Some people assume that if you have cancer you must be depressed. Actually, only about 1 in 4 of people with cancer become depressed. Those who get treatment are often surprised by how much better they feel.

It's important to spot depression as soon as possible to stop a downward spiral of sadness. Sometimes it can be hard to tell what is happening, since cancer and cancer treatment can cause physical symptoms that look like depression, such as appetite loss, weight change, and fatigue. Doctors must look past these symptoms to see if depression is the problem. Once it is diagnosed, there are many ways to treat depression. Treatment can help people regain joy, hope, and the ability to cope.

• You feel sad or "empty" almost every day for most of the day 
• Your days bring little or no pleasure 
• Family members or friends have made comments about your sadness
• You have trouble making decisions or have problems concentrating that are not caused by medicines or cancer treatment
• You feel angry almost every day for most of the day
• You cry most of the time
• You feel worthless or without hope
• You think about killing yourself
• You have tried to hurt yourself or kill yourself

It isn't unusual to have a couple of these symptoms for a short time after you learn that you have cancer. However, they may mean that you are at risk for becoming depressed. You may want to print out this checklist and discuss it with your doctor or cancer care team. It may also help to get more information on coping with cancer, how to talk about cancer, and how to find a support group.

If you have symptoms that last for 2 weeks or longer, or are severe enough to interfere with normal day-to-day life, see a doctor or mental health professional to be checked for depression. You may want to print this checklist and take it to show your doctor or health care team.

Asking for help does not mean a person is crazy. Depression can be caused by the stress of caring for someone with cancer and the serious life issues that a cancer diagnosis creates. Depression may also occur because of a family history of depression, or with no clear reason. Most important, depression can be treated with great success if people ask for help.

Looking at the last 2 questions, if you long to die or think of killing yourself, you may be seriously depressed. See your doctor right away. For more information call your American Cancer Society at 1-800-ACS-2345, 24 hours a day, 7 days a week.

ACS support programs reach cancer survivors and patients throughout the US, and practical advice is available online to help patients with managing day-to-day and coping with physical and emotional changes. For more information call your American Cancer Society at 1-800-ACS-2345.

At the ACS Cancer Survivors Network Web site you can trade information and experiences with other patients and survivors—all from the convenience of your own home.

Revised: 1/3/2008