Depression & Anxiety

Lung cancer is associated with high levels of depression and anxiety. Depression, also known as major depressive disorder or clinical depression, is a serious mood disorder that affects how a person feels, thinks, and handles daily activities. Anxiety, which can show up as generalized anxiety disorder or panic disorder, is also a mood disorder that can affect daily activities. Although the projected outcome for lung cancer patients has improved as treatment evolves, lung cancer is still the leading cause of cancer deaths. This fact is a likely contributor to the increased incidence of depression and anxiety among lung cancer patients. It is estimated that one in four persons with lung cancer experiences periods of depression or other psychosocial problems during and after treatment. Other studies have shown rates of 43-47 percent of patients with lung cancer experiencing depression.^1-3

Mood disorders affect quality of life among lung cancer patients

Quality of life (QOL) can be defined as the general well-being of a person in terms of health and happiness. QOL can include physical, mental, and social domains and is a self-reported, subjective measure (patients report on their own QOL and it is generally based on personal opinion).⁴

Anxiety and depression have been documented as having a negative affect on quality of life in people with lung cancer. While QOL is also negatively impacted by the physical response to lung cancer and its treatment, studies have also documented the decrease in QOL due to the emotional toll and negative self-concept (patients having a negative opinion of themselves).¹

Anxiety and depression after diagnosis

While anxiety and depression have been linked to the diagnosis of cancer, one study aimed to understand the impact diagnosis of cancer has on a person’s psychological health by comparing data before and after diagnosis. Patients who were suspected of having lung cancer were first given a questionnaire to assess their psychological health and quality of life before any diagnosis was made. This questionnaire was repeated three months after diagnosis.³

At the initial assessment, the majority of patients in the study had normal scores on anxiety (84 percent) and depression (77 percent). At follow-up, the number of patients that initially had borderline scores of anxiety and depression (potential cases of psychological disorders) almost doubled, with 11 percent showing signs of anxiety (up from 6 percent initially) and 22 percent showing signs of depression (up from 11 percent initially). In addition, the study showed a correlation (relationship) of anxiety and depression with lowered QOL.³

Symptoms of depression

Depression is characterized as experiencing some of the following symptoms most of the day, nearly everyday, for at least two weeks:

• Persistent sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Irritability
• Feeling guilty, worthless or helpless
• Loss of interest or pleasure in hobbies or activities that were previously pleasurable
• Decreased energy
• Increased fatigue
• Difficulty concentrating or making decisions
• Difficulty sleeping or sleeping too much
• Appetite or weight changes (either too much or not enough)
• Aches or pains without a clear physical cause
• Thoughts of death or suicide ²

Symptoms of anxiety

Generalized anxiety is characterized as excessive anxiety or worry for months. Symptoms of generalized anxiety include:

• A feeling of restlessness, being wound-up, or on-edge
• Being easily fatigued
• Difficulty concentrating
• Irritability
• Increased muscle tension
• Difficulty controlling worry
• Sleep problems²

With panic disorder, another type of anxiety, patients experience recurrent, unexpected panic attacks. Panic attacks are characterized as periods of intense fear that may include symptoms such as:

• Pounding heart
• Accelerated heart rate
• Sweating
• Trembling
• Shaking
• Shortness of breath ²

Seeking support for anxiety or depression

Mood disorders like depression and anxiety are generally treated with psychotherapy (talking with a psychiatrist), medication, or a combination of therapy and medication. Anxiety and depression are serious disorders, and they must be recognized and treated in lung cancer patients to improve quality of life.^2,3