If you’ve been diagnosed with metastatic breast cancer, it’s understandable if you’ve had anxiety, depression, or both. Anxiety is a stress response of fear and uneasiness. Depression can be a combination of sadness, despair, and loss of energy that interferes with daily life.

It’s not unusual to have one or some of these feelings after a metastatic breast cancer diagnosis. The good news is that there are many strategies for feeling better, so you can continue staying connected to the people and things that mean the most to you.

It makes sense that research shows people in long-term treatment may be more likely to feel depressed or anxious. Stress about the diagnosis, worry about loved ones, uncertainty about the future, and other concerns can all lead to anxiety and depression. 

Anxiety and depression can surface in uncertain situations, such as when a treatment is no longer working and it’s time to try a new one. Life changes unrelated to the diagnosis can also trigger anxiety and depression.

Anxiety and depression also may develop as side effects of breast cancer treatment itself. Some medicines may trigger these feelings directly. Medicines can also indirectly lead to anxiety and depression for some people if they cause pain, fatigue, or changes in appetite.

Because long-term emotional stress can result in depression and anxiety, either may appear any time after a metastatic diagnosis. Depression and anxiety can occur together or separately. When or how a person develops anxiety or depression can also depend on possibly triggering factors such as a physical issue, an emotional issue, or personal experiences.

It’s normal to feel nervous and worried after you learn you have metastatic disease, or when you need to make a treatment change. If intense anxiety affects your day-to-day life, or you feel very sad and disinterested in things you used to enjoy, ask your healthcare team for help, just as you would for any other symptom or side effect.

Ways to manage depression and anxiety

If you’re feeling depressed or anxious, know that you are not alone. Many people feel the way you do, and there are a few different ways you can manage these feelings with the help of a professional or on your own.

Here are some tips:

• Review your medicines with your doctor:
  • If a breast cancer medicine is causing you to feel depressed or anxious, your doctors may switch you to another medicine to help you feel better. Make sure they know all the medicines you’re taking, including those not for cancer and any vitamins and supplements. Some of these could also be the problem.
• Consider asking your doctor about antidepressants or antianxiety medicines:
  • Prescription medicines exist to help anyone feeling depressed or anxious feel more like themselves. Talk with your doctor about which might help you.  If you are taking tamoxifen, it’s important to know that some antidepressants and antianxiety medications interfere with tamoxifen. Talk with your doctor about medication that’s safe to take with tamoxifen.
  • Your providers might ask you to see a therapist or counselor before giving you an antidepressant or antianxiety medicine. These professionals can help you learn skills to cope with depression and anxiety. Or, they might suggest you see a psychiatrist, a mental health provider who can prescribe a medicine for you.
  • Be sure to see a psychiatrist who has experience working with people who’ve been diagnosed with cancer.
• Try complementary therapies:
  • Some mind-body practices can lower stress and anxiety. Yoga, guided imagery, meditation, and deep breathing may help.
  • Exercise causes the brain to release chemicals that lift the mood. And any activity, such as walking, biking, or gardening, has the potential to shift your thoughts away from cancer. These activities also offer a chance to be social and connect with others, which can ease anxiety.
  • Music, art and writing can help you creatively express your emotions.
  • Learn more about complementary therapies here.
• Work on your daily lifestyle:
  • Getting more and better sleep makes almost anyone feel better. Set up a regular sleep schedule to be better rested.
  • Eat more vegetables, fruits, beans and whole grains to round out your nutrition.
  • Drink less caffeine, found in soda, coffee and tea, and take in less sugar and alcohol.
• See an oncology counselor:
  • Counselors trained in cancer-related concerns can help you cope with the stresses you feel.
  • They understand when sadness is due to the life change of metastatic breast cancer or when it is clinical depression.
  • Oncology counselors work in cancer centers, hospitals and communities.
    • Your doctor, oncology nurse or others on your healthcare team can help you find the support you deserve.

Tell your healthcare team right away if you are feeling depressed or extremely anxious for more than a day or two. They can assess your condition and provide care, or refer you to a professional who can help.

It’s not uncommon for people with metastatic breast cancer to delay asking for help because of a belief that depression and anxiety come with the diagnosis and can’t be changed. This is not true. Just because you have metastatic breast cancer does not mean you are expected to have anxiety and depression. If you are struggling, it can be an act of great courage to acknowledge that things feel overwhelming and you need help. Asking for help can relieve the pressure of carrying an intense emotional experience by yourself. A professional counselor or therapist can be a great source of support. As one oncology counselor has said, “I’m in it with you.”

Seeing a counselor or taking medicines prescribed to stabilize mood show that you are strong and making choices to take control of your care – and to have the quality of life you deserve.

If you feel life is not worth living

If you feel hopeless and helpless and think you are in danger of hurting yourself, we strongly encourage you to call the National Suicide Prevention Lifeline at (800) 273-8255. This hotline provides free and confidential emotional support 24 hours a day, 7 days a week. 

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