Depression and anxiety

There are many feelings to deal with when you're living with a terminal illness. If you feel sad, worried, or low, for days at a time, this could be depression or anxiety. On this page, we'll talk about how depression and anxiety may affect you if you have a terminal illness, and the support you can get.

On this page:

Feelings you might have when you're living with a terminal illness

Being diagnosed with a terminal illness is a huge, life-changing event. You might go through a whole range of emotions. You might feel:

• afraid, if you're worried about what's going to happen in the future
• lonely, if you feel like you're going through this on your own
• time-pressured, like you have to get lots done before you become more unwell
• sad, at knowing you won't be around in the future
• like you aren't able to join in with things or be as active.
• like your self-esteem (how you feel about yourself) has changed
• guilty, if you can't do the things you used to anymore or if people have to look after you.

You don't have to manage difficult feelings alone.

Read about coping with a terminal diagnosis.

Depression

Most people feel low or sad some of the time. But when feelings like sadness and anxiety last for weeks or months and start to affect your daily life, it may be depression.

Symptoms of depression

Depression affects everyone in a different way. People living with a terminal illness are more likely to experience depression. Some symptoms of depression are similar to the symptoms you might get with your illness. These can be physical and emotional, and include:

• not being able to find pleasure in anything
• feeling guilty, helpless, worthless or having low self esteem
• feeling constantly sad
• not being able to concentrate
• thinking about ending your life
• feeling tired
• changes to your appetite or weight
• difficulty sleeping
• losing your sex drive
• feeling irritable
• crying more often
• difficulty making decisions
• not wanting to see people.

Causes of depression

Depression can happen for lots of reasons. Often, more than one thing causes depression.

Not everyone who has a terminal illness experiences depression. But the following things might add to you feeling sad or low:

• Symptoms of your illness or treatment.
• Lots of stressful events happening at once. For example, if you're having treatment and you have to decide whether to stop working.
• Feeling like you can't do the things you always wanted to.
• Not having people to talk to. If you can't speak to anyone, your emotions can feel harder to manage.
• Drugs and alcohol. These might make you feel better for a short amount of time, but often make you feel worse after they've worn off.
• If you've been depressed before, or there is a history of depression in your family.

Anxiety

Most people feel worried sometimes. But when these worries are hard to control or last for a long time, it may be anxiety. People living with a terminal illness are more likely to experience anxiety.

Symptoms of anxiety

If you have anxiety, you might worry about lots of different things at the same time. Or, you might find it difficult to identify what you're worried about.

Symptoms of anxiety are different for everyone, and they can be emotional and physical. Symptoms include:

• feeling worried or restless
• finding it difficult to sleep
• not being able to concentrate
• feeling dizzy
• feeling like your heart is beating harder or faster
• feeling irritable
• feeling on edge or not being able to relax
• finding it harder to make decisions
• feeling tearful or crying
• changes in appetite
• feeling like you want to avoid places, situations or people
• sweating
• trembling
• feeling sick.

Causes of anxiety

Causes of anxiety are different for everyone, and sometimes, there won't be just one cause. Causes include:

• side effects of medication or treatment
• fears about the future, like being apart from the people important to you
• fears about being in pain
• fears about your symptoms not being controlled
• fears about dying
• worrying about the people close to you
• worrying about becoming a burden.

Anxiety can also be a symptom of another condition, like post-traumatic stress disorder, or claustrophobia.

If you're thinking about ending your life

If you're feeling like you want to die or you're having suicidal thoughts, it's important to tell someone. Speak to your doctor as soon as possible.

If you need urgent help, call the Samaritans free helpline on 116 123. It's available 24 hours a day.

If you're caring for someone and worried they may be thinking about ending their life, the Samaritans can also provide you with support.

Getting support for depression and anxiety

People living with a terminal illness are more likely to experience depression and anxiety. But this doesn't mean you have to cope with them alone.

If you're feeling low or worried, speak to your doctor. They may refer you to a specialist like a psychologist, psychiatrist or specialist nurse for more support.

The NHS has an online depression and anxiety self-assessment quiz.   It can help you to understand how you're feeling and give you advice about support and treatment.

Treatment can help you to cope better and manage negative thoughts and feelings. Treatment includes:

• medication, like antidepressants
• talking therapy, like cognitive behavioural therapy (CBT) or counselling
• combination therapy, for example a combination of talking therapy and medication
• other therapies, like relaxation, art therapy, and music therapy
• self-help
• support groups
• exercise.

Tackling other symptoms like pain or adjusting your treatments may reduce symptoms of depression. Speak to your doctor about how you're feeling and any symptoms you're experiencing.

Read more about managing depression and anxiety.  

Helping yourself

There are things you can do to help you feel better:

• Avoid caffeine, smoking, drinking and recreational drugs.
• Keep active, if you can, as this can boost your mood.
• Try complementary therapies to help you relax.
• Try a change of scenery.
• Do something you enjoy, like listening to music or reading.
• Contact support groups, where you can meet other people with similar experiences.
• Speak to others on an online forum, like the Marie Curie Community.
• Practise mindfulness or meditation. Find out more about mindfulness.

Communicating with others about how you feel

How you cope with your feelings depends on the type of person you are. You may find it helpful to talk to others about how you're feeling. Not everyone does, and that's OK. Below, you can find some ideas of who you could speak to.

If you have extra communication needs, ask you nurse or doctor what support you could get with communicating your feelings. For example, you might be able to get a sign language interpreter or translator.

Talking to those important to you

Talking about how you feel can help you, and the people around you, to make sense of your feelings.

It can be difficult to talk. The other person may be feeling emotional too, and it's not always easy to talk about how you're feeling. But if you can, try not to keep your feelings inside.

If you're looking after someone with depression or anxiety, it might help to speak to others in a similar situation. Read more about finding emotional support as a carer.

If you don't want to talk

People may tell you to be positive, but this is often hard. Some people feeling low or anxious find it hard to talk to the people they're close to. Sometimes, people try to appear cheerful even though they're having difficult emotions.

If you don't want to talk, that's OK. Here are some things to try instead:

• Activities which don't involve speaking to others about your feelings. For example, art therapy, meditation, or relaxation.
• Give yourself time to process. If you don't feel like talking now, you might in the future.
• Let those around you know that you don't want to talk. Ask them to respect your decision and let them know they're still important to you.
• Speak to someone you don't know as well. This could be a professional, like a counsellor or psychologist.

Talking to a counsellor

A counsellor can help you to understand your feelings and find ways to manage them.
Counselling is often free. You can access it through hospices, hospitals or GP surgeries. Speak to your doctor or nurse - they can let you know what's available locally.

Find a free counselling service on the NHS.  

Find a private counsellor near you.  

Local support

Support groups can help you cope with depression or anxiety. They're also a way to meet people going through similar experiences . Find local support using the organisations below.

External websites

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