Alleviating Depression in Cancer Patients - Assignment Example

Alleviating Depression in Cancer Patients Depression is a persistent depressive disorder whose risk is normally high in cancer patients. Cancer is normally a disease that comes about when abnormal cells in a human body divides and multiplies with no control. This happens when extra cells that are not required by the body continue to multiply forming a mass often referred to as a tumor which can either be benign or malignant. Benign tumors are usually not cancerous while the malignant ones are cancerous. The cancer cells’ development isn’t restricted to any part of the body and can form anywhere and be transferred through the blood and/or the lymph system of the body (Greden, Riba and McInnis, 2011). Cancer cells often interfere with the body organs they invade and results into a lot of health complications. Linking the two diseases, cancer and depression, together is hard but once a patient is diagnosed with cancer, an individual becomes overwhelmed with the feelings of stress and deep sadness that eventually matures to depression. The depression interferes with the entire body of an individual, and impacts heavily on one’s daily routine and quality of life. Depression instigates a feeling of hopelessness and despair and has its effects on both men and women alike with little or no noted disparities for the different genders; this is in regard to its severity and prevalence effects (Hopko & Lejuez, 2007). In most cases when a patient is diagnosed with cancer, thoughts of fear and despair are experienced almost immediately. During the treatment and/or post treatment stages, depression becomes an important component in a patient’s recovery. The depression determines the after effects of the cancer and also has an influential ability to dissuade a patient from participating in a treatment program. Depression causes impairment to the normal body functions and a disruption to the psychological makeup of a person and in extreme cases might be an impediment to treatment plans for the patients (Hopko & Lejuez, 2007). Depression impacts both on the patients diagnosed with the cancer and to their respective families. These groups of people, both patients and their families faced with a cancer diagnosis; undergo varying degrees of emotional breakdowns and its associated stress. Children and spouses alike get traumatized with the invasion of cancer and its effects, and this has been a major contributor to the behavioral changes in such children (Yeung, 2007). Patients diagnosed with cancer or those suffering from cancer often experience unprecedented anxiety which in most cases come about as a result of; The fear of death The interruptions on their respective life plans The changes in their body images and their individual self-esteem The unprecedented changes in one’s social roles and lifestyle Literary review It has been known that depression has the ability to affect cancer physically. Research and studies have established that cancer patients experiencing extreme stress and depression have boosted levels of cancer-causing protein than those patients with a leaner and more optimistic view of life (Institute of Medicine, (U.S), 2007). Depression then has to be to be effectively dealt with for the cancer patients in order to achieve better treatment results for the disease. Other past studies relating to cancer, in patients suffering from either brain, lung or breast cancer has also shown that depression resulted into lower survival rates (Institute of Medicine (U.S.), 2007). According to Franca et al.(2012), there was high correlation between screening instruments for depression and different somatic symptoms clusters. In their study, Franca et al.(2012) found out that the BDI-II cognitive subscale that did not show a significant correlation with any somatic symptoms. That is, depression patients can benefit from an intervention, mostly screening, that they would otherwise not have received. Gary et al. (2007), suggest that cancer pateints may benefit from pharmacological treatments of depression. However, the results show that combined approaches to the treatment of depression may be the most effective. On their study, “Depression, Correlates of Depression, and Receipt of Depression Care among Low-Income Women with Breast or Gynecologic Cancer” Kathleen et al. (2005), found out that depressive disorder was significantly high among minority ethnic groups, low income women with breast or gynecologic cancer. The results further showed that the depressive disorder among this group was characterized by pain, anxiety and health-related quality of life. They argued that the women are not exposed to depression treatment or necessary counseling hence the need for evaluation, screening and treatment. According to Riccardo &Valentina (2013), untreated depression can increase the burden of oncology symptoms. This may result to worsening of the cancer prognosis that may be as a result of the relationship that exist between mood and immunity. Annet et al. (2011), those who suffer from cancer and major depression are characterized by wide problems that include, but exceed concerns about, both depression and cancer. These problems include; well-being, difficulties in interpersonal relationships. These problems should be taken into serious consideration when