How do I know if the distress has reached such a level that my loved one needs professional help?

33.How do I know if the distress has reached
such a level that my loved one needs
professional help?

If your loved one feels “down” for more than
several consecutive weeks, or if unsettling
moods interfere with his or her ability to
function in daily life, then contact a doctor or
mental health professional to discuss possible
ways to get help.

Periodic mood swings and distress are normal for
patients and family after a diagnosis of cancer and during
treatments. However, these normal reactions may
become severe enough for a person to experience
symptoms of clinical depression, anxiety disorders such
as phobias or panic attacks, or other treatable psychological
problems. In fact, some researchers estimate
that as many as 25% to almost 50% of cancer patients
experience clinically significant distress, such as
depression. If your loved one feels “down” for more
than several consecutive weeks, or if unsettling moods
interfere with his or her ability to function in daily life,
then contact a doctor or mental health professional to
discuss possible ways to get help. If the person has a
history of abusing or misusing drugs or alcohol, and/or
a psychiatric diagnosis, or even has had episodes of
feeling depressed or anxious that have not been formally
diagnosed, he or she could be particularly susceptible
to depression, anxiety, or the misuse of drugs
during the stress of this illness.

Phobia = Overwhelming fear of an object,situation, or
procedure.


Review the list of symptoms for depression and anxiety
in Table 1. This list is not comprehensive, and it is
not intended for self-diagnosis. It is intended to educate
you about the possible symptoms of depression and
anxiety disorders (which can occur simultaneously).

Table 1 Symptoms of depression and anxiety

• Sleep disturbances
• Appetite changes, weight fluctuation
• Little enjoyment of activities that you used to like
• Increased thoughts about death, hopelessness, and sometimes
thoughts or plans of suicide
• Feeling fatigued or having little energy
• Being physically slowed down—or the opposite, feeling nervous or
restless
• Depressed mood or sadness, tearfulness
• Feeling alone and isolating yourself from others
• Being less able to concentrate or make decisions
• Feeling worthless or guilty
• Uncontrollable or excessive anxiety or worry
• Fear or phobia of a specific situation or event (needles, blood draws,
going to hospitals)
• Being more irritable or agitated
• Engaging in compulsive behaviors (e.g., seeking reassurance by
repeatedly asking the same questions)
• Feeling muscle tension
• Mentally and emotionally re-experiencing past upsetting events

Derived from Diagnostic and Statistical Manual of 
Mental Disorders, 4th Edition (DSM-IV).


There are many other psychological problems that
have different symptoms. Sometimes it is hard to distinguish
between the physical side effects of certain
treatments or symptoms related to the cancer itself
and the symptoms of distress. Therefore, if you or
your loved one experiences the symptoms listed or
others that are not listed, and these symptoms persist
for over two weeks, tell your physician and/or other
mental health professionals so that they can accurately
diagnose and treat the concern so that you or
your loved one can start to feel better. Call 911 if
anyone is planning suicide or harm to someone else.

Suicidal ideation = Thoughts or plans to commit suicide.