpless, worthless, even feeling like they want to hurt themselves may also be present. People may have trouble experiencing any pleasure.

With depression people feel very low in their spirits. It affects the person’s day-to-day life. Not wanting to talk to family or friends is common with depression. Depression is not the same as an occasional, short-lived period of sadness. In depression, these low feelings are severe, and stay for two or more weeks.

What causes depression and sadness?
Depression can occur from some specific events, or when a loved one has a serious illness. Depression can happen from medications, from having fatigue, or from chemical changes in the brain. People can usually cope with general short-term feelings of depression. Persistent depression is treatable with counseling and/or medication.

How do people cope with depression and sadness?
Every person uses different approaches when they are depressed and sad.

Here are some tips other people have found helpful:

• Try controlled breathing and relaxation exercises; these help release mood-enhancing substances from the brain.
• Express your feelings through journal writing or creative expression (dance, cooking, exercise, painting or music).
• Avoid alcohol consumption; it can make you more depressed.
• Eat foods that are nutritional to maintain good health. Ask for assistance from a dietician if you are having problems eating.
• Try distraction/guided imagery, journaling, music therapy or relaxation.
• Try to get enough sleep at night; avoid napping during the day.
• Go outdoors and walk in natural settings, such as a garden or park.
• Try meditation, or massage.
• Try to identify something that brings you pleasure every day.
• Be with other people as much as possible, if this helps you relax.
• Participate in regular, routine exercise (walking for 20 minutes, 3-5 times per week, for example). Exercise has been shown to improve mood and well being.
• Make an appointment with your doctor, telling him/her exactly how you feel and asking for help.
• Make a list of all the medications you take; show this to your doctor or nurse. Some medicines may have to be stopped or changed.
• Join a support group. This can help relieve the isolation that is often felt by those who are depressed.
• Make an appointment with a counselor, pastor, priest or psychologist.
• If medicines have been ordered for you depression, take them as directed.

• Ask family members and friends to stay with you (if you live alone) so that you are not by yourself.
• Ask family members and friends to talk with you about what you’re going through.
• Ask family members and friends to engage in enjoyable activities with you.
• Ask family members and friends to sit with you during difficult times, sometimes just having someone there with you is enough.
• Ask family members and friends to help you with your daily needs until you are able to care for these on your own.
• Have family members and friends help you with relaxation exercises, controlled breathing exercises, or visualizing pleasant scenes.
• Ask family members and friends to help you with situations or chores that you identify as stressful, such as going to your doctor visits, writing out bills, or helping with household chores.
• Ask family members and friends to notify your doctor or nurse for you when needed.

• Try to describe your depression and how it affects you.
• Ask your family members and friends for ideas to help you deal with your depression.
• Be open and honest about your feelings with your family members.
• Ask family members and friends what they think might be causing your depression.

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SUMMARY OF THE SYMPTOMS OF DEPRESSION

IF.... there is no physical illness of the brain or psychiatric illness.

THEN...depression consists of five of these symptoms present for two weeks (one of them must be Item 1 or 2)

1. Depressed mood every day for most of the day
2. Very little interest or pleasure in most activities nearly every day for most of the day.
3. Noticeable weight loss or weight gain - or a major change in appetite.
4. Sleep disturbance: not being able to get to sleep or waking early or being very sleepy nearly every day.
5. Feeling agitated, or feeling slowed-down nearly every day.
6. Feeling excessively tired or lacking in energy nearly very day.
7. Feeling worthless or guilty nearly every day.
8. Feeling unable to concentrate or make decisions.
9. Frequent thoughts of death or suicide.
10. Problems concentrating, thinking, remembering, and making decisions.
11. Feelings (or actions) that you want to hurt or kill yourself.
12. Not wanting to get out of bed or get dressed.
13. Loss of interest in activities you used to enjoy, including sex.
14. Weight loss of more than 5 pounds in one week.
15. Feelings of hopelessness and/or helplessness.

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• Contact your doctor or nurse.
• Visit http://www.cancersymptoms.org on the internet.
• Visit the Family Care Research Program on the internet at: http://www.cancercare.msu.edu.
• Visit the National Coalition for Cancer Survivorship on the internet at: http://www.canceradvocacy.org. Click on Essential Care.
• Visit the National Family Caregiver Alliance at: http://www.caregiver.org/caregiver/jsp/home.jsp.

• Rawl, S.M., Given, B.A., Given, C.W., Champion, V.L., Kozachik, S.L., Barton, D., Emsley, C.L., & Williams, S.D. (2002). Intervention to improve psychological functioning for newly diagnosed patients with cancer. Oncology Nursing Forum, 29(6), 967-75.
• Barsevick, A., & Much, J.K. (2003). Depression. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer symptom management, 3rd Ed. (pp. 668-692). Boston: Jones and Bartlett.