Many people experience anxiety or depression, or both, after a cancer diagnosis, studies show. But in rare cases, anxiety and depression can be an early symptom of a tumor in the brain.
Doctors point out that anxiety and depression are among the most common health problems in the United States, and that only a very small percentage of cases stem from brain tumors. Still, psychologists, psychiatrists, and other health professionals need to be alert to the possibility that an individual’s anxiety or depression may be linked to a tumor or other underlying medical condition.
The challenge in tracing anxious or depressed behavior to a brain tumor is that this behavior can result from a wide range of illnesses. “Depression is a syndrome with multiple symptoms,” says Fremonta Meyer, MD, a psychiatrist in the Department of Adult Psychosocial Oncology and Palliative Care at Dana-Farber. “Low energy, fatigue, loss of appetite – all symptoms of depression – can also be signs of a medical illness that has yet to be diagnosed.”
In examining a patient’s history of anxiety or depression, Meyer looks for clues of possible medical problems. People usually receive their first diagnosis of anxiety or depression in their 20s, 30s, or 40s; if an older person is experiencing those issues for the first time, it may be due to a medical condition.
“When a patient in his 50s is feeling depressed or anxious, but doesn’t have a history of either condition and isn’t experiencing any particular stressors in his life, it may be advisable to refer him for a medical workup,” Meyer says.
Symptoms such as headaches, dizziness, falls, unusual clumsiness, or weakness on one side of the body may also serve as red flags of underlying medical problems when they are accompanied by depression and anxiety.
Brain tumors are most apt to give rise to depression if they arise in the frontal lobe, which controls emotional expression, memory, and judgment, among other faculties, or the temporal lobe, which can sometimes cause seizures that mimic anxiety, says Patrick Wen, MD, director of the Center for Neuro-Oncology at Dana-Farber.
Because anxiety and depression are common and brain cancer is rare, it’s not unusual for people with brain tumors to initially be treated with antidepressants or anti-anxiety medications, Wen notes. In many cases, it’s only after patients fail to benefit from such drugs that doctors begin to look for other causes of the problem.