assessing and managing depressed cancer patients. On their study, Wells et al. (2013) found out that there is the need for psycho-educational approaches during the early cognitive treatment. This is important is curbing some of the negative perceptions that may occur from antidepressant. Beside clinical depression, the antidepressants can be effective in dealing with or treating depressive symptoms (Laoutidis & Mathiak, (2013). A lot of research has been carried out to determine the groups and number of patients most affected by depression. One study carried out in the University of Oxford, in a view to determine the prevalence of depression in cancer patients, recorded lower rates. The prevalence of depression in cancer patients however vary widely depending on different regions and environments. It’s more prevalent though on adults aged 45-64 years old. Depression has also led to a lot of deaths of patients diagnosed with cancer. The morality rate has gone higher, according to these statistics, and has led to more premature deaths of the cancer patients. The risk factors that are normally contributory and which cause depression should be noted before and eliminated. For a successful and effective remedial action to be provided for the cancer patients who experience depressions by the nurses and the patients’ doctors, the identification of the symptoms of depression is key. Although this is harder in the initial stages, it becomes clearer as time progresses. When a health care provider suspects a patient to be depressed, he/she will assess the patient for symptoms before recommendation of any medication or treatment procedure. Some of the symptoms for depression that should be looked out for include; Change in one’s mood; the patient is always sad and mood less most of the time   Loss of particular interest in one’s usual activities and also in his/her family and friends One’s inability to find pleasurable things in life Having agitated reactions and a feeling of restlessness most of the time Extreme fatigue accompanied by a considerable loss of one’s energy. A change in one’s sleeping habits, this could be realized either through sleeping too much or insomnia or when one gets early wakes. Loss or considerable increase in one’s appetite which could either result into a weight gain or weight loss Decreased libido and a loss of interest in previously enjoyed sexual activities Not being able to think and concentrate Difficulty in the fulfillment of one’s accustomed roles Development of a constant feeling of guilt Development of a feeling of dissatisfaction, helplessness or lack of self worth Negativity in one’s thoughts and ideas Ever recurring ideas and thoughts of suicide These in totality, affect the quality of one’s life and cause a lot of distractions to the cancer patients, both to hospital and its facilities, their healthcare givers and the affected families. Depression comes with a lot of associated problems, which are experienced by patients who are either in the treatment or post treatment phases. These problem effects involve not only the patients but those in their surroundings like their care givers and the family members. Some of these problems experienced as a result depression effects in cancer patients include; Increased length and cost of hospitalization; due to depression caused as a result of cancer diagnosis in patients, the recovery period of the patients is extended. Depression results from an anxiety and related fears when one is in the hospital. One tends to worry about a lot of things, especially about their families. This affects the recovery period of such patients who end spending a lot of days in the hospital. This increased stay in the hospital impacts heavily on the hospital bills and the medication cost become higher as a result. A lot of post treatment therapy talks are needed for such patients to help them overcome their depression before they are finally left to resume their normal lives (Bruera and Portenoy, 2010). Delayed treatment; depression experienced by the cancer patients could more than often result into delayed treatments. Before one is either admitted for cancer treatment or subjected to therapy treatments, the health care providers would have to analyze and prescribe for the depressions always associated with the cancer diagnosis. Cancer patients would need to undergo a period of fear and denial before reality checks in. Some could blatantly reject either of these treatments or the follow ups required in both case as a result of this depression. Result in treatment noncompliance (this includes missing of doctor’s appointments or not remembering to take medications); depression in cancer patients leads to a lot of stress and low self esteem. It interferes with the patient’s ability to reason, concentrate and even make proper judgments. It is because of depression that a cancer patient could fail to attend to a doctor’s call or fail even to follow up on his/her medication. His loss of interest in things and the sense of no worth is the main cause for this. It is believed that depression is one of the factors that results into the premature deaths of most cancer patients (Bruera and Portenoy, 2010). Increased stress for the caretakers; cancer diagnosis, treatment and recovery is always stressful not just to the patient, but also to the family and the health