The ongoing COVID-19 pandemic has resulted in a uniquely uncertain and stressful way of life for us all. Not knowing what will happen next — in addition to fear for our own health, that of our loved ones, and the disruption to our lives — can lead to distress and depression. This can be particularly true for patients with cancer, as well as their caregivers.
These feelings are completely normal, according to Natalie Alas, LICSW, a clinical social worker at Dana-Farber, who notes that there are ways to manage depression, even in the midst of COVID-19.
“This evolving situation is a new experience for everyone, and it’s normal to feel stressed or depressed,” Alas says. “It’s important we don’t put too much pressure on ourselves to feel better immediately. With the help of mental health professionals and strengthening coping skills, depression can be managed.”
Below is information about depression, common symptoms, and tips on how to address and/or manage it. Remember: this content is not intended to be a substitute for professional medical or mental health advice, diagnosis, or treatment. If you have questions about your mental health, make sure to discuss them with a qualified health provider; they will be able to help you find and access the resources you need.
What is depression?
Depression is a common, but serious, illness that can impact how you feel, think, and handle daily activities. Depression can make even baseline self-care feel like a chore: showering or just getting out of bed can become incredibly overwhelming, for example. Many people will experience sadness and low mood throughout their lifetimes — but more intense feelings of sadness, along with feeling hopeless or worthless, can indicate depression.
Anyone can experience depression regardless of their age, race, gender, or socioeconomic status. It is important to know that it is OK to feel depressed, and many people will feel this way at least once in a while.
Symptoms of depression
The signs and symptoms of depression, along with their severity, will vary for everyone. Some people will experience a majority of these symptoms, while others may experience only a few.
If you experience any of the below symptoms of depression for more than a few weeks, or these symptoms are interfering with your daily life, it is important to talk with someone you trust and think about how to get help. It may be beneficial to speak with your care team at Dana-Farber or with another medical or mental health professional.
- A persistent sad, anxious or “empty” mood
- Feeling guilty, worthless, helpless, moody, or short-tempered
- Losing interest in activities that you used to enjoy
- Having trouble concentrating
- Loss of energy or fatigue
- Lack of appetite or increased hunger
- Difficulty sleeping or oversleeping
- Physical symptoms, such as a headache or stomachache, that do not ease even with treatment
- Neglecting self-care (e.g., not showering, not changing your clothes, etc.)
- Thoughts of death, or harming or killing yourself. If you are in distress now, call 911 or the National Suicide Prevention Lifeline 24/7 at 1-800-273-8255, or go to your local emergency room right away.
Remember: You can reach out for help at any time, and it is important to speak with someone you trust if you feel you are not yourself.
Concern for a loved one
If you are concerned that someone you care about may be experiencing symptoms of depression, the best thing you can do is have a conversation with them about how they are coping. During this discussion, be sure to bring up the topic in a supportive way. Never ask someone, “What’s wrong with you?” or tell them that they “need therapy.” Instead, begin the conversation in a manner that will let them express how they are feeling. If you’re not sure how to start, try something like, “Is everything OK? You can talk to me.”
Often, acting as a supportive, non-judgmental listener is a great way to get someone to initially open up. As the conversation continues, and if it feels appropriate, offer to help connect the person to the resources they need. What you are letting them know is that they are not alone.
There are many different ways to address depression, ranging from counseling or talk therapy to medication. To learn more about the various treatment options, be sure to connect with a licensed mental health professional or your trusted medical provider. Together, you can find a plan that works for you.
Do not be afraid to advocate for yourself or ask questions. There is no universal treatment for depression, so it is important to work with a licensed individual you trust.
“Treatment can help add structure to one’s life and allow you to care for yourself in compassionate ways,” explains Molly Williamson, LICSW, a clinical social worker at Dana-Farber. “It’s important to partner with someone you trust and explore what works for you.”
Tips for coping
There are things you can do every day to help cope with feelings of fear, anxiety, or depression. Nothing is “one size fits all,” and it’s important to figure out what works best for you. Here are some starting points to consider.
Create a routine and stick to it.
This can help provide structure to your day and increase your sense of control.
- Aim to get out of bed at the same time each day.
- Pick a time and set an alarm so that you end work at the same time each day.
- Make a daily to-do list and check off items as you complete them. Break down tasks into smaller, do-able chunks.
As we continue to physically distance during COVID-19, it is important to find and maintain a sense of community and connection.
- Pick a date and time each week to call someone you care about.
- Continue to participate in virtual meetings (even if you’re tired of them).
- Consider outside activities at a social distance, such as a walk (with a mask).
- Try your best to utilize social media as a way of connection, not as a means of comparison. Limit your use of these platforms if you are finding the content upsetting.
Pay attention to your self-care.
This is even more important in times of heightened stress and vulnerability.
- Get plenty of rest, and make sure to take breaks from work throughout the day.
- Limit your alcohol intake or substance use.
- Regularly exercise (if you’re able to), eat healthfully, and drink plenty of water.
Limit media exposure.
It is important to stay up to date on the news, but too much exposure can add to worry and stress.
- Stick to reliable sources of information about COVID-19, such as the Center for Disease Control and Prevention (CDC), World Health Organization (WHO), or local government agencies.
- Limit the amount of time you are interacting with the news each day.
- Consider restricting your news coverage to a regularly scheduled hour of your day.
Be aware of your thoughts.
The way we think affects the way we feel and behave.
- Be kind to yourself.
- Identify the thoughts that are contributing to your anxiety and stress.
- Write down your thoughts and try to stick to the facts.
You don’t have to be alone.
- Call a friend or loved one.
- Review the resources listed below. There are a number of options.
- Call a national hotline. The National Suicide Prevention Lifeline is 1-800-273-8255. The National Alliance of Mental Illness (NAMI) Helpline can be reached at 1-800-950-6264. or text “NAMI” to 741741.
- Arrange to speak to a therapist over the phone.
There are many services available for those suffering from depression. Below are a number of resources specific to Dana-Farber, as well as a few national organizations. If you are a patient at Dana-Farber, please know you can talk to any member of your team for support with depression.
- To reach a licensed Dana-Farber social worker, please call 617-632-3301. Clinical social workers focus on the impact of cancer on the many aspects of patients’ lives. They are trained to address emotional and mental health needs and can discuss how to support you and your family during this challenging time. Social workers at DFCI also work closely with colleagues in psychiatry and psychology and can refer you to those services as needed.
- Spiritual Care: Chaplains from many faiths provide guidance and counseling. Call 617-632-5778 for more information.
- One-to-One is a telephone support network for patients and families dealing with cancer. It can connect you to someone who has “been there,” and can be a great source of comfort.
- Support Groups: Dana-Farber/Brigham and Women’s Cancer Center offers a variety of educational seminars and support groups to help adult patients and their families with tools that can help them regain a sense of control over their lives. Many groups are available via video or phone during this time of COVID.
- The Leonard P. Zakim Center for Integrative Therapies and Healthy Living at Dana-Farber is dedicated to enhancing the quality of life for cancer patients through integrative therapies.
- The Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within the U.S. Department of Health and Human Services, has a behavioral health treatment services locator, as well as other tools for addressing depression.
- Mental Health America (MHA) is a community-based nonprofit dedicated to addressing the needs of those living with mental illness and promoting the overall mental health of all.
- NAMI is a grassroots mental health organization dedicated to building better lives for those affected by mental illness.
- CancerCare provides free, professional support services and information to help people manage the emotional, practical and financial challenges of cancer.
- The American Cancer Society is a nationwide, community-based voluntary health organization dedicated to eliminating cancer as a major health problem.