Depression and Anxiety in People With Bladder Cancer

Several recent studies have found that people with bladder cancer have higher rates of depression and anxiety. Many emotional burdens and stressors caused by bladder cancer can lead to poor mental health. Depression and anxiety make bladder cancer harder to manage or treat.

However, better monitoring and treatment of depression and anxiety can help improve cancer treatment. Talk to your doctor if you notice any symptoms of depression or anxiety. They can refer you to a mental health professional or other resources to help you cope. There are many different approaches to reducing and managing symptoms of depression and anxiety.

What are depression and anxiety?

Depression and anxiety are two different mood disorders. They often happen together and have similar treatments. It is normal to feel unhappy or anxious from time to time. But severe and ongoing depression and anxiety can interfere with daily activities.1

Depression is a persistent feeling of sadness and lack of interest. It affects how you think and behave and can lead to other problems. Symptoms may occur every day. Some symptoms of depression include:2

  • Feelings of sadness, emptiness, or hopelessness;
  • Irritability;
  • Loss of interest in activities you once enjoyed;
  • Trouble sleeping;
  • Tiredness and lack of energy;
  • Low appetite;
  • Slowed thinking and speaking;
  • Trouble concentrating;
  • Recurring thoughts of death or self-harm.

Anxiety is a frequent feeling of excessive fear and worries about everyday situations. Many people with anxiety experience intense episodes of sudden fear. These are called panic attacks. There are several types of anxiety disorders. Some symptoms of anxiety include:3

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  • Feeling nervous or tense
  • High heart rate and fast breathing
  • Sweating or trembling
  • Feeling weak or tired
  • Trouble concentrating
  • Difficulty sleeping
  • Avoiding things that trigger anxiety

What does the research say about depression and anxiety in people with bladder cancer?

Depression and anxiety occur 2 to 3 times more often in people with cancer than in the general population. Bladder cancer may lead to depression and anxiety because of:4, 5

  • Fear of cancer coming back or getting worse;
  • The burden of long-term follow-ups;
  • Economic stress;
  • Stress-related to post-surgery symptoms;
  • Chemotherapy.

Nearly 25 percent of people with cancer show symptoms of depression or anxiety. The percentage is higher for those who are hospitalized (almost 40 percent). Specific rates depend on clinical setting, cancer type and stage, treatment, and other factors unique to each person.4

According to one study, about 25 percent of people with bladder cancer in outpatient settings have moderate to severe depression, and 16 percent have anxiety. The rate is much higher for people with bladder cancer who are hospitalized. About 50 percent of these people show symptoms of depression, and 40 percent show symptoms of anxiety.4

Different studies have shown slightly different rates. This is because of differences in study methods and geographic variations.5,6

What is the impact on bladder cancer treatment?

Depression and anxiety make cancer treatment harder. This is because of a lower ability to cope with the burdens of living with cancer. For example, some studies have shown that depression and anxiety can affect sticking to treatment schedules, length of hospital stays, and cancer survival rate.4

Studies show depression and anxiety also increase the risk of self harm. People with cancer have nearly twice the rate of self harm as the general population. Bladder cancer is linked to higher rates of self harm than other types of cancer, especially right after diagnosis.5

How are depression and anxiety treated?

Treatment for depression and anxiety depends on the severity and other personal factors. More severe depression may be treated with antidepressant drugs. Milder depression may be treated using other strategies.6

Studies have found low use of antidepressants in people with cancer and depression. About 25 percent of people with cancer report feeling depressed. But only 15 percent say they use antidepressant drugs.4

Talk to your doctor if you notice any symptoms of depression or anxiety. They can advise you whether antidepressants are right for you and suggest specific medicines. They can also refer you to a therapist or mental health professional. This is an expert who can help you find ways to manage your mental health.1-3

Some ways to manage depression and anxiety include talk therapy, mindfulness-based approaches, self-management strategies, and exercise.4,7

Your mental and emotional health is important. If you are struggling or do not feel like yourself, there is help available. You do not have to go through your cancer experience alone.

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