care providers. It is always the responsibility of the health care providers to provide a supportive environment to ensure the effective recovery of the cancer patients. Accompanied by depression, it’s always stressful to convince these patients to develop positive thoughts especially with regards to their future lives and that of their families. The respective families also bear the burden of having to take care of such patients and should be able to cope with the negative impacts that come with their depressions. Increased suicide attempts; once depression sets in after cancer diagnosis, there is no telling of the limits of thoughts that traverses these patients mind. Depression comes as a result of fear of the unknown. Due to this, and coupled with other factors, one could consider the option of committing suicide. Life for such patients become hopeless and of no particular value. When one indulges into such hopeless thoughts, then it becomes more than likely that he/she would attempt to commit suicide. This is the reason why group therapy talks should be organized and encouraged so that these people are able to share their experiences and avoid such negative thoughts. Therapeutic talks and constant counseling should also be done to cushion such patients from sliding and succumbing to their depressions. The diagnosis and treatment for cancer is usually done by a health care provider and the treatments to depressions are beneficial as they help in improving the general health of the patients. They also help in the cancer treatment management. In order to effectively overcome depression and lead a normal life, one has to able to see a doctor almost regularly. It is these heath care providers and specialists, based on their knowledge and experience, who are able to determine the state of one’s depression and provide the necessary and appropriate remedies and interventions (Bruera and Portenoy, 2010). These treatments and/or remedies are of utmost importance to patients who would need a speedy recovery, even though some of them may take a bit of some time to prove effective. The various treatments sought out for by these specialists for intervention purposes often include; The use of anti depressant medicines; these are drugs taken to help in the treatment of depressions. They are administered depending on the symptoms of the depression, the period and the age of the patients to be treated. These drugs work by helping restore the balance that should exist of the chemicals that are responsible for dictating one’s moods in the body. Their effects can effectively uplift one’s moods and make them feel better and optimistic about life once again. Such medications include the selective serotonin reuptake inhibitor (SSRI) and the Serotonin and norepinephrine reuptake inhibitor (SNRI), both of which work to restore the moods of patients. The use of anti depressant medications can enable one to feel back in control of his life and over the things he/she previously enjoyed. While using these drugs though, possible interactions and the various side effects of the drugs should be monitored. The health care providers should also be able notice these side effects and provide counter reactions. Apart from the use of these drugs, other types of medication should be implored so that positive results can be effectively achieved (Harmer, 2011). The use of talking therapies; depressions can also be effectively managed through the use of talking therapies which could include both counseling and psychotherapy. This involves talking to trained therapists or councilors. Therapy often helps people change their way of thinking, most of which involve negative thoughts which results into depression. There are more than one type of therapeutic talks, based on the different theories of the development of humans and their different modes of working. In therapeutic talks, one or a combination of these talks could be applied. Different types of therapies are prescribed for different patients depending on the types of depressions considering the one that would give out the best results. Although known not to be entirely successful in all the patients who have undergone such talks, this method of treatment has been of a great help to some others. When its use and that of anti depressant medications are combined together, effective and speedy results can be obtained as one method acts to complement the other (Institute of Medicine (U.S.), (2007). Counseling helps improve the effectiveness of anti depressants and make their effect to last longer. To gain the maximum benefits from a combination of these remedies, one has to be free and open to their doctors and health care providers. The various talking therapies provided to the patients with depressions include; Counseling; this type of talking therapy involves engaging a trained professional who through work, knowledge and experience is able to help one in determining the causative agents and factors to his/her depression and figure out a way out in an environment that is supportive enough.. Engaging a councilor is a way out for one to establish and accept their conditions and develop a way to cope with them (Arbro et al, 2011).  Cognitive behavioral therapy (CBT); this type of talking therapy implores the mental process of individuals. It tends to alter the basic mental processes such as the ability and trend of remembrance of situations and the problem solving ability. It focuses its efforts on the individuals’ actions and the way one reacts to situations and conditions. Cognitive behavioral therapy is important in helping to alter how people react to situations. It provides a basis for the understanding of how one’s thought process would be a contributory factor to depression and unwarranted anxiety. This kind of talking therapy helps the cancer patients to be able to calm their minds and ideas and establish a control over their feelings. Once its application becomes effective, one is able to develop clear thoughts and an optimistic way of viewing life (Institute of Medicine (U.S.), 2007). Psychotherapy; this type of talking therapy involves engaging a therapist who is trained to deal with such emotional issues that would cause depression. It invokes deeper thoughts in an individual and enables one to sufficiently deal with his deep seated sources of fears and depression. It entails more of flashbacks into one’s past life and how one can use this life to influence how he/she navigates his current troubles and problems (Institute of Medicine (U.S.), 2007). There are various different types of this therapy including interpersonal psychotherapy which focuses on one’s relationship with himself/herself and others. It is able to help one improve on the way he/she communicates to other people and in the end improve on their depression. The experience of the therapist involved should be high in order to achieve better and effective results. The use of herbal remedies; a significant amount of research has also initiated some varieties of herbal remedies that could be used to suppress the effects and causes of depressions especially for cancer patients. The particular herbal remedies that have been used include St John’s Wort and Ginkgo biloba .Their usage though should always be scrutinized because they carry with them some risks and have a potential of negatively interacting with the other medications applied. The other methods often used in such treatment include; Psychoeducation; this is often geared towards educating individuals with the particular illnesses especially the ones relating to cancer and depression about their treatments and the available medical remedies. Stress management training; this training is geared towards teaching people on the best ways to deal with their anxiety and fear issues. Anxiety and the fear of the death are usually the main causes of depression in cancer patients. Training of these patients on the ways to cope with such issues often helps to demystify the various myths associated with such illnesses (Kearney & Richardson, 2005). Problem solving therapy; this kind of therapy usually helps in the identification of the problems and issues that interrupts one’s normal life contributing to depressions and the means to solve such problems. Nursing practice should be able to encompass all these remedies and be able to provide the therapeutic needs of patients under duress caused by such terminal diseases. The nursing profession should capitalize on the provision of a supportive and better environment for these patients to help in their recovery (Yeung, 2007). The nurses being the primary care givers to such patients should be helpful and supportive, providing a loving and caring environment to these patients especially to those undergoing therapy. Conclusion From the above detailed review of the depression effects in cancer patients, it is of a great concern to reduce this depression to help enhance the survival rates of these patients. It is been noted that depression in cancer patients causes a reduction in the quality of life and premature deaths for some patients. The patients thus should be encouraged to regularly talk to their health care providers to help subvert the effects of their depressions. Key to some of these talks is the openness of the patients about their treatments and conditions. The other is the willingness of such patients to participate in either group or individual talk therapies to help overcome their fear and anxieties. These patients should also be able to recognize the various factors that often put them at risk of depression and work on them to effectively improve on the quality of their lives. In case of any suicidal thoughts, one is always encouraged to get in touch with someone nearby or to get in touch with a doctor and seek for help. For a positive recovery, these patients should always be encouraged to let those nearby them know how they feel, what they need as these would help in relieving some of the depression pressures (Greden, Riba and McInnis, 2011) Reference 427-441. doi:10.1007/s11414-013-9354-y Annet K., Frances B., Laura H., Jane W., Parvez T., and Michael S. (2011).The problems reported by cancer patients with major depression: Psycho-Oncology, 20(1), 62-68. DOI: 10.1002/pon.1708 Bruera, E., & Portenoy, R. K. (2010). Cancer pain: Assessment and management. Cambridge: Cambridge University Press. Franca W., Chris v. W., Kris V., Judith P. (2012). Screening Instruments for Depression in Advanced Cancer Patients: What Do We Actually Measure? Pain Practice, 13(6), 467-475. DOI. 10.1111/papr.12012 Gary R., Nancy L., Mark K., Esther G., Jean AM., Rebecca K. S. W. 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